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proctitis flare again

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Ulcerative Colitis
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Posted 12/26/2013 4:55 PM (GMT 0)
After a year my proctitis is flaring again. Have been using 1g asacol suppositories together with 3600mg of mezavant for the last 4 weeks. Got my pred in standby but can't decide whether to take it or not. I am having between 4 and 8 bms in the morning within a two hour period but urgency not bad. they are formed and with little or no blood. Then I am okay for the rest of the day.

I keep saying to myself wait, its not to bad. Then maybe I should take the pred.


Is four weeks long enough to be using the supps to expect the inflammation to have gone. What are everyone elses experiences of reaching remission using supps and not pred. Pred got me in remission last time. How long would the supps take to work. Last time I was worse than this and definitely needed pred.

Hope everyone had a good Christmas.
Posted 12/26/2013 5:31 PM (GMT 0)
I think you'd get better results with the 4g enemas, and I'd try that before going to pred. You might also consider steroid enemas or cortifoam.
Posted 12/26/2013 5:33 PM (GMT 0)
Certain flares are best dealt with a prednisone treatment, but what I have noticed with my proctosigmoiditis, which is mostly (90%) in the rectum, is that flares are often years apart and have the ability to spontaneously disappear. The feeling of having to use the bathroom multiple times in the morning and then rarely later on in the day is a trademark of rectal inflammation. If you are unwilling to take prednisone, which is fully understandable, talk to your doctor about increasing the dose for your current medicine or researching some alternative treatments and diets. I wish you all the best and I would like to remind you that you are not alone.
Posted 12/26/2013 5:39 PM (GMT 0)
Thank Kazbern. Have used predfoam enemas in the past and steroid suppositories with no results. After speaking with my IBD nurse, steroids is the next step. I can cope with things as they are now at the moment but how long will it last I wonder. Two weeks ago I was only going twice a day as soon as I get up.

Seems thing are done differently here in the uk than they are in the states. Feel that I don't get access to the stuff that you do.
Posted 12/26/2013 5:42 PM (GMT 0)
Thanks Izzy

I am willing to take the pred but not sure if it is necessary at the moment. I keep saying to myself maybe things will be better next week.

I have taken on board what you have said.
Posted 12/26/2013 6:36 PM (GMT 0)
Sounds like you used meds to get you into remission and then quit, sitting around waiting to flare again. If so, that is a mistake. While you can't take pred long term, once you reach remission you should continue doing maintenance meds (like oral and rectal 5ASA's) forever (to some degree) to remain in remission with the objective being to never have another flare. Often flares get harder and harder to treat, causing you to have to go up the med chain ladder so it is by far better to take less invasive meds forever so that you don't get backed into that corner.
Posted 12/26/2013 7:01 PM (GMT 0)
I would get the enemas and do one of them in the evening and then a suppository in the am after your bathroom trips. I think I would do that for at least 2 weeks before considering pred. Also the steriod enema or supp is a good idea and remember all flares are different it seems. Pred itself may not work as well for you this time either. And I fully understand wanting to avoid it. Hate the stuff.
Posted 12/26/2013 8:01 PM (GMT 0)
Gary. Been on maintenance dose of mezavant for two years now. My gi only told me to use rectals when flaring. I agree that I should use them for maintenance. Will have a word with him.
Thanks for your advice Shearbear. Think I will hang out a bit longer
Posted 12/26/2013 8:49 PM (GMT 0)
That would be a good idea to use rectals occasionally for maintanence, even if just once a week. The oral does not reach far enough down to stop you from flaring. The goal is to not flare again, not wait until you do flare to do something.
Posted 12/27/2013 3:01 AM (GMT 0)
Is there a reason you haven't tried the 4g mesalamine enemas as of yet?

Is there anything new that you've added in supplements or are eating in more quantity?

You d need to be on maintenance rectals....and I stress the enemas rather than the suppositories for treatment. Save the supps maybe for maintenance.

q
Posted 12/27/2013 12:47 PM (GMT 0)
proctitis is the biggest pain in the A**
Posted 12/27/2013 3:53 PM (GMT 0)
Quincy = In the hands of my consultant. He prefers supps to enemas. Proctitis only in 5 inches (or was that cms) so says better suited to supps. Going to carry on with supps for maintenance when I get this under control.

Up to now have not noticed any foods that are particularly bad for me apart from nuts that I rarely eat.

No new supplements.

Funnily enough have not been to bad today.
Posted 12/27/2013 6:01 PM (GMT 0)
You could double the supps...morning and night and see how that improves.

q
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