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I just started rectal meds & am wondering ....

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Posted 9/22/2010 7:40 PM (GMT 0)
First, thanks to all here for normalizing the idea of rectal meds for me.  I was disturbed by my experience of tapering prednisone and, no doubt irrationally, blamed the prednisone for the fact that my symptoms worsened as I tapered off to finally be much worse than I'd experience before in this flare or in my initial flare.  Because of reading here about others' experience with rectal meds and also with the idea that oral mesalamine might not be reaching as far as its needed, I suggested to my doctor that I start cordisone enemas, to which he readily agreed.

I just started last night.  I actually put off starting them for five days because it appeared to me that I might be going into remission and I wanted to see whether that remained true.   I changed my diet pretty radically about 2 weeks ago and that seemed to help (basically a low residue diet, but I've been saying I'm only eating "white" food -- rice, pasta, potatoes, a little fish, a little turkey, cottage cheese, yogurt). 

Yesterday I was a little more wobbly than I had been for the preceding few days (more urgency, more frequent trips to the bathroom, although not nearly as many as had been true even just 10 days ago), so I started the enemas last night.

So this morning I had my first relatively normal bowel movement since May or June, but then I had much more of a sense of "incompleteness" than I've had in a long time, too.

So could those who have had longer experience with rectal meds compare this to their own experience?  Did you have an immediate response like this?  Could formed stool, as opposed to liquid, create that "incomplete" feeling? 

Also, are the enemas used as maintenance meds in remission?

Thanks to all.

Posted 9/22/2010 8:17 PM (GMT 0)
I usually have a pretty immediate response to steroid enemas, too.
That sense of "incompleteness" sounds to me like what I feel when there is some low rectal inflammation. Maybe the feeling was from friction from this first sold stool after a long time of looseness ...?
I usually stay on the steroid enemas for a week after my symptoms have stopped, then start to taper them. Have you tried Rowasa - the mesalamine enemas? I usually work those in as I taper off the steroid enemas.
Rowasa, twice a week, is a common maintenance med to prolong remission. The steroid enemas, while a lot less nasty than prednisone, are still steroids, and aren't to my knowledge viewed as maintenance.
Posted 9/22/2010 8:38 PM (GMT 0)
Thanks very much -- I haven't tried Rowasa, but am absolutely open to the idea, since Lialda (+ acupuncture) was all that was needed to put me into remission the first time. I was kind of thinking along the your lines w/r/t the discomfort after a solid stool.

I feel a lot more comfortable with the idea of a twice weekly enema before bed than with a nightly one. My boyfriend is really really understanding but I would strongly prefer to not have to do this on the weekends, which he spends with me.

Thanks very much.
Posted 9/22/2010 8:51 PM (GMT 0)
I think that "incomplete" feeling is common, so common it even has a name... Tenesmus.

You can read about it here:

www.nlm.nih.gov/medlineplus/ency/article/003131.htm

I get all kinds of weird sensations like that when things are healing up.

Of course straining can be bad, especially if you are prone to hemorrhoids. No need to rush things really, even if you have to go back a few times to pass everything without straining.
Posted 9/22/2010 9:13 PM (GMT 0)
Oh, absolutely, I have a lifelong commitment to no straining, dating back to at least 20 years before I was diagnosed with UC. :-)

Thanks for the link!
Posted 9/22/2010 9:53 PM (GMT 0)
Tenesmus definitely was a sign of a flare or rectal inflammation for me. It's a very frustrating and discomforting symptoms. Hope you feel better.
Posted 9/22/2010 11:19 PM (GMT 0)
For me when the rectum and sigmoid start to heal, the first bit of stool is sort of puddy like and adds to the difficulty in passing it. Should firm up after a few days if you are like me.
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