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Rectal Meds and Scopes - Quincy?

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Ulcerative Colitis
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Posted 9/8/2015 7:49 AM (GMT 0)
Hi Guys

Thanks for so much support over the past week, you helped me with some great decisions.
Right now I am in flare up and have been for 6 weeks; minor bleeding and mucus.

The first GI wanted a Colonoscopy which I declined as I did one last year. The second one is now wanting to do a sigmoidoscopy.

However, the rectal meds I have been taking since Saturday are working (500g of Asacol suppositories); I have mild Proctitis in additon to 3rd degree hemmies both of which was found on rigid sigmoidoscopy. I felt better right away.

However, it does get tougher as the evening approaches and the meds are wearing off.

Questions:

1. How long should I take rectal meds for, how often and what dose?
2. Should I get a flexible sigmoidoscopy?

Thanks
Posted 9/8/2015 9:23 AM (GMT 0)
Did you notice hemmies before or after the suppostories? I was kinda in the same boat, minor bleeding, mucus, 8-10 trips to the bathroom every day. I was given suppostries(pentaas) 2 weeks ago, my bowel movements went back to normal but i had some fierce hemmies a day or so after first taking them, some nights i could not place the suppository up there, one awkward night it got stuck half in half out. I got some hemmie cream from my regular doc, applied it 3 times a day, took the suppositories every 2nd day and its almost back to normal now, doesnt hurt to poop, i can sit down and UC seems to have calmed down too. Hope this is relevant.

1. for however long your Doc advises.
2. Personally id go for the colonoscopy, i was first diagnosed via one and had one 3 months later to see did it progress or recede and another a year after to check progress(it was not as bad as the year before). Tho i dont know if a sigmoid is as good.
Posted 9/8/2015 10:01 AM (GMT 0)
1.) I'd take canasa daily for Proctitis.
2.) A sigmoidoscopy is justified when your symptoms get dramatically worse (that is a flare) to get the severity and extent of active disease, and make sure your medications match it. The prep is easy, just two fleet enemas, and the procedure is quick with no sedation (unless you want it). Fleets are salt water solutions, and salt on a wound can be a bad idea. I've empied the bottle, refilled it with tap water, and used that before.
Posted 9/8/2015 2:50 PM (GMT 0)
Hi...one supp of 500mg isn't enough...get on them twice daily till things are back to normal. Then consider tapering.

your doc could do a rigid rectoscope to see how bad the inflammation is and if it extends past that. Or do the sig scope. Best to see whats going on .

to treat the hemmies, there are rectal rockets that can be compounded for better coverage.

q
Posted 9/8/2015 5:24 PM (GMT 0)
My bleeding has nearly stopped since the Asacol on Saturday night and he's asked me to do 500g a day for a week then evaluate.

On the rigid sig he said the inflammation was very mild. With a large set of hemmies.

My bum feels sore during the day, I get small amounts of mucus, stools are normal, and no urgency. Maybe getting better?

The mucus and soreness inside my rectum scares me.
Posted 9/9/2015 2:35 AM (GMT 0)
Since the doc only suggested for you to the 500 mg (not g) supp daily for a week then evaluate...then that's what you can choose to do.

Since you DO have inflammation in the rectum, albeit mild, as well as mucus and obvious soreness...you could up the supps to twice daily and see how that goes in the week and tell your doc you did that.

If you do have Proctocedyl suppositories available to you in the UK...ask your doc for a prescription for them in a week if the Asacol supps isn't enough.

Just to be clear, are all the hemmies you have internal or do you have some that are external?

Have you tried doing sitz baths?

Since your bleeding has subsided since starting the ASacol, and your rectal inflammation is mild, something is working for the hemmies.

q
Posted 9/9/2015 7:58 AM (GMT 0)
@LondonRed It did to me too(the soreness), sitting down for a week or so afterward was interesting. Keep track of what you eat too, i tried a small pack of popcorn one day and regretted it that night.

BTW are you a gooner?

Post Edited (ChrisHUC) : 9/9/2015 2:06:43 AM (GMT-6)

Posted 9/9/2015 1:51 PM (GMT 0)
No I am not a Gooner! I support Liverpool - my grandparents are from Liverpool.

Quincy; I am getting much better now with the 500mg Suppositories each night.

1. The bleeding has virtually stopped
2. Three solid bowel movements a day
3. Mucus has subsided

I just need time now to continue on these drugs for 2 to 3 weeks and see where we end up. So I will stay on the 500mg per night for this week, and then maybe use the day time one starting Saturday.

The hemmies are internal, grade 2/3 - and they do bleed. However, it looks like they must have been inflamed because anti-inflammatory Asacol has stopped both proctitis and the hemmies.

God willing it continues.

The GI now wants to do Flexi-Sig for completeness and to check out the proctitis extent. GI's love scopes, my issues is the camera always makes me bleed!
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