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Pregnancy and safety of enemas

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Ulcerative Colitis
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Posted 2/12/2014 12:32 AM (GMT 0)
Hey Everyone!

wow..its been soo long since I have posted here....years its been! I hope everyone is doing well and that UC is being managed as best as can be!!

I am four months pregnant with my second child and in a small flare right now. I am on 6 500mg Salofalk tablets per day and have a pending RX for Salofalk enemas.  When I first went in to see my GI with this flare he would NOT prescribe me enemas saying they can cause miscarriages or preterm labour.  ...well I gave it two weeks and went back to him today and asked again for them...after some back and forth he finally said "ok fine if you want them I will give them to you"...I called motherisk three times and they have assured me they ARE fine and safe in pregnancy...I also did some reading online and nothing I read says they are not safe but I did read not to take them in the last trimester on one website...not sure why though.

So I wanted to hear others experiences with pregnancy and UC and using the enemas...before I start them...hope I can get some feedback :)

Posted 2/12/2014 12:48 AM (GMT 0)
Mesalamine enemas are totally safe. I mean, you're already taking it orally, and less mesalamine is absorbed with the enemas than oral meds.

I used them twice weekly (and the other meds listed in my sig) throughout my second pregnancy, and my baby girl was born just one day before her due date at a healthy 7 lb 13 oz. She's now just a few weeks shy of turning one, and is, of course, perfect! ;)

And congrats!
Posted 2/12/2014 12:47 PM (GMT 0)
bump! anyone else?
Posted 2/12/2014 1:17 PM (GMT 0)
Somehow I missed the fact that your GI told you they can cause miscarriage or preterm labor. That's just asanine!
Posted 2/12/2014 1:59 PM (GMT 0)
That's why I am scared to use them...its not the meslamine I am scared of its the actual act of doing an enema...like maybe something about the enema will disrupt the baby or cause contractions???
Posted 2/12/2014 2:02 PM (GMT 0)
If that were the case, then how in the world would it be safe to have sex while pregnant? Think about it.

Have you even discussed this with your OB?
Posted 2/12/2014 2:06 PM (GMT 0)
My OB knows NOTHING about Colitis and always refers me back to my GI.
Posted 2/12/2014 2:18 PM (GMT 0)
Your OB should be able to have an intelligent discussion about which meds are and are not safe to use when you're pregnant -- you're not asking HOW to control your UC, you're asking if the meds are safe for the pregnancy. Those are two completely different things.

At my first prenatal appointment, my OB asked what meds I was using, and when I told her, she nodded her head, said something along the lines of "Good, keep on taking them and be sure to let both me and your GI know if you start having symptoms." Then at every appointment, asked me if my UC was behaving.
Posted 3/13/2015 11:26 AM (GMT 0)
Hello everyone!
I am four month pregnant with ulcerative colitis. I'm taking Salofalk 500 mg x 6 and Salofalk enemas occasionally. I started to notice to have small flare last couple of days so I'm using enamas more frequently. I also read that is not safe to take enemas in the last trimester but I'm not sure why. Does anyone has answer to that question?
Posted 3/13/2015 12:21 PM (GMT 0)
I have never seen that enemas aren't safe in the third trimester. Where did you see that? I used them the entire time I was pregnant with my daughter. She was born the day before her due date (scheduled C-section, but I went into labor that morning anyway) and is a spunky, smart, and happy two year old now.
Posted 3/13/2015 1:06 PM (GMT 0)
There are two articles about uc and pregnancy in our resources section. I am pasting those below. Overall, studies have shown small risks during pregnancy but it cannot be determined if uc is the cause of increased risk, or 5ASA is. Mostly seen in mice models...

From conception to delivery: Managing the pregnant inflammatory bowel disease patient
www.wjgnet.com/1007-9327/pdf/v20/i13/3495.pdf

The Second European Evidenced-Based Consensus on Reproduction and Pregnancy in Inflammatory Bowel Disease
ecco-jcc.oxfordjournals.org/content/eccojc/9/2/107.full.pdf

The third trimester is only mentioned for biologics.
Posted 3/13/2015 1:11 PM (GMT 0)
I'm in my third trimester and used Rowasa twice weekly up until 26 weeks when I started flaring very badly. Since then I have been using steroid enemas on and off but at least twice a week. No issues here!

The main goal is to keep or get yourself healthy. The risks of flaring far out weigh any of the UC meds. Most of the UC meds are category B during pregnancy. Good luck.
Posted 3/13/2015 6:27 PM (GMT 0)
Thanks for the info, it's very helpful! I'm seeing my GI soon and will ask him about all the details.
Posted 3/13/2015 6:47 PM (GMT 0)
Fleet enemas are recommended against in the third trimester because the induce very strong contractions (in the rectum, but it's pretty close in the pelvis to the important stuff). That said, mesalamine enemas DON'T induce contractions -- you're meant to retain the contents. I'm pretty sure that sets them apart and excludes them from the "no enemas during third trimester" advice.
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