Salofalk enemas

I am in the uk. I am towards the end of a persistent flare. I am left with some bright ish red blood daily and some urgency mucus. Everything else is fine. I am tapering of pred but to be honest there was no difference in symptoms at 30mg of pred than there was at 15mg of pred. I managed to get some salofalk foam enemas and they are working well one week in. I still have some blood but not as much and a touch of mucus. I note that the instructions say each squirt is 1g of mesalamine and normal dose is 2 squirts per night for 4-6 weeks.
I have been given 2 weeks worth of enemas and the prescription says one squirt only. So 1g of mesalamine. Given I still have some blood etc wouldn't I be better actually taking the stated dose?! I am on max oral mesalamine but that shouldn't matter should it?
Everything else I have read says 2-4g of rectal is the normal dose. Can't understand why they are saying only 1g! Shall i up it?

I have a flex sig at end of month to determine way forward. They just seem so reluctant with the enemas. They preferred I went on pred than upping the enema when flare started 2 months ago.
I had thought they would have given me freedom to hit it hard with enema but instead I have to ring and beg for more every 2 weeks.
I am taking 4.8g of Octasa and 15mg of pred tapering down over another 4 weeks.
Stools are formed, going twice per day. There is some blood and mucus before stool and some urgency and in the morning with blood and mucus. I seem to be able to hold enemas no issue whatsoever so maybe will try 1g am and 1g pm or would it be better all in one go before bed?
I prob have enough to get me thru to my flex sig where I can argue it out with them a bit more!!

In the morning it's all a bit mushy stool wise but I think that's also mixed up with the enema. Usually later on in the day I will go again and the stool itself seems normal size and shape etc but I usually pass some blood and mucus first, then the stool follows very quickly.
Tenesmus looking up the description is def what I have more than actual urgency itself.

I don't agree that the liquid enemas reach to the splenic flexure, but they would definitely go past the sigmoid.
Yes, doctors may be leery to prescribe rectal meds because of noncompliance, but that's surely remiss on their part to not explain why they should be used and how.

feeberry...if you can request the liquid enemas, that might be better if you can get it in a 4g rather than 2 to get you over the flare. The 2g can be used for maintenance once you've tapered the 4g.
The foam, however, may be easier to retain for some, so if that's the only route your doc wants to go...request the 2g dosage.

I agree that the mushy stool could be in part from mixing with the enema...that's common. but you are still flaring (with progress which is good).

It takes time and patience, which sucks.
Since you are still having tenesmus (those wonderful white-knucklers as I call it)...the 2g dosage would probably be best and give you a break during the day.

for sure keep us posted on how you're doing. If you don't have enough medication before your appointment, maybe alternate a double one night a single the other. you'll still be getting rectal medication...and...you are on steroid which hopefully will get the inflammation under control for you.

Remember that enemas also come in steroid as well, should you need another option while tapering the pred.

q

With what dosage?
Great ro hear...
q

You will go through a constipation type phase...plus tapering off the pred will have you up and down.

You might be able to avoid pred in the future....the doc should have given that to you initially.. ..but i have a strong oponion on that issue for obvious reasons. But in the future, your symptoms will hopefully alert you to increase rectals first. Thats how you can hopefully keep your flares to a minimum intensity.
q