My "beloved" mesalamine enemas seem to have failed me

So I developed a mild flare a while back. Things got somewhat better after bumping up mesalamine enemas to nightly, then a lot better after adding hydrocort enemas. For a couple of weeks, I used the meslamine at bedtime and hydrocort during the day. I stopped doing that when I started having trouble sleeping, and went to alternating nights between mesalamine and hydrocort.

The past 2-3 weeks, things have been pretty good, other than a still very slight increase in frequency (2, maybe 3 BMs a day instead of my normal 1) and consistency was pretty loose. I saw my GI on Tuesday, and he said to quit using the hydrocort enemas and just use the mesalamine.

I thought things were maybe getting a bit more loose, but figured it may be because my intake of fresh fruit has gone up quite a bit, given the season. However, my daughter had tubes put in on Thursday, so I decided to skip an enema on Wednesday night, as we had to be at the surgery center pretty early Thursday morning. I ended up just having 1 BM on Thursday, and it was a LOT more formed than it had been.

I used an enema Thursday night, and had three very, very loose BMs on Friday. Thought "hmmmmm...." and decided to not use on Friday night; one really good poop on Saturday. Used one again Saturday night, just as a test, and had four almost watery BMs yesterday. Didn't use one last night, and so far, just one very good poop this morning.

So, I'm thinking that I've developed a sensitivity to something in the mesalamine enemas. My guess, at this point, is that it's the sulfites, as I'm still on Apriso and things are "normal" when I don't use an enema. I'm planning to call my GI, tell him what's up, and request an Rx for the sulfite-free enemas. But I thought I'd see what you fine folks think first. I still also have a box of hydrocort enemas (that have no sulfites), so I may use one of those tonight, just to see what happens (as in, see if the problems are just because of extra "stuff" being "up there.")

You need enemas blessed by Quincy. Ship them to her so she can bless them and she'll ship them back to you.

Lol! at Somedude!

Chantrelle, I've never had blood with this flare. My symptoms never escalated beyond having more frequent and looser stools, plus urgency. If I only had slightly looser stools, I wouldn't worry about it. But I had four completely watery poops yesterday.

I think that's a good plan. Maybe the sulfite free version will work wonders for you. Everything seems to work well for me for a period of time but it fails eventually. I wonder if the sulfite free rowasa would help me, maybe i will give it a try. I've never been able to get out of a flare up with rectal meds, whether mesalamine or steroid, I end up getting worse once things progress in that direction. I always seem to be diagnosed with mild inflammation too. it's very strange. You would think mild would be treatable with rectals but even at 2x a day, things get worse.

I don't think I can give you any advice because you are pretty educated in all this but I just want to say that I'm sorry you're flaring again. That sucks. How's the little one?

If you got over the urgency, King Colon must be on-the-mend from flare-- so you may need less Rowasa assuming Apriso is back to work. That could be the happy case. Try to have a serving of plain-boiled white rice daily for 5-7 days; if tissue has healed from flare that might boost your fluid absorption in colon. Glad you updated us-- I've been concerned about you & Beth75.*** I hope Claire feels better after tube placement; was she getting a lot of infections in ear canal? / Old Hat (33 yrs with left-sided UC; presently in remission taking brandname Colazal)

I'm glad your situation isn't as dire as the topic title made me fear :) Let us know how the knew enemas work.

Maybe try Canasa in the meantime. I know it's awful, but if I have an off day or two, I smoke a couple cigarettes and that seems to calm things down. I'm still on the same pack from last year so I use it as a last resort.

I'm not sure what else to suggest. You seem like a pro. When I was worried about a postpartum flare, you were my inspiration that it could be avoided! Hope you're feeling back to normal soon.

But Quincy, why would she need stool samples done? If she is having formed solid stool the days she skips the enemas; then clearly the problem is with the enemas.
FG: just FYI the same thing that you describe happened to me. I now cannot tolerate mesalamine enemas at all. I also suspect the sulphites but unfortunately there is no sulphite free version here in Australia.

While it's very possible that you're sensitive to the mesalamine (which sucks if that's true :'-(
I think you should try the SF first.

Are you using the suppositories?...at least they'll still be treating the rectum.

q

Apriso is lower dosage, but without sulphites I guess.

For sure use something. I think the combo of the Canasa and the hydrocort enema is at least treating. If the enema is a problem as well, then maybe try a foam one.

For sure keep us posted how it's going...pun intended I guess, lol.

q

Right...lower dosage, great releasing mechanism! But for those who are sensitive to mesalamine (aka sherry), it's been her best option.

I'd suggest the Canasa twice a day for 4 at least. If all is good, then maybe do the enema every second or every third night.

q

Curious if that enema has metabisulphites in it as preservative?

A good start to the day regarding poops ;-)

q