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Resistant proctitis?

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Ulcerative Colitis
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Posted 10/26/2012 7:39 PM (GMT 0)
I have been suffering from a proctitis flare up for almost 4 months now. Things became worse when I injured myself w the tip of the enema. So, both my GI and surgeon decided I should switch to suppositories ( which have never been effective) and I take 4g oral pentasa. In my last visit to the colorectal surgeon, he added metronidazole suppositories for 5 days. I took it w pentasa supp and things started to become manageable. After the 5 days elapsed, I'm suffering: the rectum is very much swollen from outside, there is dull stabbing pain going up my rectum, I can't either sit or lie down and my bms are almost watery. So, I called the surgeon and he told me that this is called "resistant proctitis". He was very upset and told me that I usually responded to meds and told me to repeat the metronidazole for another time only. Did anyone have this before? How was it treated?
Any advice will be highly appreciated.
Posted 10/28/2012 2:14 PM (GMT 0)
I had really bad inflammation in the rectum and lower sigmoid for over a year with my last flare. It was so bad that I had to wear adult diapers at times because of the urgency.

After trying just about everything, the thing that finally cleared the inflammation out of the rectum was the triple antibiotic therapy (Metronidazole, Amoxicillin and Tetracycline),

www.ncbi.nlm.nih.gov/pubmed/20216533

My other option was Remicade. That will be the next treatment I try should I flare again, but I've been in remission for about a year now just using asacol and rowasa (overnight).

Even though I have days where I have extra trips to the bathroom (no blood or mucous) if I eat things that irritate my scarred and beat up colon (whole grains, junk food, spicy foods, soda, etc), I do not have urgency issues any more now that the rectum is clear of inflammation, and that makes a huge difference.

I am eagerly awaiting the approval of vedolizumab. I think it will be a better choice than remicade for UC since it only suppresses the immune system in the gut instead of your entire body.
Posted 10/28/2012 6:36 PM (GMT 0)
C_G_K, thank you very much. I really appreciate it. My GI accepted that I increase both the metronidazole supps and the pentasa supps to two/ day. I'll give it a try though I have watery D. And if I fail, I'll ask him about this triple antibiotic therapy.
Posted 10/29/2012 12:19 AM (GMT 0)
Did you try oral flagyl or just suppositories? I am surprised he gave you metronidazole instead of canasa. Are the pentasa supps 500mg or 1000mg? What about a steroid supp?? That may help with the rectal inflammation.
Posted 10/29/2012 1:51 PM (GMT 0)
Notsosicklygirl, thank you. There is no canasa where I live. The supps are not working so I returned to the enemas though I'm having now severe abdominal cramps.
Posted 11/7/2015 3:18 PM (GMT 0)
Hi, I have been dealing with proctitis for over 3 years now. I have been on nearly everything, Oral and rectal steroids, flagyl, biologics (remicade messed me up more), canasa suppositories, and now this triple anti biotic therapy that i found on here. Now it has been only a week but I was wondering what you dealt with while on the triple anti biotic treatment and how long it took to start being able to have normal size BMs again. I am tired of going skinnier than my pinky finger leaving me feeling like I didn't get enough out and backed up all day. Since I started this new treatment I feel intermittent throbbing down there instead of just numb and stiff which I guess is a move in the right direction.
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