How long should it take for Ulcerative Proctitis to clear?

Hi, I have another question.

I have recently been diagnosed with ulcerative proctitis. I have been prescribed Pentasa (mesalazine 1g) and Hydrocortisone 50mg suppositories - which I'm supposed to alternate daily between for the next month(s) until things settle down.

I have now been taking these for 2 weeks and have seen not change in my symptoms - if anything, things have got worse.

I was hoping to have seen some improvement by now but my doctor only gave a vague 'it might take a while' statement. So was wondering if anyone else has any experience of how long these things might take to (temporarily) clear up?

Thanks.

Personally I think Proctitus is just stage one of Pancolitis. In other words, if you took no medicine at all after a few short months you would not have UC just in the Proctitus area but throughout your entire colon. I don't agree with treating Proctitus in that area only because more than likely it will spread to the rest of your colon so if you aren't taking meds for the rest of your colon, even if your Proctitus area gets better due to meds, the rest of your colon will then be having problems. I think your doc should have treated with oral mesalamines to keep that area from getting UC while the rectal meds battled the Proctitus area. It also sounds like your current treatment plan is not working even for the Proctitus. What country are you in?

In my case it took about a year to see no more signs of UC. My solution was to avoid dairy. No medications worked for me. It tends to vary among people though.

@d1jsp. How did you find dairy was the root cause? Did you have any allergy reaction or you just tried elimination method?

When you say dairy did you just stop milk or even yogurt,cheese and butter too?

I noticed improvements in the first week, on salofalk enema and suppository. My GI said rectal meds usually start working within a week to two for most people - not saying cured, but start improving.

as you can see from answers, somewhere between 2 weeks and never.

Gary's idea of an oral melsalamine as a prophylactic is a pretty good idea.

I do not find any scientific evidence that dairy is ever "root cause". It is clearly established that genetics and some triggers (possibly dairy for some) interact with disturbed gut microbes to result in UC. The exact mix is still poorly understood but that genes, gut microbes, and triggers are involved is beyond dispute.

When gut microbes are in dysbiosis, you can get sensitivities to foods that would not be a problem if your gut microbes were OK. In that case eliminating some hard to digest foods can help with symptoms a lot. Underlying inflammation and risk of cancer may still be a problem.

Post Edited (DBwithUC) : 3/17/2014 12:30:31 PM (GMT-6)

The first time I got diagnosed I had proctitis and it went away after a couple days of salofalk suppositories and a switch to a grain-free diet. Once it was gone I stopped taking meds and went back to eating normally. about 6 months later it came back and the same thing did not work for me, I let it get progressively worse, not anything oral meds, thinking it should just go away easily, trying diet mods, got pregnant and had it spread to colitis very quickly. That was 3 years ago and here I still am... I'd probably be in remission if I chose to take the immunosuppressants or biologics though, that's just the choice I made. My advice: if things are getting worse, you should look into oral meds and stop it before it gets even worse, wish I had!

For me, it comes and goes (minor symptoms). Right now, I'm doing pretty good.

A couple years back, it took a year for me to get it under control but I was under a lot of stress.

garylouisville said...
Personally I think Proctitus is just stage one of Pancolitis. In other words, if you took no medicine at all after a few short months you would not have UC just in the Proctitus area but throughout your entire colon. I don't agree with treating Proctitus in that area only because more than likely it will spread to the rest of your colon so if you aren't taking meds for the rest of your colon, even if your Proctitus area gets better due to meds, the rest of your colon will then be having problems. I think your doc should have treated with oral mesalamines to keep that area from getting UC while the rectal meds battled the Proctitus area. It also sounds like your current treatment plan is not working even for the Proctitus. What country are you in?

Do you have a link to support this? It's just that I don't like relying on blog posts for my information.

Mmm thanks, some interesting thoughts. Depressing, but interesting :)

I am in the UK and on the NHS. To be honest, it has been a disaster. My GP insisted it was just hemorrhoids so I ended up paying for a private consultation. All in all, it has taken about 5 months to get an 'ulcerative proctitis' diagnosis and my specialist, whilst helpful, has now fobbed me off for another 3 months.

I will stick with the current medication for at least another couple of weeks in the vague hope that I may yet see some improvement. Failing that, then I guess diet is the next port of call.

It is annoying as according to my endoscopy report, I only have a 2-3 cm band of inflammation (or at least, I did back in January). But I have been told that it is mild inflammations that are the hardest to shift.

Oh well, thanks guys.

AZ: The first sentence of my post said, "Personally I think Proctitus is just stage one of Pancolitis". That is just my personal opinion with not even a blog like Stealth would post to back it up. It's just my opinion. Nothing more. Nothing less. I never even tried claiming I thought it was fact. I believe it. No one else has to. If I really wanted to I'm sure I could dig up something and make it look like I have evidence (like others do) but I have no desire to do that. As far as I know we are entitled to post our opinions on a subject.

UP has the best prognosis of all the UC diagnosis and is the least likely to spread. It was once considered "curable" because a good percentage of patients treated with steroids went into remission permanently. Probably 20% have a bad time with the disease while pancoititus it is almost 50%. Your chances of staying in remission are greatly enhanced by maintenance meds. It is not a curable disease.

I responded well to meds and it took 3 weeks for rectal bleeding to stop and 8 weeks for the diareha to stop completely.

Post Edited (AZYooper) : 3/17/2014 5:26:17 PM (GMT-6)

cjd..since you were diagnosed via sig-scope, I would strongly advise you request a c-scope for the obvious reasons.

Please get a copy of your biopsies results.

I'd suggest you ask the doc to increase your dosage of med regimen to be twice a day suppositories.

q