pregnant with issues and questions

Hi all. I havent been on here in a while. I am currently 24 weeks pregnant and experiencing some colitis issues. I was diagnosed with UC 4 weeks after my son was born in 2012. I have only had that one flare which ended up being severe and put me in the hospital.

I was in remission for almost a year before I got pregnant and my current pregnancy has been great up until now.

Current symptoms - having bm's 2-4 times a day, some mucus, no blood but I swear I see mucus balls that are tinged pink or red/brown (but nothing in the toilet or on tp that is true blood), spasms as I am going but its like a wave of cramping then I go and then they stop, stools are thin (not shoe string but definitely thinner).

I am on 2 Lialda a day - upped by GI to 4 today. I was on twice weekly Rowasa - upped to nightly last week - switched to cort enemas as of today. I take zofran as needed. Supplemental wise I take Benefiber and Miralax each day (per GI) because these all seemed to start as constipation 2 weeks ago. And slowly the colitis symptoms crept in.

My main issue with the Rowasa is not all of a sudden I am not absorbing them completely. I retain them all night but then when i wake up a good amount of the liquid hasnt been absorbed. Usually its all gone and I only have a little white on my stool. Is this because of the baby on my colon and the liquid is pooling? I AM SO CONFUSED AND SCARED. I don't want to let this spiral like it did last time.

Does anyone have insight for me? Is this pregnancy? Is this the beginning of a flare? I have never been pregnant without colitis basically so I have no idea what to think.

I think you're doing all the right things. I don't believe the mesalamine enema is meant to be absorbed. Sometimes I see it in my stool, sometimes I don't. Hang in there.

In my 2nd pregnancy (like you, I was diagnosed after the birth of my first) I had no issues with my IBD. However, in BOTH pregnancies I had asthma flares in the 2nd trimester that put me on oral steroids. Talk to your OB and your GI about how long you should wait until taking a step like that.

You are doing the right things: increasing lialda to 4.8gs a day, doing rowasa nightly, and adding cortenema. Regarding enema absorption, an inflamed intestine isn't nearly as good at absorbing liquids; it takes longer. If you are taking the enema right before bed, lay on your left side for 30 to 40 minutes and read a book, watch tv, or whatever in that position. If you sleep still without rolling around much, then just go to sleep on your left side without waiting. Enema fluid can pool in your rectum if you sleep in other positions, and the rectum isn't very good at absorbing fluids; better if the fluid distributes over a larger area as it increases the odds of complete absorption. Passing a little of the enema fluid in the morning is fine, just try to minimize it, if you can (sometimes I'd pass enema fluid in the morning and these things helped me). Good luck,

I flared after my 1st and 2nd baby. I was determined not to flare after my 3rd. I was very proactive in taking canasa suppositories and enemas and I never had a full on flare. Just a couple bad days here and there which were probably just IBS. It sounds like you're doing all you can. If it's not getting under control maybe try a little prednisone or uceris (not sure if it's approved for pregnancy) to give the other meds time to work. Good luck!

I used Canasa almost exclusively immediately postpartum. Once the baby got into more of a routine I would use the enemas just before bed when I knew I'd be lying down for at least 4 hours. I didn't stress if the baby woke up and I had to expel it. I just put a canasa in and went back to bed. I haven't been able to get sulfate free Rowasa in a few years on my insurance and I feel like Canasa in less irritating than generic rowasa so I tended to use the suppositories about 4 days a week then alternate Rowasa in when convenient about 3 days a week. For a while I was also in a pretty good routine of going to the bathroom twice in the morning and knowing that was it for the day. So I would use a Canasa after I knew I was empty and keep it in until the next day. These days I use about 3 Canasas a week and that's it as far as rectal medicine goes. Watch your diet for triggers too. I won't give specific advice on that bc everyone seems to be different. But everyone seems to agree to limit sugar. All the best.

Hi! I was undiagnosed when I was pregnant with my first child, but definitely had UC... I had D the entire pregnancy.

I had two more children after I was diagnosed with no major flaring. I took Asacol throughout the second and third pregnancies.

I just wanted to pipe in with some advice about staying hydrated. I ended up having my first child a month early and it was from dehydration due to the D. Make sure you are drinking plenty of fluids.

I flared during pregnancy and just wanted to add that prednisolone is safe in late pregnancy. Also, if you have responded very fast and well to pred in the past then you might be able to persuade your GI to go for a lower dose, eg 25mg, to limit baby's exposure. Best of luck...