Oral meds for proctitis?

Have scopes scheduled for April 6th... I’m definitely not getting worse. The mesalamine works. After a little over four months on combo therapy I seem to finally be in a groove where things are going okay. Most days are great. Tiny bit of blood maybe three BMs within the last month. As I said above the GI mentioned possible Remicade to knock it out but I’m not going there yet! I don’t think I need it at the moment. As for steroid comboing with mesalamine, I have not tried that yet but I will give it a shot in the future if I need to.

Doc says to stay on the exact regimen I’m on until at least after colonoscopy assessment... assuming things stay ok, I’m kinda wondering if I should drop down the Lialda or start tapering rectals first. Seems everything with treating this is experimental anyway. I’m treading very lightly as it can take so long to feel “normal.”

One question I have is what probiotics y’all might recommend post-scope. I haven’t done research yet but I wonder if that prep solution could blow some good bacteria out of the gut. What do you think?

Totally, I pushed for a scope despite my last GI telling me based on my symptoms that my condition is still mild proctitis. The PA waved me off based on inflammatory markers being normal too (which I’ve heard doesn’t necessarily mean anything). It’s been too long since the last one and I need evidence. I keep getting the feeling I’m *almost* in remission but how can I really know without proof?

I got Suprep. Dreadful stuff! Looking forward to getting conked out with Propofol though. I’ve had good luck with that one.

Last one was in 2015... I’m planning on going every 3 years from now on, provided things aren’t worsening. So I’m trying to get ahold of the GI to ask his advice but figure I’d ask here as I haven’t talked to him yet: would you take an oral med like Lialda on an empty stomach (fasting) the day before the test or just skip it? The bottle says to take it with food which makes me think it can be hard on the gut. I don’t want to rip my gut up before the scopes but I don’t want to flare more from missing a dose... I’ll still be taking Rowasa the night before the test.

Had the scopes today... went well. Here’s some results from the tests:

Endoscopy - non-bleeding duodenal ulcers. Everything else appears normal.
Colonoscopy - non-bleeding internal hemorrhoids. Mild inflammation in rectum and sigmoid. Everything else appears normal.

Biopsies were taken throughout. Waiting on the lab results.

Told the doc again I don’t want any oral steroids. My guess is I’ll be trying twice daily rectals again (for a longer period of time) to see if that works. Not sure about the duodenum thing yet but it might explain my weird stomach symptoms. All in all though - no terrible news.

Thank you... Still waiting on labs... I’m thinking of requesting either hydrocortisone enemas to try short-term (3-4 weeks) in the morning, budesonide foam or cortifoam. I noticed the foams recommend twice daily use for the first few weeks before dropping down. Is there a dosage limit to using rectals this often? At most I’d be getting two doses of steroid per day and a mesalamine 4G at night for a month... seems like a ton of action back there. Haha.

Thinking of bumping up to 4.8G Lialda for a while, too. I’m determined to try whatever I can to avoid pred or biologics if I can. I’m having to be insistent with my doc on this. As I said, my disease has been identified as mild by two scopes almost six years apart. It hasn’t crept up the colon either. My symptoms aren’t terrible, I just haven’t been able to get sustained remission. My gut is telling me I don’t need big gun meds so far. Maybe more dosing with rectals is my ticket. Gotta give it the college try anyway.

lots of fine folks have found small dietary changes can make a definite positive change in symptoms - have you ever tried tweaking things a bit ?

TT