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hydrocortisone Enema - taking it for first time after lastest c-scope - need advice

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Ulcerative Colitis
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Posted 11/7/2007 1:52 AM (GMT 0)
Hey guys,

It's been a few weeks since I've posted, but I have been checking the boards and keeping meself in the loop. I just had my 4th colonoscopy yesterday, and the doctor said that he found some inflamation polyps, and that my sigmond, lover left colon and recturm were  "moderetly severely" inflamed. Currently I am on 12 asacol daily and 1 casana nightly. I am still waiting for the byopsy results, but my doc now wants me to take hydrocortisone Enema's twice a day (morning and night) :(......isn't there a non-steroid enema that I could try first? Also, i wasn't aware that you need to lay on your side for 30 minutes just to take the medicine! How do you guys do it? Do you just lay on the bathroom floor every morning and night? I don't go away very often, but I have some trips coming up for the holidays, and I can't imagine having to do this in a hotel room with my friends, family, or girlfriend........I had thouhgt I was finally doing better....this is very discourgeing news.......hopefully the biopsies wont show any dispasala.....(I had this show up once before, 2 colonscopies ago, but it hasn't been found since)....any help would be appericated..thanks

Posted 11/7/2007 2:49 AM (GMT 0)
I don't know where you got the 30 minutes from but it is not necessary at all. I take the Hydro cortisone enemas and I usually lay on my side to insert the medication and that's it. Sometimes I just bend over straight forward and insert it. After a few times it is really no big deal at all. I generally take this med before bed and therefore I am laying down soon after. The only problem I ever had was while in a flare it is harder to "hold" the medication. In this case, the morning dose can will be a bigger problem. but I have taken it at work in the stall by bending over.
It isn't so bad.

Yes there are other enemas, but this one works best for me.
You can ask you Dr for another type, like rowasa.

Good luck
Posted 11/7/2007 2:58 AM (GMT 0)
It is definitely preferable to lay on your side for 30 minutes after inserting the meds because it helps the medication distribute itself as far as possible in your colon.  It's not as bad as it sounds - you do get used to it.  When I was using enemas I would do them right in my bed before I went to sleep at night and just lay on my left side (usually fell asleep before the half hour was up).  In the morning - that one was tough - I had to wait till I finished my morning toilet run and then use it.  It was harder to remain laying for that long cuz I usually had to get out of the house - but stay in that position as long as you can - it's for your benefit.

Yes - you should definitely ask for Rowasa enemas first - before the hydrocortisone enemas.  It's the same medication as the Canasa in a stronger form - the Canasas are usually either 500mg or 1000mg and the Rowasa comes in 2g (2000mg) or 4g (4000mg).

Good luck.

Posted 11/7/2007 3:23 AM (GMT 0)
No, I have too much frequency in the mornings to have ever used it then, it would be a waste for me so I only have ever used it once at bedtime, sitting on the toilet (not laying down) inserting it and going to bed right after and it's always worked like a charm...it's that easy.

And a steroid based enema is more effective than a non-steroid based one, no need to be concerned about the steroid content, it's nothing compared to swallowing prednisone, unlike pred it doesn't go into your system the same way as oral steroids causing nasty side-effects.

Being a foam it absorbs almost instantly...another reason why you don't have to insert it laying down or stay laying down for any period of time afterwards...

I have almost 17yrs experiance with it so rest assured I'm speaking from alot of experiance with it and other rectal meds I've tried in the past and nothing compares for me anyways.

:)
Posted 11/7/2007 4:46 AM (GMT 0)
It's definitely preference. The foam would be easier to retain than a liquid, especially if using it twice a day.

The 5ASA retention enemas would be your best bet to increase you from what you're already using since you have no problem with 5ASA meds....but you could be using both.....the 5ASA at night and the steroid foam in the mornings.


Don't lay on the floor....lay in your bed and it's best to stay there for about a half hour if using the liquids considering where the inflammation is.

During your holidays....If you opt for the steroid foam enemas...I would think that you could do pb4's routine..no one would be the wiser and the comfort level would be optimal for during the day.

quincy
Posted 11/7/2007 1:21 PM (GMT 0)
Thanks for the advice guys! I'm at work right now so I have to keep this short. I will ask my doc about the foam enema's. I took one last night, and one again this morning, and so far, I've been able to retain the morning dose for close to an hour (and counting!). I'm hoping that I am able to continue to do this, as I am a bit suprised that I have kept in the morning dose for this long. How long has anyone taken the steriod ememas for? My doc gave me a two week prescerption, with one refill, and I am schedled to meet with him a week from tommarow. Is this going to be an on going treatment? Thanks again everyone..........
Posted 11/7/2007 2:16 PM (GMT 0)
been on the hydrocortisone e's for a month now and first few tries were a little difficult, but I do them at night in bed and when I was flaring really badly it helped me to lay on my left side b/c when I would move I would have to have a bm and lose the 'e'.  Now that my bm's are semi formed and no blood it is much easier to retain.  Also, I did take them a few times in the am when I did not hold it at night well and laid down for a 1/2 hour then was able to keep it in from 4 to 8 hours.  I believe this medicine really helped me (took a couple of weeks) and hope it does the same for you.  I was going 25+ times a day with blood, d, & nasty cramps and the past week has been 2 to 5 times a day no blood, no d and only slightly cramping when I have to go (not the kind I had before where It hurt so bad I thought I would throw up from the pain).  And before this week I was going 5 to 10 times a day.......taking it day by day.

Posted 11/7/2007 4:32 PM (GMT 0)
Pb4 seems to be advising you to try Cortifoam (10% steroid rectal foam); I agree that it's definitely easier to use/retain in the mornings-- also easier to travel with as it comes in a compact box with washable, reusable applicator. The liquid hydrocortisone retention enemas are much faster-acting than Rowasa mesalamine enemas-- so if you need quick relief from major symptoms, they're definitely the way to go. If you stay on them longer than 21 days, you will need to taper off gradually. You may experience a big increase in appetite if you stay on them longer than a few weeks. They can heal inflammation as far up as descending colon-- that's one reason you should try to lie on left-side for 30 minutes after instilling the liquid. It gets easier to do this after the 1st few times. Try your best to retain it all night. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily; seem to be back in remission after July flare)

Posted 11/7/2007 4:36 PM (GMT 0)
Hey, Beth 75, so wonderful to read that you're doing so much better! (Sorry to hijack the thread). How's the progress going on your kidney problems? Hope it, too, is moving in the right direction!!!

Mitz
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