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Steroid Enemas Not Working

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Ulcerative Colitis
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Posted 7/18/2017 2:15 PM (GMT 0)
Hi all,

I'm in my second flare - blood, some urgency but not too bad, lots of gas. I've upped my Lialda to 4 a day and I've been using Hydrocort enemas for 8 days. I've seen a bit of improvement in the amount of bood, but that's it. During my last flare I used them (after trying Rowasa for a while) and after one use, the blood was gone.

I guess I'm just wondering if it's normal for it to take this long to see results with the steroid enemas. From what I've read on the forum it seems most people have quick results. I haven't had to go the oral steroid route yet and am trying to avoid that if at all possible so really want these enemas to do the job!

Thanks for any advice you may have . smile
Posted 7/18/2017 4:01 PM (GMT 0)
Steroid enemas do have a set dose and maximum effectiveness, and if your flareup is more severe than it can handle then it won't be enough. You could need stronger prednisone to recover if your flare is moderate/severe. Generally uceris and steeoidvenemas are best for mild inflammation only. Give it a little while longer, just to see.
Posted 7/18/2017 4:08 PM (GMT 0)
I didn't have quick results either and ended up going back to the mesalamine enemas. In fact, oddly enough I saw more blood with the steroids. This could be unconnected.....because even after going back to the melamine enemas it took awhile to get it all to stop.

I've read here often enough that the rectum heals slowly and can take much longer than we expect it to. True for me.

That said, I am on day 11 symptom free.....it has been a long haul, but I am really relieved.
Posted 7/18/2017 4:45 PM (GMT 0)
It could take months. Steroid or mesalamine. Unrealistic expectations can set you up for switching too quickly regarding meds.
You can use the rowasa at night and steroid during the day.

q
Posted 7/19/2017 6:34 AM (GMT 0)
Steroid enemas are the fastest acting medication I have found. But it takes 2-3 weeks before I see improvement; that's "fast".
Posted 7/20/2017 8:31 PM (GMT 0)
Thanks for the responses! I guess I'm just a little confused. I always read on these forums that rectal meds, especially steroid ones, should stop the bleeding for most people pretty quickly. And last time, they did do the trick for me. But now I'm on day 10 (and unfortunately about to go on a camping trip tomorrow) and there is no improvement in the blood.

I've been hoping to avoid prednisone, but when should I start looking at that as a next step?
Posted 7/20/2017 9:20 PM (GMT 0)
my suggestion would be to try the rowasa enemas again, and use as quincy said -

you might try sulfite free rowasa just in case you have an allergy -
Posted 7/20/2017 11:22 PM (GMT 0)
Prednisone might be needed.
Posted 7/21/2017 8:14 PM (GMT 0)
Ask the GI what their LT plan is.

Have you recently had your UC measured? e.g. How many inches of disease is your Colitis? They measure form the 'bottom up' in a scope..

I never formally had this done and got this measurement information until I switched to an IBD only GI. I'd highly recommend seeing one.

It may be that your disease is "higher" than the enemas can reach...

UC spreads from the bottom -- and goes upward.
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