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Rowasa VS Prednisone enema

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Ulcerative Colitis
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Posted 8/5/2009 10:03 AM (GMT 0)
Anyone find a big difference switching from a Rowasa enema to a Prednisone enema? Have been flaring for several weeks now and increased my 5 ASA from 6 pills to 8 pills and nightly Rowasa enemas. Better but still not where I want to be. Was thinking of trying the Pred enemas first before goiing onto oral prednisone which I tolerate very poorly.
Posted 8/5/2009 4:09 PM (GMT 0)
One works great for me and one doesn't. Rowasa doesn't do much. I usually notice a difference with the cortenemas next day.
Posted 8/5/2009 5:06 PM (GMT 0)
I'm totally the opposite- I can do the Rowasa's fine, but the steroid enemas are not my friend! I think it's because you use the Rowasas to keep yourself in remission, generally they won't stop a flare, but keep you from getting one. They're maintenance meds. But the steroid enemas, you use while flaring- & every time I tried to use those suckers, the inflammation was already so great the I could barely get the enema in, then once I emptied it, the urge was so quick & overpowering I'd jump right up & sit on the toilet. Bye bye steroid enema. I don't think you're supposed to use steroid enemas as maintenance...I could be wrong though. The few times I tried to nip the flare early with steroid enemas, I wound up on oral pred after all.
Posted 8/5/2009 9:44 PM (GMT 0)
I'm hardcore 5ASA meds, oral and rectal....you really need patience with them, however..

Are you improving at all???

I can't see why you'd NEED to be on pred....try not to think of it as an option, for it doesn't seem you're any where at the point where you'd need it...especially if you say you didn't do well on it.

My doc didn't even consider it for me when I ws going 20 times a day....patience...OK....I improved....better yet.....sick of waiting.....patience....OK....yep, it's working.


Hang tough....patience.

quincy
Posted 8/5/2009 10:02 PM (GMT 0)
Can you also increase your oral 5ASA doseage, or are you at the max? I'd also consider that before using the steroid.

I wish I'd been able to give the oral and rectal 5ASAs more time to work. I was almost into remission using them, then got a tummy bug which threw me back into the flare. By that time, I was running out of time to get better, as I had a 2-day-long job interview coming up, and knew I couldn't do it given my frequency and urgency issues. So I resorted to pred.
Posted 8/5/2009 10:05 PM (GMT 0)
Yes, there is some improvement and I know that you have to have patience because I have had UC for quite a few years now. However, I usually see a better and quicker improvement by now with the oral and rectal 5ASA meds. It has been almost 11 weeks of nightly enemas and still my movements are not right. They are thin and soft with blood. I have extreme peristalsis every night in the early morning hours with huge amounts of gas so needless to say I am now not sleeping well. Then first thing when I get up in the morning I have to hit the bathroom. I have tried prednisone orally and did not tolerate it well. However, when I first got UC my doc put me on prednisone enemas and 5 ASA and I did not do that badly. That is why I thought if I tried the prednisone enemas for a short time it just might break this cycle.
Posted 8/6/2009 1:56 AM (GMT 0)
The enemas (foam would be nicer to use...)might be worth a try then...in conjunction the 5ASA.

What oral dosage of 5ASA are you on?

You should ask the doctor if he can give you a prescription of dicyclomine, it's an antispasmodic. That might help the extreme peristalsis.

As well....consider fibre supplements.

q
Posted 8/6/2009 2:19 PM (GMT 0)
Topical steroids are entirely different than systemic- 11 weeks is a long time to see no improvement. I don't have that kind of patience.... Steroid enemas are quite safe to use on a regular basis for a fairly long period of time- I mean a month or 2. As opposed to oral steroids, where the damage they can do starts fast. I've spoken with both my GI & my PCP (& my daughters pediatrician- she does an steroid inhaler daily for asthma) about the difference between topical & oral steroids- they've all told me that to incur the kind of side effects/health problems you see with oral steroids, you'd basically have to apply/inhale the topical steroids about 50,000,000 times a day for about 50,000,000 years! If you think the steroid enemas will help, use them! There's no reason to be so uncomfortable- also, it sounds as if things are going downhill for you, not uphill- try to stop it now.  Hey Quincy, it's funny- I know you're totally anti-pred, yet you use an inhaled steroid for asthma! That's what my daughter uses, Pulmicort. Funny, no?
Posted 8/6/2009 3:37 PM (GMT 0)
Pulmicort is topical and it works well as a preventer. I have to double it at the first sign of a cold and then back to regular dosage afterward. My lungs are already scarred from untreated asthma and bronchitis..etc. yes, I worry about side effects like glaucoma eventually. Hope all of me falls apart at the same time..lol.

Could be considered ironic I guess, I'm against LONG TERM use of systemic prednisone as a first-line med for UC when 5ASA meds of oral and rectal should be tried initially...for UC anyway.
or at least used in conjunction with a fast pred taper..etc.

I use hydrocortisone cream on many inflammations on my skin..works in a day or two.

Steroids are a miracle med....but abused by the doctors for some conditions.

q
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