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Starting Rowasa enema

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Ulcerative Colitis
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Posted 3/10/2011 4:51 PM (GMT 0)
First, let me say thank you for the information and support on this forum that I have received over the last two weeks as I have dealt with my first big flare. I am definitely improving slowly but surely. I got repeat blood work done Tuesday. My white blood count was back to normal which is good but my inflamation (sed rate) actually went up a bit. The PA said this is actually expected as it is sort of a lagging indicator of the disease, it doesn't show where you are right then but where you have been. In any case, my main problem now is trememendous rectal pressure and soreness, so I pushed for something in addition to the Canasa, and specifically asked about the Rowasa enema. She checked with the MD and called it in today. It seems that many of you have had good success with this so I am hopeful it will help me too. I have never in my life had any enema but I am willing to do whatever it takes to get better.

So, any tips about using the Rowasa? She said I can continue with the Canasa too at a different time. I used one Canasa this morning already. Should I wait til nighttime for the Rowasa or what? Do I need to sleep in the bathroom? LOL.

Thanks again,

Posted 3/10/2011 4:58 PM (GMT 0)
That's what I usually do, canasa in the morning because it's easier to retain and Rowasa before bed.

It's funny because you would think an enema would be hard to retain or would drip out but it doesn't. Some people do them in the bathroom, some do them on their side in bed. It is not messy at all. I do mine in the bathroom when I am ready for bed and I walk to beed after using the enema.

One tip I was given which really helped me was to squeeze the air out of the enema bottle before using it. If you squeeze the air into your backside, it can make you feel gassy and uncomfortable. That has happened to me in the past.

You will do great. Try not the stress. The first is the hardest, after that you're a pro.
Posted 3/10/2011 5:53 PM (GMT 0)
I've been using the Rowasa nightly for 9 weeks now and have it down pat. It was strange and daunting at first but you will pick it up pretty fast. Here is what I do:

1. Get my nightstand all set up with whatever I need to get through the night, water, book any other medications etc. That way I can just jump into bed later and not have to get up for a while.

2. Brush my teeth and try to go to the bathroom to empty everything out :)

3. In the bathroom, lie either face down or on my left side with my right knee up. I bring a magazine or book with me to read for a few minutes afterwords.

4. Squeeze as much air out of the bottle as I can. I do this over a trash can because sometimes a little will spurt out. The tip will normally have some goo on it for easy insertion so try to not remove that.

5. Slide it in easily and try to squeeze out as much as you can. I try to get it all out but that takes some work. The bottles are somewhat hard so I sometimes have to shift it around a bit in my hand to squeeze it all out. It may take a few times before you learn how to get the most out of the bottle.

6. Lie on the floor on my left side for a while and read. How long depends on you really. Initially I found that I had to lie there for 15-20 minutes before I could run into bed without too much urgency. Now I only need to lie there for 5-10 minutes.

7. When you feel you are ready, move quickly to bed and try to lay on your left side for at least 30 minutes.

Some night it will go better than others. I try not to stress about holding it in. Twice I had to let it out after about an hour but most times I was able to keep in in all night. It does sometimes make me gassy, I have found after 30 minutes or so I can pass gas without any of the Rowasa coming out. If I have to pass some earlier I might have a few drops come out. I stuff some tp back there before I run to bed just in case.

Good luck to you, I hope it helps you.
Posted 3/10/2011 6:09 PM (GMT 0)
These tips help a lot! Stuffing some tp in my underwear sounds smart. I'm afraid to pass any gas right now if I'm not on the toilet because usually something else leaks out too.
Also having some pretty amazing gas pass all on it's own while I'm sitting on the throne.
They gave me a 7 day supply. I hope it helps. Sounds like if I call with any more concerns they are going to set me up for colonoscopy. My last one was last march so i guess another one now would be reasonable but the idea of the prep just as I'm feeling better doesn't thrill me.
Posted 3/10/2011 7:10 PM (GMT 0)
I wouldn't lie on the floor....cozy bed is much better...

Yes, use them at night.


Insert, squeeze until nothing comes out...then fold the bottom up like you would a paper bag, and then fold again...that should get most everything out of the enema.

Grunt, groan, squeeze your butt after administration when you get the urge to go...lie quietly and it should pass.

Over the 22 years, I've only had to let 2 go because of how bad I was flaring.  But, since you're using the Canasa already, hopefully that will have already helped the urge to let it go.

Keep us posted.
q

Posted 3/11/2011 4:43 PM (GMT 0)
My first rowasa enema was ok. I think I need more detail about how yiunguys squeeze the air out of the bottle first. Can you please describe exactly what you do? I think I got the whole bottle in and laid on the floor of the bathroom a few minutes before moving to bed. If my hubby wasn't already there I may have done it in bed. I laid on my left side for about an hour, unable to sleep. I had some cramping and feeling like in had to go but I wiggled through it. After a hour I had a strong need to pee. My bladder has been really tight or constricted during this flare. I've really been needing to sort of squeeze to pee, but an hour after the rowasa I had to just pee. Of course everything else came out too. I had the urge to go about every hour for the next three or four hours and then finally took a vicodin so I could sleep. I sleep about three or four good hours. This morning I do feel like there is less rectal pressure and inflammation. Maybe it's wishful thinking or maybe the rowasa did help some. I used my Canasa this morning too. I am still passing mostly liquid stool every hour or so but I think it is beginning to get a bit more solid, which sort of hurts more but I hope will mean less frequency soon. I can't leave the house like this.
Posted 3/11/2011 5:29 PM (GMT 0)
It'll take a while, so be patient. The enemas aren't an immediate relief thing, but improvement can be seen fairly quickly.

Sounds like you did well....

Yeah, looking back 22 years of using them, I still remember the first night.

q
Posted 3/11/2011 5:41 PM (GMT 0)
Sometimes I find them hard to retain and it is always a challenge to pee while you're using an enema but you will get used to it after a while. I agree with qunicy, it sounds like you're doing well, you just need to figure out what works for you.

I tilt the bottle and squeeze it until liquid comes out. When I insert them, I usually only squeeze about 85% in so the little drops that goes in the sink aren't a big deal. I have cramping from the enemas sometimes but the more you heal, the less cramping you will have. I do have cramping now if I use an enema even though I am feeling well but I think it's when I use the enema and my bowel isn't 100% empty. On those days, I personally use a suppository because an enema can be uncomfortable.

I notice if I can make it through the 5 minutes of cramps, I can retain the enema all night. It gets easier, don't worry.

If you're not seeing any improvement with Rowasa, you could also try using cortifoam enemas at night. I think those helped me pull through when I was flaring badly.

Posted 3/11/2011 5:52 PM (GMT 0)
Glad to hear you got through it at least, even if it was a little rough. After a couple of times you will get used to using and it will go better. I try to empty my bladder before hand and not drink afterwords for the reasons you mentioned.

To squeeze the air out, I hold it upright, tap the side to try to clear out the nozzle, and squeeze the bottle gently until I start to feel some resistance from the liquid. A few drops may shoot out, beware of that. Then in it goes.
Posted 3/11/2011 7:50 PM (GMT 0)
Thanks for the detail about getting the air out of the bottle. I will try that tonight.

I definitely tried to empty out everything I could before the enema last night but I've been going every hour or more so emptying out really doesn't work for long. It seems that as soon as I change positions (especially when I stand up after resting a while), I have to go immediately. I am hoping this will all get better soon. 

Posted 3/11/2011 9:28 PM (GMT 0)
I ask my husband to leave the room for a couple of minutes so I can do it in bed. I'm sure he won't mind. It may be easier for you if you can lay completely still for a little while after.
Posted 3/12/2011 3:51 AM (GMT 0)
I also recommend doing it in bed and staying still for a while (it does get easier but it can take some time). For me, particularly at the start while i was flaring, I'd have cramping (as if I needed to pass gas) right away after administering, then it would pass, but then almost like clockwork cramps would hit again even harder around the 10 minute mark. Deep breathing and focusing on other parts of my body helped (slowly stretching legs or rubbing hands together) get threw the minute or two of cramping. Good luck and give them a chance to work.

Be aware that while removing air from the bottle, if some of it squirts out it can stain, particularly on white or light sheets.
Posted 3/12/2011 5:52 AM (GMT 0)
My tip: when it's cold I warm the enema up by putting the tube next to my body for half an hour before going to bed. Cold enemas were not agreeable to my nether regions at all and made me less interested in using them. Warm enema=very easy to use.

I'm lucky that my spouse goes to bed 1-2 hours later than me, lots of privacy. I would not have been able to inject in another room and walk to bed when I first began using the enema, totally impossible. It took several tries before I could retain them at all lying in bed. Then it got easier.

Haven't had to use them in months now but nice to have them in reserve for bad times.
Posted 3/12/2011 7:17 AM (GMT 0)
I hope you're shaking the bottle well.....


q
Posted 3/12/2011 2:59 PM (GMT 0)
Night two was a bit better. I squeezed the air out best I could and used it in bed before hubby came in. I had my iPad set up so I could watch an episode of The Good Wife while lying on my side. It helped distract me. I've been so exhausted that I was sure I'd then go right to sleep, but I had trouble sleeping. A couple of time after an hour or so it felt like it was all going to come out. After about 90 minutes in had the urgent feeling to go and I had to get to the toilet where it all of course came out. I had a lot of pain and pressure around 3am and took half a vicodin to sleep. I think tonight in will take the vicodin before the enema!

One thing about being so out of it for three weeks- I started watching The Good Wife and now watched all of season 1 and 2!! Got caught up last night so now need another series to watch...

I think I am improving but for pain and inflammation right at the very end combined with a hemi or two maybe. I am using some prep h. Anything else I should add?
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