Proctitis Diet

when I was first diagnosed after colonoscopy of ulcerative proctitis, the doctor put me on cortifoam enema and asacol 2 pills 3 times a day. After about 10 days on the cortifoam and canasa every 3rd day, I was much better and remained in remission on the asacol 2 pills 3 times a day for over a year. Being in denial I dropped the asacol to 1 pill a day (mistake) and eventually I did get another flare.

I drank aloe vera juice, took align probiotic and really did not change much in my diet while in remission.
But when it came back I started to drink aloe juice again and switched to vsl#3ds (prescription), canasa and started back up the asacol 2 x 3 times a day and tried multiple supplements to get out of flare but nothing seemed to help. I still had blood when I wiped and sometimes on stool.

I have been recently after having a 2x 2 week course of hydrocortisone enema (which stopped the blood within 4 days started eating more spinach, butternut squash and trying to eat only Scd diet approved foods.

I am hoping after stopping the hydrocortisone enema a week ago, and starting my new diet, I will continue to be symptom free.

Recently, I started using a 14 mg. patch, because a lot of people say that quitting smoking causes you to get UC, which i did about 7 years ago. I got uc after 4 years of quitting.

Wish you luck in your colonscopy and try to keep up with your meds.

To help your proctitis you probably want to be doing all you can to support your butyrate production and phosphatidylcholine production as these are apparently thinnest at the rectum and vital to the mucous integrity. Have a search on here for threads discussing these. I wouldn't supplement though until you know your body much better.

Important to avoid constipation as you don't want stools stacking up where the mucous layer is thinnest, this puts you at risk of bacteria breaking the barrier. Consider what is best for you to "keep regular". Sometimes people are constipated despite the B and M.

Sorry to hear that rectal meds not doing it for you. I use the 2gram salofalk and it clears up the bleeding. You should definitely discuss the effects of it with your GI as you may be one of the unlucky intolerant ones. Have they offered you any rectal prednisolone? It's not first line treatment for proctitis anymore like it was when I got it 30(!) years ago but it cleared it like a dream for me that time, this was before rectal mesalazine was available in the UK. However, it is not something to use regularly.

You can reduce gas and trips to the bathroom by going on a low fiber(low residue) diet. Try BRAT diet(bannas, rice, apple sauce toast) over a weekend and see what happens. Caffeine, alchohol, and dairy make things worse for a lot of people so stop them or reduce them and see what happens. Try a quality probiotic like VSL#3. Eat small frequent meals. Basically just grazing lightly all day. This will rest you system.

When you get in remission work fiber back in and eat a healthy balanced diet. If dairy isn't a issue try yogurt or kefir.

Hi cjd - it is not in the current NICE guidelines although I am sure they are open to review

These are the UK guidelines
"Inducing remission: step 1 therapy for mild to moderate ulcerative colitis

To induce remission in people with a mild to moderate first presentation or inflammatory exacerbation of proctitis or proctosigmoiditis:

offer a topical aminosalicylate alone (suppository or enema, taking into account the person's preferences) or

consider adding an oral aminosalicylate to a topical aminosalicylate or

consider an oral aminosalicylate alone, taking into account the person's preferences and explaining that this is not as effective as a topical aminosalicylate alone or combined treatment.
"

From here publications.nice.org.uk/ulcerative-colitis-cg166/introduction

I am sure though that an experienced GI who has seen pred enemas work for proctitis would still want to prescribe them if the mesalazine was not working.

Thank you for all your responses.

@DBwithUC: It is a suppository I take each night before bed.

@notsosicklygirl: I'm not sure if it is the salofalk that causes the gas in the morning but I find that after taking it before bed I notice significant gas in the morning. The doctor did notice inflammation and a biopsy was taken during my first appointment with the specialist. I returned two weeks later and he informed me that it was proctitis. During this visit I had another scope to see any changes from the previous two weeks. After this, I was recommended for a colonoscopy in order to determine if it is proctitis or ulcerative proctitis which will take place next Friday. He also never mentioned steroid suppositories, only the salofalk.

The low fiber diet does sound appealing. At first, my family doctor thought it may be a hemorrhoid causing the blood so he recommended a high fibre diet for two weeks which made me making many trips to the can. I've also been using peptobismol and immodium before going out on a weekend but I don't want to rely on this for each outing.