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Uceris oral vs rectal foam

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Ulcerative Colitis
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Posted 4/21/2018 5:04 PM (GMT 0)
Was diagnosed last fall in my first mild/moderate flare and was put on Uceris oral for 8 weeks, plus Lialda. Immediately reached remission. Accidentally missed my Lialda for 3 days recently and started seeing mucous and light bleeding. I was traveling so I took the oral Uceris for 4 days, but doc wants me to switch the the rectal Uceris foam. Is this because it is better tolerated systemically? Bleeding has stopped but I still see some mucous. Any experience with increasing Lialda to stop the worsening of a flare? Hoping I can simply get by at this point without any more Uceris.
Posted 4/21/2018 5:18 PM (GMT 0)
The foam sounds kind of gross, but I actually found it quite soothing to my rear and was really helpful for me with urgency and mild cramping. The good thing is it is site-specific, plus there's a lot of pressure in those little bottles, and it shoots up pretty far. IMHO, it's really a good option.
Posted 4/21/2018 5:25 PM (GMT 0)
Of you're suspecting a flare then you should take 4-lialda a day.

How far in ectent is your uc?

Uceris oral treats the entire large intestine. Better for pancolitis.

Steroid enemas treat just the left-side, rectum + sigmoid colon. Better for proctosigmoiditis or proctitis.
Posted 4/21/2018 5:31 PM (GMT 0)
I am taking Lialda 3xday. I will increase to 4 today. Hated to suddenly double my dose. I believe that my initial diagnosis was involving the transverse colon? Just taking the 4 Uceris made the bleeding go away, but the mucous is making me a bit nervous. It’s sort of a “wait and see” for now. But if I have to start the foam, does it tend to have fewer systemic effects than the oral?
Posted 4/21/2018 5:37 PM (GMT 0)
Uceris and steroid enemas are both equivalent, 90% topical and 10% systematic. They're the equivalent of being on 10mgs of pred, so you're talking chance of the more mild steroid side effects of a steroid.

Transverse colon involvement required uceris, as enemas cannot go thay far. Tranverse colon goes horizontal from left to right side near your belly button. Enemas are limited to left-side only.
Posted 4/21/2018 5:54 PM (GMT 0)
Thanks. So my next question is: the nurse told me I shouldn’t really take more Uceris since I took 8 weeks last fall (ending in November).. is it dangerous to be taking it again 5 months later? Idk how often UCERIS can be used. Also, I wonder why he would give the foam if it was my transverse colon. (Just checked my lab reports and they showed mild activity in the transverse, sigmoid, and rectum. Pics looked worse in transverse. So honestly I should be on oral Uceris?

Again, I’m crossing fingers that increasing my Lialda will do the trick. sad
Posted 4/21/2018 7:23 PM (GMT 0)
For me mucous means rectal inflammation. That may be why he is suggesting a rectal foam. I don't think any oral meds that work topically (i.e. Mesalamines, Uceris) work on rectal inflammation. The Uceris is fine for the colon, but rectals are better for the rectum. I've been on Uceris, but its purpose was to treat inflammation in the upper left side of the colon. I was also using rectals simultaneously. I have no idea why the nurse said you can't go back on Uceris. That is completely incorrect. I would speak directly with your doctor and not the nurse.
Posted 4/21/2018 7:37 PM (GMT 0)
If 8 weeks is the maximum for Uceris, how often can you take it?
Posted 4/21/2018 8:03 PM (GMT 0)
The sigmoid and rectum is treated by enemas.

No limits on usage of uceris to my knowledge, but I'm no doctor *shrug*. Could be an insurance requirement? Could be recommended by uceris?
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