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Ulcerative Colitis
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Posted 7/1/2014 9:15 AM (GMT 0)
Previous diagnosis over 4 years ago was severe pancolitis.

My recent flex sig shows 6cm of rectal inflammation and ulcers. A little inflammation above that but not looking too bad, and this is credited to recent nightly enema usage.

I've been prescribed suppositories to try and tackle the inflammation as the enemas are bypassing this area. I'm waiting on the suppositories as they've been ordered. I've never used suppositories but have been reading previous threads for useful info.

Do suppositories only reach the rectum?
When using the enemas, I've also started to remove the tip slowly so the foam will also coat the rectum.
I use the foam enemas so do you think if I only insert the tip a little (rather than inserting the tip fully into the rectum)and then release this may work on the area I've been bypassing?


For those that use enemas, how do you ensure it reaches the rectum? Or is it not an issue because most of you use liquid enemas and it then seeps into the rectum? I'm sure I'm not explaining this very well but hopefully you'll understand what I'm trying to say!
Posted 7/1/2014 10:24 AM (GMT 0)
That's great that the enemas have helped you so much. It's strange that you would have so much success treating pancolitis with enemas, enemas only reach the left side, anything above remains untreated. I would think in your case suppositories will be much easier to use because they are designed to work in the rectum. I've never tried to get the foam only in a certain area, I put it in and push the button. I do usually use liquid enemas, they are the only mesalamine enemas i've seen in the US. I have used cortifoam and usually I will use that and a suppository for the rectum at the same time. You could do that if you feel it's necessary, ask your GI of course, but it sounds like you really just need something for the rectum at this time.
Posted 7/1/2014 11:30 AM (GMT 0)
Yes, I've been in remission for nearly 2 years and credit this to aza and leaving a very horrible job where they were not supportive to my illness at all. It's shocking how stress really does affect symptoms.

I've been mildly flaring for the last 6 weeks and my only symptoms now remaining are tenesmus, a little mucous and blood (I mean very little on tp or in t bowl every few days). I have bad cramps when I have bms in the morning (approx 3 times). No D which is great. Previous symptoms early on in this mild flare was extreme fatigue and very bad joint pain, and constipation. The frequency of seeing blood and mucous has decreased.

I'm amazed by how healthy my colon looked with the exception of those 6cm.

I posted recently about aza/allo route. My GI thinks the supps will sort out the rectal inflammation and I'm to go back in 8 weeks. Hopefully the symptoms will have eased and then I can decide whether to up my aza or take it alongside the allo. Even not being in the therapeutic range I stayed in remission for 2 years so I can only wonder how long I could be in remission at therapeutic range.

I'll give the supps a go and see how I get on with them. I've just never used supps before so feeling a little uncertain and am anxious about not using the enemas I find the foam enemas so easy to retain and they've obviously done a great job the last few weeks.
Posted 7/1/2014 8:33 PM (GMT 0)
Rectal inflammation is the most stubborn, as takes the longest to get rid of.

Do suppositories only reach the rectum? Yes

I use the foam enemas so do you think if I only insert the tip a little (rather than inserting the tip fully into the rectum)and then release this may work on the area I've been bypassing?
Doesn't matter how far you stick the tip in.

For those that use enemas, how do you ensure it reaches the rectum? Or is it not an issue because most of you use liquid enemas and it then seeps into the rectum? The rectum is always reached with suppositories, and both foam and liquid enemas. The rectum starts after the sphincter, so as long as you get the liquid in you then it definitely reaches the rectum without fail. The question is rather often can those reach beyond the rectum, to the sigmoid column, or further upward: suppositories are rectum only, foams are rectum only, liquid enemas can go the furthest to and beyond the sigmoid colon.
Posted 7/1/2014 9:10 PM (GMT 0)
I use the liquid enemas and still had rectal inflammation. My dr had me use suppositories to tackle that last bit. I am now using a combo of both enema and suppository, alternating nights. Butt meds suck, but they seam to work for lots of people.
Posted 7/1/2014 9:27 PM (GMT 0)
Thanks for the replies. My GI thinks the foam enema is bypassing the inflamed part of the rectum. I'm collecting my suppositories on Saturday so will start using them then. I think I will alternate nightly between the supps and foam enema.

I'm aware that the rectum is one of the most stubborn areas to treat and I think I'm a little anxious as I've really come to rely on my enemas which is why I think using enemas and supps in conjunction should hopefully sort this inflammation out.
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