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Bleeding- Proctitis

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Ulcerative Colitis
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Posted 1/6/2014 3:01 AM (GMT 0)
I have proctitis and I was in remission for a few months but now it seems that I have some bleeding. It isn't much, just on the toilet paper when I am done going to the bathroom. I usually go once a day, but now I seem to be going twice a day, but no diarrhea. I have a bit of stomach cramping but nothing too painful. I take lialda 2x per day as maintnance medicines. Now, I have been using mesalamine enemas for the past few days before bed. It does not seem like the enemas are helping the bleeding go away.

I am not really bothered by the flare right now, but I am not sure if I should be calling the doctor to get a change in prescription or anything. Also, not sure how long I should wait for the enemas to start working.
Posted 1/6/2014 3:03 AM (GMT 0)
Did you already have the enema script or did your doc call you in a new script?

I would say give it a couple of days for the enema, but you might want to talk to your GI about increasing your Lialda dosage for maintenance.
Posted 1/6/2014 3:05 AM (GMT 0)
Yes, I already had enemas from a previous script.

Thank you! I will probably call sometime this week if things do not get better.
Posted 1/6/2014 4:21 AM (GMT 0)
Definitely sounds like it would be a good idea to bump up the Lialda to "remission inducing" dosage since you are beginning to see some flare symptoms. I would call up your GI and ask to go up to 4 Lialda pills and keep your fingers crossed for the enemas.

Did you use your enemas as maintenance at all? Many people find that continuing their enemas during remission (a few times a week, no everyday) help them stay in remission longer :)
Posted 1/6/2014 6:47 AM (GMT 0)
You don't need to bump up the Lialda for proctitis, but it would be good if you're at least on 2400mg daily.

Stick with the enemas...it can take weeks for the bleeding to stop and maybe longer for you to start to feel flare symptoms have stopped.

Then....there's a tapering process to get to a maintenance level of twice weekly...that I strongly suggest you stick to.

Make sure you have refills for the mesalamine enemas.

Patience.

You might also want to add another probiotic to the Culturelle.


welcome to the forum.
q
Posted 1/6/2014 6:54 AM (GMT 0)
You could ask the doctor to Rx Cortifoam (10% steroid retention foam that comes in a small canister of 10-12 doses). It usually speeds healing in the rectum & is easier to retain than the liquid enemas; you don't have to lie down because the foam stays where you put it. (In case you're outside N. America, in UK-Europe-Australia-NZ, you can get an Rx for mesalamine retention foam. Members posting here from those places find it very helpful, too.) / Old Hat (33 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 1/6/2014 3:12 PM (GMT 0)
If you have inflammation in your rectum, you should be using Canasa (mesalamine suppositories) in addition to the enemas. The suppository does not have as much medicine in it as the enema (1g vs 4g), but it does directly treat the rectum. I find them very effective. Enema by night and suppository by day. Party on.
Posted 1/6/2014 11:23 PM (GMT 0)
I agree with the Canasa recommendation. Was struggling with a Proctitis flare for weeks, was on Mesalamine enemas then hydrocortisone, went on suppositories and whammo saw improvement right away.
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