HealingWell
Search Close Search
☰

Mesalamine Enemas 4G side effects

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
12
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 4/9/2017 7:24 PM (GMT 0)
Hey everyone!

I am in remission right now confirmed by colonoscopy last wk (GI doc did not see any inflammation on colon/rectum).

Anyhow, I could not tolerate yet another oral mesalamine (balsalaside) so I went off it after the colonoscopy.

I am now just taking generic mesalamine enemas and was wondering If you guys think they are making me worse or if these side effects are completely normal and should continue?

1) since starting the enemas, I'm having urgency in the AM when waking up possibly due to the liquid in there (this happened last time I tried them).
2) They increase my BM's from 1 a day to 2 a day (this happened before as well)
3) Stool is covered in white and there is more liquid so everything looks a bit looser (no D though) and I can't tell if I'm having mucous since the white of the enema is covering things.

There is no blood or any other symptom so would you continue the enemas? Without the enema, I was going 1 per day, formed without any blood, now 2 BM per day, a bit looser but no D, and urgency in the am before going then normal.
Posted 4/9/2017 7:57 PM (GMT 0)
Congrats on the remission!

What you describe is perfectly normal while on mesalamine enemas. You cannot absorb 100 percent of the enema fluid, so you always have slighlty more urgent bms and loose bms while on rowasa. Rowasa stains the bm white or light tan.
Posted 4/9/2017 9:03 PM (GMT 0)
I have the same symptoms on the enema and some days are better than others. I also get bloating from them as well. I skipped the enema Friday night (used Canasa instead) and felt amazing yesterday but if I stop altogether I know I could flare again. Its just the lesser of 2 evils. Congrats on no inflammation!!!
Posted 4/9/2017 9:11 PM (GMT 0)
I am using generic 4g mesalamine enemas and you just described my 'movement patterns' on them to a tee.....including the remission, although today is only day 8 symptom free, so maybe I ought to slow the roll a tad. Hopeful though !
Posted 4/9/2017 9:49 PM (GMT 0)
Yes same here. What you gotta remember though is feeling like you need to expel all that liquid because it's sitting in your bowel ready to come out in the morning, is not the same thing as rushing to the toilet because of inflammation causing loose stools and rectal urgency.

That's the thing. I don't know how much mesalazine enemas help me, but I stay on them as I am still flaring, and because when I use them it is really quite rare that I see blood.

I only have 2g enemas though, I'm not even sure if you can get hold of the 4g enemas in the UK. I'm not really sure if they have much of an advantage at the higher dose, but I see many people here seem to use those ones. I wouldn't be surprised if doing two 2g enemas (at different times) was actually more effective, but most people don't have time for that, quite right too!
Posted 4/9/2017 9:55 PM (GMT 0)

~ chicken wings ~ said...
I wouldn't be surprised if doing two 2g enemas (at different times) was actually more effective, but most people don't have time for that, quite right too!

This is an interesting idea. I think I'll employ it for my last 3 enemas (1/2 per night) instead of a taper. I will still be on oral mesalamine......
Posted 4/9/2017 9:59 PM (GMT 0)

Katie222 said...

~ chicken wings ~ said...
I wouldn't be surprised if doing two 2g enemas (at different times) was actually more effective, but most people don't have time for that, quite right too!

This is an interesting idea. I think I'll employ it for my last 3 enemas (1/2 per night) instead of a taper. I will still be on oral mesalamine......

You could certainly do that. However, I am comparing a 60ml 2g enema with a 60ml 4g enema (I assume yours are 60ml too?), and the downside to only putting ~30ml of the 4g enema in is that you will not be covering nearly as much of the bowel. Having said that, if you are in the process of weening yourself off them anyway then I doubt this is much of a consideration.
Posted 4/9/2017 10:22 PM (GMT 0)
Thanks everyone! Great to know this is normal and not a sign of getting worse. I will continue with them.

I'm curious if anyone knows if they make 2G or 1G enemas in the US or only in UK? Sometimes I have not been squeezing out the full liquid because there it's a high dose and wanted to see if lower dose would be helpful. Thanks.
Posted 4/9/2017 10:36 PM (GMT 0)
Yes, chicken wings, they are 60ml.......maybe I better just stick to every other night on the last 3. I know some of the inflammation this time WAS higher up. I think this is why he chose to prescribe the enemas instead of the suppositories.....

Jane, I am really glad you posted this because I was kind of curious about the double BM within an hour of each other....
Posted 4/9/2017 10:39 PM (GMT 0)
Jane - are you in the UK? If so, might be worth trying a foam enema? I've never used liquid so can't compare between the two but I find the foam enema super easy to retain. Might help you as I don't find my stool is any looser the morning after the enema.
Posted 4/9/2017 10:46 PM (GMT 0)
"I'm curious if anyone knows if they make 2G or 1G enemas in the US or only in UK?"

I've never seen or heard of them being prescribed in less than 4 gram doses within the USA. I know the UK prescribes them in 1 and 2 gram doses abd I'm sure other countries have them as well.
Posted 4/10/2017 2:17 AM (GMT 0)

StarGirl10 said...
Jane - are you in the UK? If so, might be worth trying a foam enema? I've never used liquid so can't compare between the two but I find the foam enema super easy to retain. Might help you as I don't find my stool is any looser the morning after the enema.

I'm in the US and for some reason we don't have the foam or the 1 or 2 Gram enemas! That is strange to me.

Thanks again!
Posted 4/10/2017 4:33 AM (GMT 0)
Pentasa is in 1g, 2g, 4g. But 100 ml liquid.
q
Posted 4/10/2017 4:07 PM (GMT 0)
"Wow, wouldn't it be great to actually know which of all these enema "formats" were the best? It'd be great to have some actual trials / research done into this, pitting off 30ml / 60ml / 100ml 1g / 2g / 4g enemas against each other and find which are actually the most cost-effective enemas for nightly treatment."

There's difference country to country and I've never seen a study that says whose is best. I'd assume that higher gram doses are better than lower gram doses. There's a point of diminishing returns though where anti-inflammatory just isn't strong enough to do anything significant though.

Post Edited By Moderator (iPoop) : 4/10/2017 5:07:43 PM (GMT-6)

Posted 4/10/2017 8:06 PM (GMT 0)
I'm about to start these tonight for the first time. How hard are these realistically to retain? Is it a conscious effort to keep your butt puckered or does the sensation of something could leak out at any moment pass? 60ml is not a lot of volume but it's still 60ml more than I'm used to holding in. I mean one inadvertent fart and its on the sheets.... Which I've already read to put down towels on.
Posted 4/10/2017 8:29 PM (GMT 0)

Wolsnik said...
I'm about to start these tonight for the first time. How hard are these realistically to retain? Is it a conscious effort to keep your butt puckered or does the sensation of something could leak out at any moment pass? 60ml is not a lot of volume but it's still 60ml more than I'm used to holding in. I mean one inadvertent fart and its on the sheets.... Which I've already read to put down towels on.

Try to empty your bowels beforehand. Administer it on your left side and stay lying for 20-30 mins.

If you find it difficult to retain at first, don't worry about it. As the inflammation comes down, and you get used to enemas, it gets easier.

If you lose it within the first 5-10 mins, you could always do another one.

After a few mins, it shouldn't be effort. If you had to consciously keep your butt puckered all night while you sleep, then that might be somewhat of a challenge! wink
Posted 4/10/2017 8:31 PM (GMT 0)
Wolsnik, they aren't hard for me at all. In fact, right after administration last night I hustled downstairs and let the dogs out, shuffled around in the kitchen until they were ready to come back in and all was fine. Never had any nightly leakage either....
Posted 4/10/2017 8:46 PM (GMT 0)

ArtsyFartsy said...
Wolsnik, they aren't hard for me at all. In fact, right after administration last night I hustled downstairs and let the dogs out, shuffled around in the kitchen until they were ready to come back in and all was fine. Never had any nightly leakage either....

That can be possible too, although I believe that the reasons for staying on the left side aren't just to do with retaining, but also getting the maximum benefit from the enema (avoiding it pooling in one place in the bowel, spreading it out more)
Posted 4/11/2017 8:12 PM (GMT 0)
Thanks for the input. Last night was no issue at all. Or this morning either. It's like it all got absorbed or something because there was no liquid at all with my bowel movement a bit ago.
Posted 4/11/2017 8:18 PM (GMT 0)
Yeah, that's true chicken wings......I thought the enema might be "pooling" and I was getting worried. In my case my inflamed area is the entire rectum, well 15cm anyway. I have been trying to stay on my left side 30 minutes after distribution . And knock on wood....HARD....I haven't seen blood or mucus in around 9 days now.
Posted 4/11/2017 9:08 PM (GMT 0)
I'm treating proctitis at the moment and I was thinking maybe laying on my left side might be counterproductive. It makes sense to lay on the left side if you want to make sure the medicine reaches the sigmoid and especially left descending colon. But with someone who just has it confined to the rectum wouldn't it make sense to not lay on your left side that much and try to keep most of it in or near your rectum? Just a thought from someone who is new to this. Maybe it doesn't matter.
Posted 4/11/2017 9:56 PM (GMT 0)
^^^ Off to look at my chart of the colon (again, lol) someday I'll have it memorized smile
Posted 4/11/2017 11:41 PM (GMT 0)
That's possible, Wolsnik. I am biased as I am trying to treat my pancolitis :D

I also have Salofalk rectal foam in stock, maybe see if you can get a hold of that as well! I use it now and again and it delivers 2g to the rectum.
Posted 4/12/2017 10:17 AM (GMT 0)

Wolsnik said...
Thanks for the input. Last night was no issue at all. Or this morning either. It's like it all got absorbed or something because there was no liquid at all with my bowel movement a bit ago.

Wolsnik, this is surprising......every bit got absorbed? no white skunk stripe on the poop? I wonder if I am having a problem absorbing because I am passing a lot of the white stuff w/ my two BM/s (about an hour apart). Hopefully it doesn't mean the inflammation became too tough to absorb it.....

I only have a 3 left and my follow up isn't for another 6 days. Luckily I am still taking the pentasa (oral mesalamine). I am going to ask for an ongoing enema RX to use as maintenance.
Posted 4/12/2017 11:03 AM (GMT 0)
I use rowasa and see white and tan on poops and that's perfectly normal, no absorption probs.
✚ New Topic ✚ Reply
12