Bad night with Pentasa, not sure what to do...

I am fairly new here, and I just started Pentasa enemas last week.
So far, they have been OK. Minimal discomfort, no real urge to pass them, etc.
Until last night.

With my current bowel situation, I am not having diarrhea, but I am still having 3+ bowel movements in a day, at least one with blood.

Last night I lay down, did my thing, and then it was awful. I managed an hour (I couldn't even sit up to take my other meds, it made the urge to pass almost unbearable) before I was running to the bathroom. And now I am having what seems to be the start of a flare. I was up multiple times in the night, I have been in the bathroom multiple times today. My bowels are slowly but surely becoming diarrhea, and I am having issues with cramping and appetite. The only saving grace is the blood doesn't seem to be getting worse (yet).

So... do I continue with the enemas, seeing as it may have caused this? Do I give it a rest for a day and try again tomorrow? Do I go back to my oral Asacol? My pharmacy is no use, they don't even normally stock these enemas, and my doc is a bit of a brainless lout when it comes to UC. I am supposed to be seeing my GI specialist "soon" but that may not be until September.

Serious case of the UC blahs.

Because the Pentasa is 4g/100ml, and I was at the the max dose orally - 4800mg (so 4.8g), my GP didn't want me to be overdosing on Asacol. I don't know what kind of a risk that actually is, but like I say, he isn't very well versed in UC. I fully expect my meds will change in September when I see the specialist. Also, we weren't sure what kind of good the oral Asacol was actually doing, as it was frequently in my stool appearing to be undigested (I was taking the reddish brown tablets, not a capsule).

Looking at my diet for the last few days, nothing is jumping out at me as being the culprit. I have said it before and I will say it again, I don't eat super well/clean due to cost of food and the fact that prednisone makes me crave and eat everything right now. Spicy food is my one big trigger food, and I haven't had anything remotely spicy since my last big flare started in May. (Technically I feel like I am still in this flare, as I haven't recovered for more than a week at a time)

I have only done 4 days of the enemas. Tonight will be day 5, provided I can retain for any length of time. :S

The only other thing I can think of is that my bowel is getting worse because I am tapering down my prednisone. I am down to 5mg and tomorrow is my last day. I am adamant about not being on it until I see the specialist, because it has caused so many problems this last round... weight gain, heartburn with reflux, sleep apnea, worsening of my costochondritis, muscle spasms... I can't deal with another month of all that!

have you ever seen a gi ?

seems like you're between a rock and a bigger rock - ya, tapering off the pred can give you fits - we ALL want to be off it, but like kmom said, we do know how it swings -

sorry you're in a tough spot -

Get back on the Asacol....at least 2400mg to start and increase it if you need to.
Split your dosage twice a day.

Stay on the enemas.

And yes...it might have a lot to do with decreasing the pred.

It's unfortunate that your doctor opted for the pred instead of having you on both oral/rectal 5ASA....but that could be your regimen after you're off the pred.

q

Went ahead and did the enema again last night. Lots of cramping and nausea, but managed to retain all night. (I am currently doing the enemas every single night)

I have seen a GI, and I am supposed to see him again in September (or sooner if someone cancels, I am on the top of the cancellation list). He is the one who diagnosed me after a colonoscopy, so he will be the one who knows what to do with the meds... I hope. My GP is the one who is near clueless... though he does at least try.

I don't take probiotics or a multi-vit at all, because I tend not to absorb things properly. I wouldn't even know where to start with either of those. I had been taking SierraSil for a while, but stopped when I started getting imaging done for endometriosis, because it has barium in it and I didn't want it to throw off the imaging.

It sounds to me like you're starting to flare again because you're off oral meds -- how long has it been sinc you've taken Asacol?

I was on 4800 mg of Asacol and nightly 4g mesalamine enemas for quite some time. Mesalamine is VERY poorly absorbed, whether taken orally or rectally, so it's safe to take this much. songlady used to take 16 Asacol a day!

Personally, if you have the meds in-hand, I'd use both meds.