journey2health said...
My doc questions my need to hold on to enemas in my treatment.
I would question your doctor's competence. Maybe the doctor should have a couple of flares and then decide what they are willing to do. There are plenty of studies that demonstrate the efficacy of doing maintenance enemas.
Here is a fragment from the article "Crohn’s and Colitis: Treatment of 5-ASA Responders And Nonresponders" by ELLEN J. SCHERL, MD:
Scherl said...
Because of the predominance of left-sided disease, the combination of oral and topical aminosalicylates is critical in inducing and maintaining remission. Safdi et al elegantly demonstrated that although topical mesalamine was more effective than oral in left-sided UC, the combination of 2.4 g of oral mesalamine and mesalamine enemas produced earlier and more complete cessation of rectal bleeding. For maintenance of remission for patients with UC, D’Albasio et al found that the combination of 1.6 g of oral mesalamine with twice-weekly mesalamine enemas was superior to oral therapy alone (61% vs 31%, respectively). Topical mesalamine (enemas and suppositories), used as infrequently as twice per week, is effective in maintaining remission in patients with distal colitis.
In another study, Biddle et al established that 75% (9 of 12) of patients randomized to receive mesalamine enemas remained in remission at 1 year, whereas 85% (11 of 13) of patients on placebo had relapsed by 16 weeks. Similarly, mesalamine suppositories maintained long-term remission in patients with ulcerative proctitis. By 12 and 24 months, respectively, 86% and 89% of placebo-treated patients had relapsed, compared with 32% and 46% of patients treated with mesalamine suppositories. A meta-analysis established that in patients with left-sided UC and ulcerative proctitis, topical mesalamine showed greater efficacy and fewer side effects than oral therapies and topical steroids.