Enemas

yay....ask for Rowasa retention enemas (I'm assuming you're in the US)..and don't start with suppositories.

q

Sounds good, Quincy if you've ever taken 5asa oral tabs (like Asacol) do you find Rowasa enemas are similar (just applied in different means)? Same side effects follows with all meslamines?

The mesalamine enemas are essentially the same medication as the 5-ASA oral meds. So yeah, same side effects are possible. If you are tolerating the oral meds you will do fine with the rectal meds.

I used brand name Rowasa for the first few years....took a break....returned to Rowasa and had a horrible reaction. Then my DR switched me to generic and it was fine. I have no idea what happened. I've been using oral 5-ASA for 11 years now with no difficulty.

i honestly don't know of a good enema to use. i have tried a few different kinds (sulfa, mes, and cortico) and none of them helped me. i was very strict about using them nightly, too, for the whole prescription.

Crohn's/ UC.....meaning crohn's colitis? not both.

I've been on asacol since diagnosis .. 23 years ago.

Is your inflammation limited to the rectum?

I wouldn't suggest going off the asacol. But, it's YOUR colon.

q

while oral 5-asa have relatively few side effects (compared to drugs like Pred or immunosuppressants), and are said to act mostly topically, there is some systematic absorption. I have been told that the systemic absorption of the enemas is LESS, so that would mean less side effects.

However, I had some increase in bleeding and pain after the 1st week of Rowasa. Guess that counts as a side effect. My GI said this sometimes happens, and added hydrocortisone enemas for alternate nights or for several nights weekly. (I ended up taking a mix of the two most nights, and seems to work well).

Initially retention was an issue. The hydorcortisone reduced inflammation and really helped me tolerate/retain the Rowasa. Now after a few months, retaining all night and getting good sleep is just not an issue, but it can be a hassle at first if the condition of the rectum and sigmoid is poor.

If the UC is mostly in the sigmoid, then I think it makes sense to taper down the oral meds to maintenance levels, where they can insure your UC does not spread to transverse or right colon. Possibly switch to Lialda and only do one or two tablets daily.

I would give some pause to enemas and slipper elm together. The 5-asa needs to act topically and you may not get full benefit of the enemas if you mucosal lining is coated with slippery elm. I don't this this potential interaction has been clinically studied.

 

Thanks everyone. My diagnosis was that I had severe inflammation in the descending colon and the rectum, everywhere else was perfectly normal until you get up to a severely inflamed cecum. I meet with my doc tomorrow and I'll be sure to talk to him about Rowasa Retention Enemas and other 5asa's...

His cecum is inflamed because he probably has Crohn's. That's why his signature looks the way it does. My disease presented this way too. Severe inflammation in the rectum and cecum. Hardly anything in between. I also had small ulcers in the TI. It's all very confusing to a newbie. My first GI never looked beyond the sigmoid colon. My 2nd GI found the cecum inflamed but did not call my IBD Crohn's until I showed significant improvement with Pentasa (after having tried Asacol for years with little improvement).