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Does pentasa enema cause severe abdominal cramps?

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Posted 11/19/2012 10:11 PM (GMT 0)
I'm still struggling w my rectal narrowing/stricture. For this I have to take a pentasa enema in the morning and a budesonide enema before bedtime. I used to have some cramps after inserting the pentasa enema. But this time it is different. Three days ago, whenever I inserted the pentasa enema I strarted to have severe abdominal cramps to the extent that I was crying and it could last up to 10 minutes until it stopped. As a result, I decided not to take the enema until I see my GI esp that the narrowing has become worse. Is this severe pain normal?

Your replies are highly appreciated.

Posted 11/20/2012 12:02 AM (GMT 0)
The "worst" pain I've had with an enema is not nearly as bad as yours. I've gotten the horrible cramping feeling (like you've got to go now!) accompanied with body shudders and goose bumps. Not nearly as bad as you were describing. However, that was enough to make me stop until I talked to my GI.
Posted 11/20/2012 7:16 AM (GMT 0)
The Pentasa enema has a LOT of liquid compared to the Rowasa or Salofalk...could be part of the reason you're having the cramping. Lots to hold while functioning rather than sleeping.

Try and switch to use the steroid one at night.

q
Posted 11/20/2012 10:23 AM (GMT 0)
ActiveUcer and Quincy, thank you. I take the pentasa enema during the day and not in the morning as I do not have the luxury to run to the toilet for 1 hr and then take the enema and wait for another half an hour for it to be absorbed. In the past, I could tolerate it but now it is causing severe cramping. I'll see what's my Gi's opinion regarding this today.
Posted 11/20/2012 8:07 PM (GMT 0)
Quincy, why does the Pentasa enema have so much more liquid than the Rowasa, do you know?

 

I was too curious to wait for Quincy to respond so I looked it up.  Pentasa enemas have 1 g of mesalazine in a 100 ml suspension.  Rowasa has 4 g of mesalamine in 60 ml of suspension.

Why does anyone use the Pentasa enema??????

minnietoty, why has your DR prescribed the Pentasa enema when the Rowasa enema has so much more mesalamine in it?  More is better in my opinion when trying to reduce rectal inflammation.

Posted 11/21/2012 5:57 PM (GMT 0)
Kazbern, unfortunately, I don't have Rowasa where I live and I'm stuck w pentasa. I saw my GI yesterday. After examination, he said that I'm really having severe cramps, insisted I take the pentasa enema though it causes me cramps, and prescribed a strong antispasmodic. He said that this is all caused by the narrowing and so I have to follow the prescriptions as I'm sick and I should not object to doses or meds until the inflammation eases:(
Posted 11/21/2012 6:24 PM (GMT 0)
I urge caution on the antispasmodics as I think they might cause constipation.

I am very very surprised that Rowasa or a generic equivalent is not available in your country. I would ask the pharmacist to confirm, or at least call around to other pharmacies.
Posted 11/21/2012 7:08 PM (GMT 0)
kazbem...yeah, 100ml is a lot to retain in my opinion...especially during the day??? that's torture. Night, well, OK.

I suspect 100ml will go higher as well.

q

Posted 11/21/2012 8:09 PM (GMT 0)
Kazbern and Quincy, thank you.
@Kazbern. I need antispasmodics at this stage as pain is unbearable. I'm sure Rowasa is not in my country. Yesterday, I failed to insert the budesonide enema after three attempts and lubricating the nozzle w K-Y jelly and lidocaine. Today, thanks God, I managed to take the pentasa enema and the cramps were bearable this time.
Posted 11/22/2012 7:46 AM (GMT 0)
Congratulations!! Since you can't use the budesonide enema, maybe use the Pentasa at night.

The Rowasa is a 5ASA, just as is the Pentasa. It's only available in the US.
What country are you in? You might have the Salofalk or Asacol available to you in the 60ml 2g or 4g dosage.

q
Posted 11/22/2012 9:40 AM (GMT 0)
Quincy, thank you. I'll ask my GI about the 4g enema the next time I see him.
Posted 11/22/2012 10:06 AM (GMT 0)
minnie: i hope you improve quickly with the pentasa. It is true the pentasa does come in 4g so you should ask for it. Otherwise you could use half the enema per day?

I don't want to 'insist' but if you haven't tried squatting yet i think you should...do it the proper way (on the floor) for a couple of days maybe a week or two and see if you improve...

Hope you get better soon :)
Posted 11/22/2012 10:22 AM (GMT 0)
Conquer UC, thank you. I promise I'll try squatting; honestly, I haven't tried it yet. The Sena laxative is making things better now in the morning but for the rest of the day I have to take glycerin suppositories to have a bm.
Posted 11/22/2012 8:35 PM (GMT 0)
Once the enema medication kicks in, your constipation should improve...try not to take the senna continually.

q
Posted 11/22/2012 10:12 PM (GMT 0)
Quincy, I appreciate it. I felt this today and had d till the middle of the day and then C returned.
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