rectal mesalamine question

Hi. I am dealing with the start of a flare, likely from a recent miscarriage. I have proctosigmoiditis, and while my symptoms feel awful, my doc rated the inflammation as "mild". For the first couple of years after my diagnosis, I solely had proctitis, and Canasa suppositories served me well. I now also have mesalamine enemas, and my doctor is recommending that I do the enema at night and Canasa in the morning. This morning I took the Canasa, and about 45 minutes later I had urgency, cramping, and several bowel movements. My question is, should/can I take another Canasa and then still do the enema tonight, or does this sound like too much? I just am worried that I didn't have the Canasa in long enough for it to even absorb fully, but maybe 45 minutes is enough time. I think that some of my most painful and uncomfortable symptoms are related to the inflammation in the rectum, and I just don't think the enemas are covering that area as well. I can't seem to find anything out there about how much rectal mesalamine someone can take in a day. Basically I just don't want to have another awful morning/half of the day tomorrow!

Thanks so much for the feedback! I really appreciate it, and I appreciate this forum so much.

Marie
- diagnosed proctitis 2011 after the birth of my first child. proctosigmoiditis diagnosed in May 2017
- Canasa suppositories and Rowasa Enemas as needed
- Vitamin D, probiotic, multivitamin, fish oil, L-glutamine

sorry for your loss -

Thank you so much you guys! That's a good idea to maybe try something different soon if this doesn't show any improvement over the next week or so. I actually feel like I don't really understand what is "normal" for me anymore. When I was first diagnosed, I took Canasa for 6 weeks and then was completely symptom free and in remission for a year and a half. Then I had two miscarriages, and flared again. Canasa again got me into remission, and then I became pregnant with my second child and stayed in remission until after she was born in 2014. Since then, I feel like I have been in this up and down flare. I actually am pretty confused what a flare is.... I will have periods of feeling "okay", but then I will have just debilitating symptoms for a few days, and then eventually feel okay again. My doctor said something about an oral mesalamine at my last appointment, and it sounds like that would be helpful now from what you guys are saying? I will also ask about trying a steroid foam. Thank you again for your advice!

Troubled Turds, thank you for your kind words, I really appreciate it.

Hi. I have been a silent viewer of these forms for 2 years and I registered today just to reply to your question.

I think its ok to take the canasa again if it comes out on an hour or so.

I have had indeterminate colitis (its between UC and Crohns) for 2 years. I have never really been in remission. But recently for the past 5 weeks, I have been moving steadily towards remission. I am taking enemas during the night, canasa during the day, and oral mesalamine of 2400 mgs. In my experience, i think it is very important to supplement oral mesalamine, along with both the day and night rectal mesalamine. I have used subsets of these in the past with no effect. I was also put on steriods for 3 months. I was fine when I was taking the steriods, but as I tapered them down, the symptoms came back. Only recently this combination of canasa + rowasa + oral measalamine has been working very well for me.

It took 3 weeks after starting the oral mesalamine and the suppository + nightly enemas to stop by clots and reduce the number of bowel movements. I also did 1 week of bowel rest + 1 week of budesonide.

After 2 years, my bowel movements have gone down to 3-4 in the morning, and for the rest of the day, I feel like a normal human being. Initially, I could not hold the enemas for more than an hour, but I did them anyways. Over time, as the symptoms reduced, I was able to keep them in for longer and now I am able to keep them in all night. Also what I ate made a huge difference. I think food may not always heal you, but it can definitely make things worse.

This is just my experience, it may or may not work for everyone. All the best! Keep trying and you will get there! I found the magic combination that seems to be working for me after 2 years!