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Salofalk foam enema (update & advice)

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Ulcerative Colitis
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Posted 1/24/2012 9:40 AM (GMT 0)
Hi again,

my son started the foam enema on friday night and the stubborn remaining trace of blood was gone from his stools by Monday. There was not too much blood left but it has now vanished completely.

Now, how long do you think we should keep up with the nightly enema? I was reading that some use twice a week for maintenance.

I know the taper should be gradual and I was also thinking of getting the 1 gram supps that Notsosicklygirl mentioned to use on a nightly basis.

What are your thoughts on this, 1, how long to continue on the nightly dose of foam, 2,how long to stage the taper over.

Steve

Posted 1/24/2012 1:37 PM (GMT 0)
I would do the foam for at least 2 more weeks and then slowly start tapering to every other night then to every 3rd night. Don't taper too quickly though or symptoms may start to creep back.
Posted 1/24/2012 3:31 PM (GMT 0)
Thanks for the reply, ok 2 weeks it is with no symptoms and then a slow gentle taper.
During and after the taper do you still recommend the use of the supposotories?
Posted 1/24/2012 3:41 PM (GMT 0)
I hope your son stays well, and that he goes into remission, you are doing a wonderful job it would not be easy. My thoughts are with you, UC should not be aloud near children they should get a free pass.

mum of 3
Posted 1/24/2012 6:13 PM (GMT 0)
Either the enema or the suppositories can be used for maintenance I would think. I myself use the Rowasa enemas and have had great success with a maintenance dose. I defintely would use something at least twice weekly and of course more frequently if symptoms start rearing their ugly head.
Posted 1/24/2012 6:20 PM (GMT 0)
So you do an enema twice weekly with no other rectal meds during maintenance periods?
Posted 1/24/2012 7:15 PM (GMT 0)
Yes, the enemas would be the best bet rather than suppositories since the dosage is the same.

Is he on oral 5ASA as well?

Just because bleeding is gone, it doesn't mean inflammation is. What other symptoms is he having...meaning how often bms? urgency? hard stool? skinny stool, mucous...anything.

q
Posted 1/24/2012 8:13 PM (GMT 0)
This last spot of blood, and I mean spot, shaving cut size spot of blood on the toilet paper was the remaining symptoms of a flare. He was having on average three well formed movements a day, no urgency. He also takes 2 x 500mg pentasa 3 times day orally.
He was also taking an evening and morning suppository 500mg asacol.

It started to become apparent that his rectal meds might not be sufficient, I came on here and asked for some thoughts.
We were recommended to try salofalk foam, which we have, the blood vanished and he is now having two movements instead of his usual three.
The stools have been well formed for many months.

What do you think an initial maintenance regime would be, I know we will fine tune with experience.
Posted 1/24/2012 10:14 PM (GMT 0)
Not that many members here have experience using the mesalamine foam-- because it's not available in N. America. Sherbear's advice on tapering sounds wise to me. You can check Knitty-cat's old posts again; I think she tapered to 2X weekly foam + her daily oral 5-ASA. Make sure your son drinks plenty of water daily & he should do fine between the 2 maintenance meds. Basically, he is on the right track to a solid remission from what you write. / Old Hat (31 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 1/25/2012 5:08 AM (GMT 0)
he's using the enemas twice a day? and how long on the foam?

q
Posted 1/25/2012 9:04 AM (GMT 0)
Ht oldhat, knittty_cat sticks to two doses per week for maintenance. And it appears she does not use any other rectal meds outwith these two doses.
I would like to cut his oral meds down during a maintenance period also, maybe drop from 6 tabs to four tabs a day, for a few weeks.

Hi Qunicy, he takes the foam once a day, started last friday, last trace of blood away by sunday.

We only found out about the foam enema on here, no mention of it from our GI, they just kept saying to keep going with supps and the orals. The foam would have had him sorted out months ago.

So now we will keep him on the nightly foam for 2 weeks and then cut him down to every second night for a couple of weeks and then down to every third night, which is basically twice a week.

Do you think we can now forget about the 500mg asacol supposotories and concentrate on the foam only?

Post Edited (Antiflare) : 1/25/2012 10:43:04 AM (GMT-7)

Posted 1/25/2012 5:51 PM (GMT 0)
Oldhat/Quincy

Any last words of advice before I let this thread dissapear to page 2?
Posted 1/25/2012 6:57 PM (GMT 0)
I didn't know you had to taper off Salofalk enemas? I use it every night at the moment for the last month, today in hospital he wants me to keep the same treatment, my next visit is end of march, they were very pleased. My blood has come good except for my iron being a bit low but that has been the usual for the last two years.
Posted 1/25/2012 7:15 PM (GMT 0)
I'm just learning about them too "lifesover".
Posted 1/25/2012 10:11 PM (GMT 0)
Antiflare-- my opinion is that he doesn't need to continue supps if he's on the oral med + foam. But you should NOT decrease his oral med without consulting the doctor who RXed it! / Old Hat (31 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 1/26/2012 5:08 PM (GMT 0)
Thanks again oldhat,

The GIs that he has seen, all say to reduce the oral meds a month after there is no blood and to establish a maintenance dose, could be 2 x 500mg Pentasa twice a day, or even 3 x 500mg once a day.

We will deal with the rectal taper first then look at the oral reduction.

Nice to talk to you (all)

Steve

Posted 1/26/2012 6:31 PM (GMT 0)
Glad to hear that your son benefitted from HW forum advice. / Old Hat (31 yrs with left-sided UC; presently in remission taking brandname Colazal)
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