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pentasa vs salofalk differences?

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Ulcerative Colitis
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Posted 3/16/2016 12:54 PM (GMT 0)
My GI just gave me a script for Pentasa, since he doesn't want to overmedicate my UP (since it's so localized) by using steroid enemas long term.

I've used 5ASA enemas for weeks at a time before (this was a few years ago) with nothing out of the ordinary for enemas aside from the usual discomfort when inserting etc. I was using salofalk brand enemas in the past. Well last night I used Pentasa for the first time and I woke up 4-5x in the night with urgency (and didn't quite make it once) so I had to call in sick to work because I am a dental hygienist and I can't handle sitting through appointments with the patients today.

Is there such a huge difference between brands of 5ASA enemas? Or it is just that my flare/ disease has evolved and not reacting the same any more? I've been using salofalk suppositories continually, both through my remission (few times a week) and flare (but not currently while I was on the betnesol steroid enemas the last few weeks and a few months ago for 2 weeks).
Posted 3/16/2016 3:13 PM (GMT 0)
It's possible you had a reaction to the petasa suppository or it's coating. Any chance you can get a prescription for salofalk instead (since it worked for you before)?
Posted 3/18/2016 5:51 PM (GMT 0)
It's the Pentasa enema. I had an expired (Feb 2015) salofalk enema still so I tested it out last night- no issues at all. I'll give the Pentasa one more shot to see if it was just coincidence - kinda nervous about it :-/
Posted 3/18/2016 6:14 PM (GMT 0)
The Pentasa enema has more liquid than the Salofalk enemas. That could be part of the problem.

What's the dosages of the Pentasa and Salofalk enemas you're using?

q
Posted 3/18/2016 6:36 PM (GMT 0)
The salofalk is 4g ina 60g solution and the pentasa is 4g in 100mL. But, the betnesol I've been using is also suspended in 100mLs so I'm not 100% sure it's the volume that's the issue. (Mind you, I have had a few betnesol enemas that immediately came out and couldn't retain)
Posted 3/18/2016 6:39 PM (GMT 0)
You could ask the doc to prescribe you an antispasmodic...sometimes that helps if taken about an hour or two before bedtime to help retain.

What's the routine you use when you use the enema...exactly...in bed, on the floor, you stay in bed, you get up afterward, ....etc?

q
Posted 3/18/2016 6:42 PM (GMT 0)
I do it in the bathroom on a towel... roll over to my stomach and play on my phone for 15-20 mins before getting up, washing hands properly and getting into bed. I try and warm the solution before using it, maybe odd but between my legs while I sit on the toilet for at least 5 mins and try to empty everything. I was able to retain the Pentasa, but the waking up with urgency is not usual for me.
Posted 3/18/2016 6:47 PM (GMT 0)
Maybe try to do it in bed, laying on left side, remain quiet and don't roll onto your stomach...stay on your left side.

Bring a garbage bag or whatever to your bedside with Kleenex/toilet paper, and a wash cloth to wash your hands. The less moving, the better. Left side, don't move, fall asleep on that side...stay!
If you get the urge...at very first instance, clench your butt sphincter tight. relax the rest of you....but that might help.

Try not to sit on the toilet before hand unless you have to go at that time.....

Change something, because what you're doing doesn't work.

Ask your doctor for an antispasmodic.

Waking up with urgency is normal for flaring.

Use the supps during the day....

q
Posted 3/18/2016 7:05 PM (GMT 0)
I think it's only been 3 times ever I couldn't retain an enema- not a regular occurrence. The problem with doing it in bed is I'm not always alone in there depending on my fiance's shift rotation. So I can def make some adjustments but not all. Tonight is the betnesol again since I'm alternating, I will see how tomorrow goes with the Pentasa... Luckily I will have the bed to myself so I can at least do that part correctly!
Posted 3/18/2016 7:48 PM (GMT 0)
Left side works better than stomach. On your stomach, the liquid tends to pool in places (like the rectum) and it's therefore harder to absorb.

Try falling asleep on your left side. If you have a body pillow or several normal sized pillows then you can prop yourself in that position (and make it harder to roll over). When we toss and turn in our sleep, it's usually our legs that do it. I'll cross my ankles and that seems to take a lot of the umph out of it. When I roll over in my sleep, enema fluid sloshing around then I'm sure to wakeup with urgent need to evacuate.

Alternatively, lay on your left side for up to 40 minutes to mostly absorb the liquid. Play on your phone longer, read a book, watch tv, whatever works. It's easier if you can just fall asleep that way. When I was mostly healed the bulk of the liquid absorbed in 20 minutes or less. When I was inflamed badly it took at least 40 minutes. I'd even pass some small amount of that liquid in the morning.
Posted 3/18/2016 7:55 PM (GMT 0)
If you don't want to administer the enema in front of your fiancee in bed, then do it in the bathrooom and then immediately walk to bed and lay on your left side.
Posted 3/23/2016 1:54 AM (GMT 0)
thanks for the advice everyone, I tried the Pentasa again and it didn't cause the same reaction. I still get nervous about standing up right after I've administered it, but so far so good! also much more pleasant lying in bed than on the bathroom floor on a towel, lol.
Posted 3/23/2016 1:38 PM (GMT 0)
Good to hear...keep us updated how it works for you.

q
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