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Rectal meds question

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Posted 2/20/2010 8:26 PM (GMT 0)
I've been struggling with mild to moderate bleeding on and off for almost a year after receiving IV antibiotics last year (and trying various different things including fecal transplant as many of you know). After the lack of success with FT, I started on a regimen of 2 1000mg Canasa twice a day. That stopped the bleeding after about a week or so, but I continued to have noticeable irritation at the "Irritated Site", which according to a anoscope my doctor did in December, is located right above the anus inside the rectum. The irritation improved somewhat after a couple of weeks and I reduced the Canasa to once a day, usually in the late morning or around noon. FWIW, I don't have any other sypmptoms and have just one or two BMs per day. I'm also fighting off a cold with a lot of phlegm in my chest.

A week ago, I decided to give Cortifoam a try to see if it would resolve the last bit of irritation, but I haven't really noticed much improvement. I have seen one teeny, tiny speck of blood on two different days in the past 2 weeks, so I feel like it's BARELY under control. I try to get the foam as near to the end of the rectum as possible since that's where the last bit of irritation is located.

I'd like some suggestions on how to proceed. Should I keep up the Cortifoam for awhile longer, or should I start doing alternate days of Canasa/Cortifoam, or go back to Canasa? I'm also wondering if cort suppositories would be worth trying. I also have to look at cost - the cort suppositories are really cheap with my insurance (like $10 for 30 of them); Rowasa, Cortifoam, and Canasa are all frightfully expensive (hundreds of $$ for one month). I have a decent supply of Cortifoam and Canasa right now.

I'm also a little anxious about using the Cortifoam for too long since it's a steroid.

Thanks in advance -

Kathy

 

Posted 2/20/2010 8:42 PM (GMT 0)
You see by my signature that I tried a lot of things.  When I changed to a better specialist he tapered me off prednisone and my prescription was Cortifoam 3 times a day (most times I only did twice due to scheduling)followed by Anusol suppository which is also steroid.  He said the suppositories would help heal the last bit of my rectum next to anus.  So, maybe that is what you should do - maybe!  I felt that "pushing" rectal meds got me into remission.  I have no more blood, mucous, urgency or D.  I have IBS so I have loose stools occasionally and take Imodium for that.

ElaineNY

Posted 2/20/2010 8:54 PM (GMT 0)
Hi..your inflammation limited site is one of the most difficult areas to deal with.

I'm wondering if you might profit by adding another type of rectal med such as proctocedyl which treats hemmies as well...

Are you on any other 5ASA oral meds?

When was your last c-scope? Where was your original diagnosis...throughout or limited?

quincy
Posted 2/20/2010 10:01 PM (GMT 0)
I'm on sulfasalazine - 2 500 mg tabs twice a day (doing the "attack from both ends" theory). Sometimes I take 3 at a time, but it doesn't seem to make much difference one way or the other.

I've only had one scope in 2006 when I received my initial dx. The GI said "mild" UC and it was in a couple of spots, but not throughout. This past year is the first time I've had the irritation so near the end of the colon. My symptoms prior to dx were painful gas, bloating, constipation, mucus and bleeding. The sulfa immediately cleared everything up for the first year, but then I started getting loose stools. I started the SCD diet in July 2007 and was completely symptom-free and med-free within a year, and for almost a year after that. It's only since I got those IV antibiotics that I've had this bleeding problem. Overall, my UC is more of an annoyance than a real problem ... but this spot is very stubborn!

The proctocedyl looks interesting. I've never heard of it, but looks like it's a cortisone ointment. That seems like it would be ideal because I think the foam and supps end up going too high. I was almost going to try some OTC cortisone ointment but was afraid to use it internally since they all warn "not for internal use."

Thanks for the suggestion, quincy!
Posted 2/20/2010 10:53 PM (GMT 0)
There are also the proctocedyl supps to maybe use in conjunction with the ointment. It's just a suggestion, but one never knows what can work. I use both for hemmies, mild inflammation and fissures.

I suggest good quality probiotics as well as fibre supplements.

How many bms are you having daily?

I think you should get another look-see....and UC isn't in spots..it's possibly you have Crohn's rather than UC.

q
Posted 2/21/2010 2:06 AM (GMT 0)
I just have one or two very normal BMs daily - actually I've had better form and regularity than I've ever had since getting UC - but I think that's due to being on the SCD diet ... which gives me plenty of probiotics via yogurt and fiber from fruit and veggies (no grains).

Heh heh ... think I may pass on doing another c-scope unless things get markedly worse. That prep was worse than any UC problems I've had. <groan>
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