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how does it take for enemas to have any positiv effect? plz help

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Ulcerative Colitis
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Posted 5/6/2012 11:30 AM (GMT 0)
Hi,

I hav been flarin for 2 months and d doc put on Pred enemas for two weeks only. 4 days after stopping pred enemas the symptoms are back again. the doc wants to put me on oral pred but I dont want to. I've started mesalamine enemas (1g) nightly + suppositories ( 1g) durin the day + 6 pills pentasa every day. I hav been using the enemas nd suppo for 4 days and going on. I still didn't notice any improvment. Blood+ diarrhea+ 4/5 bms. Shld I move to pred? or be more patient with enemas? I dont know what to do, please help..... this is really affectin me emotionally more than phisically. I can't work I can't study I can't socialize, I can't leav the house for fear.... u know.... am sick of it all. I just feel very low.
Desperate UC Challllenger,
Posted 5/6/2012 11:44 AM (GMT 0)
I think when you're in a bad flare it sometimes takes a few days to a week for the mesalamine enemas to work. I have found that going forward its always best to get on the mesalamine enemas at first sign of a flare. Also, while in a flare, be careful of foods that might cause your flare to be worse. Offending foods are different for everyone.

I hope you feel better soon.
Posted 5/6/2012 11:58 AM (GMT 0)
I would say it's different for everyone how quickly or if they respond to mesalamine enemas. Sounds like your doc is doing the right thing IMO. You could ask about taking Entocort rather than prednisone, less adverse symptoms, but that may depend on where you UC is located. When I was in a big flare the mesalamine enemas did little for me but when I got more into control the enemas showed benefits overnight.

And it may be that your UC is med resistant (but don't think that yet until you've tried oral steroids).
My history is that Rx meds had very little or no impact on my symptoms or inflammation. I had to try other means which for me is diet modification.

Don't be afraid of prednisone for the short run, it could get you into remission so that you can control your UC with lesser meds.
Posted 5/6/2012 12:45 PM (GMT 0)
Don't be afraid of the enemas. Even if you get only half of it in it's still good. You can ask for 2g enemas too. Up to 4 g in the us and canada.

I started the enmas last july and struggled a bit for the first 3 months. It was on and off and i did retain them but sometimes i didnt.

But since febuary, after i topped the enemas with oral asacol im really down to one bm a day and coul reintroduce a bit of wheat in my diet. The hard work is paying off.
You can do a steroid enema treatment for like 2-3 weeks and then go to melasanine enemas for treatment and maintenance.

If you arent prepared to go for prednisone (i am the same) well be patient. Concentrate on what is improving instead of remission. My remission was very gradual. One symptom or disconfort went one at a time. Really be patient. However my blood disapeared quickly, the longest part was the urgencies and mucus.

If you still see lotfs of blood after giving a chance to enemas i would seek stronger meds. However sometimes you cant reach remission in a 2-3 weeks treatment. It takes patience. And that is frustrating and hard. But its worth it.

Your doctor seems to take you to the right path but unfortunatly with UC getting better dont happens overnight.
Posted 5/6/2012 1:28 PM (GMT 0)
UC challlllenger,

I am so sorry you are having such a tough time of it, with your symptoms, and having it affect you emotionally too. UC sucks and it definitely takes its toll.

As Ima said, for different people, it takes different amount of time for the turn around.

For me, nothing helped, not the prednisone, and not the mesalamines I became intolerant of, so I had to find my own way.

IMO, you would benefit greatly by adding them to your routine:

diet modification, L-GLutamine powder, slippery elm powder, LDN.

If you'd like to read more about these, you can go to this link:

 https://www.healingwell.com/community/default.aspx?f=38&m=1666318 , and look at the 11th post.

I hope you start to feel better soon, and let us know how we can help.


 

Posted 5/6/2012 1:46 PM (GMT 0)
thank u guys for ur replies,

I'll keep u posted if there is any improvement. I am visiting my doc again Monday to c what she wld suggest.

UC Challenger, desperate
Posted 5/6/2012 3:36 PM (GMT 0)
the point here is that you're desperate. You're not on enough rectal medication at this point, so push for that.

Know what you wish for and realise that flares take a while to get under control. Make your quest to fully exhaust the 5ASA oral/rectal before even mentioning another medication such as prednisone....

My take on it...based on 23 years of experience and only using 5ASA oral/rectal.
q
Posted 5/6/2012 4:31 PM (GMT 0)
Quincy,

I agree about the fact that my rectal meds are not enough and that's exactly what I hav been trying to convince my doc about. Anyway I'll ask for higher doses tomorrow.

Uc Challllenger, still desp
Posted 5/6/2012 4:38 PM (GMT 0)
I think they take a different amount of time for everyone (and each flare is different). It's important to taper down from them, not stop them cold turkey. The best way to taper down is to swap the steroid enema for a mesalamine enema. For instance, if you're using the steroid enemas at night and Rowasa in the morning each day, you may want to try using the steroid before bed every other night and use a Rowasa in place of the steroid on the days you're not using the steroid. Then use the suppositories in the morining. There really is no magic solution and it takes a lot of trial and error. Two weeks really isn't a long time and it sounds like you didn't taper off. I'd see if your GI would give you a longer script for the enemas so you can try to taper off. Anoter question, why Pentasa? Have you ever tried Asacol or Lialda? Pentasa is formulated to release higher than necessary for UC treatment. It doesn't sound like you're having symptoms of pancolitis. I'd think, for the left side, Asacol, Lialda, APriso or Colazal would be abetter match.
Posted 5/6/2012 5:37 PM (GMT 0)
notsosicklygirl,

Thanks for ur post. U really all help me alot. As for ur question " Why Pentasa?" Its because its all there is where I live " North Africa", Morocco. So, I dont hav any idea about other brands. Its what I hav been prescribed.
UC nd Chrons are not very common diseases where I live.


UC Challllenger,
Posted 5/6/2012 5:45 PM (GMT 0)
Generally, the worse the flare is, the longer you need to be on rectal meds before tapering off of them. One of the biggest mistakes is stopping the rectal meds abruptly, it's best to wean off instead.

Patience is a virtue that's for sure....a few times in my 21 yrs of having IBD, I had to take rectal meds (Cortifoam is the only one that works for me) for a full year BEFORE I could start tapering off of it.

Best of luck to you UC challllenger!
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