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Doctors apointment soon want information on meds

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Ulcerative Colitis
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Posted 12/17/2012 7:02 PM (GMT 0)
I am going to the doctors this Friday. Previous to my current flare I was in remission for 6 months and tapered off all meds. I flared for 3 months before getting back on mesalamine in the form of Asacol HD and enemas. I went from over 15 trips a day to now about 6 to 10 but am still seeing blood and having painful cramps.

I am thinking of asking to do a pred taper since this has gotten me out of a flare in the past and it has been over a year since last I took the vile crap. I am curious about hydro cortisone enemas since reading about them here can they be used together with prednisone or in place of?

Id like to know whats up with these enemas before I go in on Friday and hope this time next week I really go back to remission.
Posted 12/17/2012 7:09 PM (GMT 0)
How long have you been on Asacol and enemas again? If it's not been that long, and you're still improving (even if it's slowly), I'd just stay the course.

However, if it's been a while and you're not noticing further improvement, I'd for sure try the steroid enemas before oral pred. The chance of the nasty steroid side effects are much less with the enemas. I suppose they can be used with oral pred, but I'd try them in place of oral pred first.

Once you get back into remission, I highly recommend you stay on both oral and rectal mesalamine. I still use oral meds daily and enemas twice a week and I've been in remission for 3.5 years now.
Posted 12/17/2012 7:20 PM (GMT 0)
Not sure about your enema question although I think you can do both. Many people take oral pred and mesalamine enemas as a treatment. One thing you should know is that prednisone is not a cure. It merely weakens your immune system, giving your colon time to heal. Once you taper down or get off the pred your symptoms are pretty much guaranteed to return if you don't have a remission plan in place. The time it takes for that to happen depends on how well your colon was healed in the first place. You should never have gotten off all meds totally. You should taper down and get off the prednisone but it is a mistake to get off of all other meds such as Asacol an enemas. You should do some kind of maintanence dose of at least one of these forever to maintain remission and forever means forever, no matter how many years have gone by with you feeling fine. Future flares get harder and harder to treat so the goal is to have a maintanence treatment plan in place forever so that you never get another flare.
Posted 12/17/2012 7:23 PM (GMT 0)
TheHangedMan, I think you are on the right course. Corticosteroid enemas might help speed things up, but they are not a good long term plan. Even though there's very little systemic absorption of the steroid, long term topical steroid use will damage the tissue of your rectum and sigmoid colon. Use them sparingly!

Please, once you have gotten yourself back into remission, DO NOT stop taking your meds. Continue on an oral mesalamine and periodic use of rectal mesalamine.
Posted 12/17/2012 7:37 PM (GMT 0)
Slow and steady huh? According to how many boxes of enemas I've been through It has been 5 weeks since I restarted on mesalamine. I have seen significant improvements one of the best being able to get a full nights sleep not having nocturnal poos. I never want to take pred I know they have terrible side effects in both long and short term but I was under the impression that messalamine alone could not bring remission. That is probably wrong headed thinking since early on in this flare I drained the one week of supplies of meds i had left and was nearly back to remission.
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