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Rowasa Enema Insertion Technique?

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Ulcerative Colitis
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Posted 6/3/2014 9:23 PM (GMT 0)
Hi all,

I was just diagnosed w/ UC on Friday. I was prescribed Rowasa and have been taking them since Friday. First off, so glad I searched it out before my first use and came across these forums that mentioned letting the air out. Can't believe how much air was in the bottle and how my Dr or pharmacy didn't mention it.

So i've been laying on my left side in bed while using the Rowasa, however I feel like it's somewhat difficult to know if it's inserted correctly and not leaking. I have been mostly successful until last night where once again I was questioning if it was leaking or not, and after a bit finally realized it was leaking. After cleaning up, I ended up just doing it in more of a face down butt in the air kind of position on my knees in the bathroom, which seemed much easier to apply.

My question is, is the face down butt up position acceptable? Is it okay to immediately get up, walk, and get into bed after applying? Any tips for applying on my side, such as angle of the bottle? How soon after applying can I turn off of my side and lay on my back?

Thank you
Posted 6/3/2014 9:40 PM (GMT 0)
Hi RoughTimes-

I've seen both "left side" and "face down" methods illustrated on instructions.
It's a good idea to try to have a bm before insertion.
After flushing, I find it easier to stay seated on the toilet, apply personal lube to both rectal opening and tip of enema, get up bending forward, reach around and insert the enema, and squeeze the bottle.
Wipe off extra lube using Tpaper and go to bed.
Most instructions say to stay on left side for at least 30 minutes.
I try to fall asleep in that position to allow the max amount of product to find its way in.
I always wake up on my right side.

I found that it got easier to do after much practice.
Good luck!
IAS
Posted 6/3/2014 11:22 PM (GMT 0)
I do it in a semi-squat, lying down was too twisty somehow, LOL. And yes, it is totally ok to walk around after inserting the enema. But not for long - you want to settle down and lay on your left side so the enema can flow into the sigmoid colon and maybe even up to the splenic flexure.
Posted 6/4/2014 1:28 AM (GMT 0)
I lay on my left side to insert it but then kinda roll more on to my stomach to get a good grip on the bottle for squeezing or the liquid. I get up, clean up, wash my hands and then get in to bed and lay on my left side as long as I can.
Posted 6/4/2014 1:55 AM (GMT 0)
My question is, is the face down butt up position acceptable? Yes. Is it okay to immediately get up, walk, and get into bed after applying? Yes. How soon after applying can I turn off of my side and lay on my back? As soon as your comfortable to do so, usually that's a minute or two for me.

Whatever technique works for you, use it, you'll develop a routine with practice and time. I sit on the toilet before using rowasa to make sure I am empty. I follow a butt-over-bowl technique. I administer 1/2 of the med slowly (too fast and it will be uncomfortable) it doesn't matter how much tip you insert. I do 1/2 the med at first as I don't always retain it, it can come up quickly and unexpected due to gas or a bm it might coax out lol. Butt over bowel is good because if any spills it simply drops in the toilet (it stains paint, clothes, and most things quite terribly). If you administer yours on the floor or in bed, then I recommend putting an old towel down first. I sit on the bowl and wait 5 minutes, and if everything seems settled, I insert the rest and then immediately go to bed. I lay on my left side and go to sleep. You can walk around after taking it, I have done chores afterwards haha.
Posted 6/4/2014 2:47 AM (GMT 0)
smile, shove it in, and hang on for dear life !

you'll be glad you did :-)
Posted 6/4/2014 9:59 AM (GMT 0)
Hi my 8 year old daughter has uc and is using salofalk she's in and out of remission as I started using a supp with her which she hates it but stops the blood in rectum, as soon as she skips a day without a supp the blood appears again.
Any tips on how I can make it easier on her
Posted 6/4/2014 3:27 PM (GMT 0)
Thanks for all the advice. I went with a method pretty similar to ItsAlwaysSomething, and found it to be much less stressful and difficult. Also nice being in the bathroom to wash up quickly.

I'll do a search and make another thread if need be, but wondering if anyone has any hard fast rules/tips in regards to tips supplements, etc. for a UC newbie.
Posted 6/4/2014 3:39 PM (GMT 0)
The only hard, fast rule is that you've got to find what works for you. Some of us do well with probiotics, others don't. Some do well with fiber supplements, others don't. It's the same for meds; I've done really well with mesalamine-based meds, but they don't do squat for other people.

I'm really not trying to be flip or snarky, just being honest. If anyone says that they have THE answer or have THE thing that will help everyone, don't believe it.
Posted 6/4/2014 3:39 PM (GMT 0)
There's a large amount of uc diets (paleo, SCD, diary-free, gluten-free, etc.) and uc supplements (fiber, probiotics, various seeds and oils) that people try. Like everything for this disease, things are highly individualized. Meaning what works for one person, doesn't necessarily work for another.

Both medication and non-medication (a.k.a alternative) approaches are mentioned in the Ulcerative Resources thread at the top of this forum. That would be a good place to start. Here's a direct link: Ulcerative colitis resources
Posted 6/4/2014 4:34 PM (GMT 0)
Thanks fruitgirl and iPoop. I'll definitely be looking through that thread.
Posted 6/4/2014 5:28 PM (GMT 0)
The colonoscopy position is usually best for me. I figure if that works best for a scope it should work best for the enema at least to get in. Then it's whatever position I need to get in to retain it the best. I have done them on knees before but that was just to get all solution out. Do what works at the time.

Fruitgirl is right on the "THE answer or have THE thing that will help everyone." I want to choke those people..... is that mean? lol. No, I am on a pred taper that thought is normal.
Posted 6/4/2014 9:57 PM (GMT 0)
I use diaper wipes for hand cleaning and wrapping the used bottle in.
I wipe off the lube that's on there and use Vaseline.
I lay on my left side on a bed protector mat.

I get up, clean up in the bathroom, and lay down for a 2hr nap around noon. I only poop once a day in the morning, so it stays in until then- 20hrs.

Gosh I hope I don't have to use these forever. But they are a great part of my treatment.
Posted 6/5/2014 5:44 AM (GMT 0)
Thanks to someone's advice here, I do my enemas standing up. I bend over very slightly, brace myself against the sink with my left hand (still completely upright) and reach around my right side with my right hand and squeeze.

For me, this works much better than lying down or squatting.

When I'm done, I get in bed and lie on my left side for a while.

I don't have any issues holding it in until I get to bed. Once in a while, I can't get in bed immediately and I hold it for 5 min. This is easier when not flaring.

I put lots of petroleum jelly on the tip to make sure it glides in.

It takes practice but once you've figured out the best way for you, and have done it for a week, you won't even have to think about it.

Good luck!
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