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Enema & Symptom Control vs. No Enema & Mild Symptoms

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Ulcerative Colitis
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Posted 1/26/2012 10:27 PM (GMT 0)
I just saw my doc today and was sort of aghast when she suggested enemas. Basically, I just have active inflammation in the rectum right now, and, by administering medication from the bottom up, so to speak, I could make my symptoms totally disappear.

Of course I was like, "No, thanks," but - now I'm getting used to the idea and wondering whether it might be wise.

Do you guys do this? Is it a big deal? How often do you do it (I forgot to ask this). Is it expensive? Are you freaked out about it in front of your spouse? I think it would be like an Asacol enema or something.

If you could make symptoms disappear for awhile just by doing this, would you? Or would you just put up with colitis symptoms in order to avoid the imposition?

Any and all thoughts/comments appreciated. Like I said, this is brand-new to me (although I've been on oral asacol for 7 years), and these are just my initial reactions. I thought some people with a more mature perspective might be able to help.

Thanks!! Sarah
Posted 1/26/2012 10:35 PM (GMT 0)
Why wouldn't you want your symptoms to disappear completely? You know that the longer you have active inflammation, the greater your risk of colon cancer is, right?

Many of us have great success with the enemas. There's nothing to be freaked out or embarrassed about. It's just a medication, like Asacol. It's pretty inexpensive if you get the generic mesalamine enemas. They really aren't bad at all and have kept me from from flaring for the past 4 years and got my initial severe flare under control with the help of Asacol.

Sounds like you have a great doctor. I had to ask my doctor for enemas. I would call them back and say you would like to give them a shot.
Posted 1/26/2012 10:43 PM (GMT 0)
Sara - I know - the connection between colon cancer and inflammation makes it a no-brainer, now that I see it in writing. I'm also upset about "needing" another type of medication - irrationally, it makes me think that the disease is getting worse.

Again, though - if I write it out like that, it's obvious that I need to go ahead and try it. Thanks!!
Posted 1/26/2012 10:43 PM (GMT 0)
Yes to enemas, one of the best ways to get inflammation down at the very bottom.
Even if your symptoms are mild there may still be inflammation which needs to be reduced. Inflammation untreated over a long term could cause cellular changes and that's not good. Think of an ulcer that never heals.

I don't know how much it will cost for you but it's about $8-$9/enema when I get a months worth. I have insurance but high deductible so it is paid by me. Is it worth it? Yes, absolutely.

Re: spouse. I go to bed before my DH so no problem and on "date" nights do it afterwards because he's a nightowl who gets up to watch TV. Some people can use their enemas standing up but I can't do it, have to do it in bed lying down and then off to sleep.

It takes a couple times before you get the hang of it but once you do it's easy as 1-2-3 sleep :-)

You have a good doctor.
Posted 1/26/2012 10:45 PM (GMT 0)
Enema's either Meslamine and/or steroid... suppositories... you name it, if it controls my flares, Im totally down with it-
(Its a good thing)

Carlie
Posted 1/26/2012 10:49 PM (GMT 0)
I was scared to use them at first too, but they honestly aren't as bad as they seem and they really help for rectal inflammation. You can always ask your husband to leave the room for a minute while you do the enema...that's what I did when I had a boyfriend. You should do them nightly until your symptoms disappear, then gradually you can taper them down to maintenance.
Posted 1/26/2012 10:55 PM (GMT 0)
I've been using rectal meds for years. I go through phases wehre my symptoms are better and worse, when they are great, I use them less frequently but I keep them in the routine to keep the inflammation to a minimum. I definitely think you should give them a shot. As for being embarrassed in front of your spouse, mine doesn't see me doing them. He wouldn't care regardless, I always run to the couch and say "I just squeezed a bottle up my butt", haha. He wouldn't know if I didn't joke about it. They can be difficult to retain if you're flaring and it can be comfortable for the first few minutes which may give it away but if you can breathe deep and relax, you can usualy retain it the whole night and you may notice improvement in your symptoms very quickly. I do the enema in the bathroom and then I lay down on the couch or in the bed and fall asleep. It's not a big deal.

Another good option are the suppositories. I pop those in in the morning and I have no problems. No one would ever know you used those, they are easy to retain. When I was flared up, I had trouble retaining anything, even a suppository. How terrible that was!

Welcome to the UC forum. :)
Posted 1/27/2012 1:55 PM (GMT 0)
Enemas are really no big deal once you are used to it. They are definetely worth using especially if the rectum is where your inflammation is. Pills have a long way to go before they reach that area...the enemas are right on it immediately. Good luck.
Posted 1/27/2012 3:13 PM (GMT 0)
Enemas really helped my first flare get under control quickly. Yes at first I was embarrassed and even shed a few tears in shame that I had to do this type of treatment to myself every night. I thought it would end the intimacy between my spouse with this nightly ritual. Fortunately my hubbie was understanding and we both realized that I just needed to get better. That was the focus and within a week my urges were under control and I was able to function. Once the initial flare was over I resumed a normal intimate relationship with my spouse and we were just so happy that I was feeling better. I went 7 years without taking enemas again. Right now I am having another bad flare and I am unable to hold the enemas in at all. Every other night I try again because I know how effective it can be. I can't believe I am looking forward to taking them now! Currently taking 40 mg of Prednisone with slow progress.
Posted 1/27/2012 3:26 PM (GMT 0)
It's always a catch 22 with this disease.

But a good thing to ask your doc, is if your already taking oral 5asa (meslamines) like Asacol, maybe that dose needs to be reduced a bit so that you can start enemas (as they too have side effects). And my doc brought it to my attention that too much meslamine in the system can cause alot of side effects.
Posted 1/27/2012 5:34 PM (GMT 0)
sarah- I understand your initial reaction to the idea of an enema. I felt the same way 10+  years ago when my GI doc first prescribed them  for me. gross, yuck, how could I possibly do that... Well they can help to  with disease that is limited to the bottom end. And they can work well to get you in full remission. They can even be used as maintenance therapy. They are better for your body because the drugs are not systematic and they are targeted and hitting right at the disease. So even  now after years of UC and currently a failed jpouch with bad diversion pouchitis, I am still doing nightly enemas.

So try it first when your spouse  is not even in the house. You won't feel rushed, weird, or embarrased. Despite the directions, try it lying down on your bed first. Its the easiest. Then each night just  ask the spouse to leave the room for a few minutes so you can "take your medicine". Its generally best if you lay still for awhile  afterwards.. helps you retain it. Its not a big deal and it can possibly help you.

Posted 1/27/2012 6:16 PM (GMT 0)
Sarah, in response to Stereofidelic's post: Just FYI, you should know that I and at least one other person on this forum have taken as many as 16 Asacol a day plus enemas with no problems from side effects, so don't assume you need to cut down your pill intake just b/c you're starting enemas.

They (the enemas) are truly not a big deal. You do them at night in bed as the very last thing, and then go to sleep, throw out the bottle in the morning. The hardest thing for me was learning to fall asleep on my side (I was a back sleeper!)-- but pregnancy cured that problem.
Posted 1/27/2012 6:37 PM (GMT 0)
Okay, guys, for real - thank you to each of you for your candid answers - because, like you probably know, there's no one in life I can just walk over to and just chat up about the realities of colitis. I'm not really one to go around talking about all my business - especially this business - and I can't believe how much better I feel, I don't know, just reading and interacting with other humans who deal with the same thing. Seriously, thanks for every single answer - I appreciate that you guys took the time.

I told my husband about the doctor's suggestion - he looked at me like I was off my nut when I told him what I told you all. So I guess it's on - I'm calling my doctor back on Monday. I'll run the dosage thing by her - I was on those 16 Asacols per day too (they switched me to the Asacol HD and now there's 6 gigantic ones).

Thanks again - I might be posting all kinds of questions now - I have, like, 7 years' worth of wondering built up.

<3 Sarah
Posted 1/27/2012 8:26 PM (GMT 0)
I personally think your oral dosage is too high....but you can consider to taper them when you're on the enemas. I would suggest you go back to the Asacol 400mg so that tapering is more gradual...but that's my opinion. But, the 800mg dosage is still much lower than 1200mg of Lialda.

Hang tough...it's difficult to get a handle on the whys of the disease and how it's happening to you.

q
Posted 1/27/2012 10:41 PM (GMT 0)
16 asacol a day - wow! I used to be on 6 a day before I switched to 9 a day of Colazal (hopefully to go down to 6). 

I'd say take the enemas. Once you feel better and are basicly symptom 'free' you will barely think much of taking them. It just gets to be part of your life like anything else you get used to.  And you may not need to take them everyday forever either.  Only thing I can say is they do increase the amount of gas I have, but I guess that's just another thing you get used to!  Better than being in pain for sure.  And they work fast cause they get right to the cause of the problem!

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