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Flare starting, what do you recommend?

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Ulcerative Colitis
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Posted 1/5/2015 3:54 AM (GMT 0)
So flare symptoms started around christmas. Muscus and blood. I increased my azathioprine from 100mg to 125mg for about a week. I am starting to see more blood now and abdominal pain. Stools are still completely formed. So I just increased my aza to 150mg hoping that will help me out a bit until I can get a hold of my GI and ask him what I should do. I am mainly interested in seeing if I can start rectal meds. I know nothing about them though...which should I ask him about? suppositories or enemas? Which is better? I was allergic to pentasa so does that rule out the 5asa kinds? Do the steriod rectal meds have the same side effects as the oral? Thanks for the help everyone.
Posted 1/5/2015 4:12 AM (GMT 0)
Cortenemas worked very effectively for me when I began a flare & had those symptoms. Did one every night for several weeks. The doctor said I could, for a brief period, also do one in the morning. 'Cort' stands for cortisone so you should know it's a steroid medication.
I also majorly simplified my diet - broth, plain proteins, rice, etc. You can see if some changes like that may help. Each of us is different, of course...
Hope you get it under control and feel better soon.
Posted 1/5/2015 4:21 AM (GMT 0)
increasing azathioprine like that can be dangerous for the liver. you need liver enzymes monitored when increasing by 50%
Posted 1/5/2015 4:26 AM (GMT 0)
The enemas can give you a puffy face, but not as bad as pred.
Posted 1/5/2015 4:48 AM (GMT 0)

Contentprof said...
Cortenemas worked very effectively for me when I began a flare & had those symptoms. Did one every night for several weeks. The doctor said I could, for a brief period, also do one in the morning. 'Cort' stands for cortisone so you should know it's a steroid medication.
I also majorly simplified my diet - broth, plain proteins, rice, etc. You can see if some changes like that may help. Each of us is different, of course...
Hope you get it under control and feel better soon.

Thanks for the suggestion. I have already made some diet changes to similar things as you. Hoping that may help too. Did you have symptoms similar to predisone while taking a steriod enema?
Posted 1/5/2015 5:36 AM (GMT 0)
No symptoms for me at all from cortenemas.
Not anywhere near as strong as oral Pred. I recall but am not 100% certain: each one is equivalent of <7 mg of Pred; it gets absorbed in rectum, not whole system. Someone with more expertise could weigh in on the latter - or you could ask your GI.
I'm so positive about their value that I keep some around just in case. (I started w/ proctitus... And am allergic to mesalamine.)
Posted 1/5/2015 5:46 AM (GMT 0)
Corticosteroid enemas can do wonders for a flare that's just about to begin, and they have much less side effects.

The best thing to do when you feel a flare cooking is to contact your GI and set up an appointment.
Posted 1/5/2015 6:00 AM (GMT 0)

Contentprof said...
No symptoms for me at all from cortenemas.
Not anywhere near as strong as oral Pred. I recall but am not 100% certain: each one is equivalent of <7 mg of Pred; it gets absorbed in rectum, not whole system. Someone with more expertise could weigh in on the latter - or you could ask your GI.
I'm so positive about their value that I keep some around just in case. (I started w/ proctitus... And am allergic to mesalamine.)

Good to hear the side effects of the steroid enema wasn't as bad as the oral for you. Seems like it is like that for most. I will have to ask my GI about them.

I am also very curious to see if others have had reactions to oral 5asa's but was fine with a 5asa supp or enema. I would rather be on a 5asa supp or enema if possible, because I think, and correct me if I am wrong anyone, you can stay on them much longer.
Posted 1/6/2015 2:45 AM (GMT 0)
You should really go get your levels checked for Aza. If you're in the therapeutic range, increasing the dose will not provide any benefit. You really should be supervised when changing doses of immune suppressants. You need to have your blood monitored. You should definitely be using rectal meds as well.
Posted 1/6/2015 4:52 AM (GMT 0)

notsosicklygirl said...
You should really go get your levels checked for Aza. If you're in the therapeutic range, increasing the dose will not provide any benefit. You really should be supervised when changing doses of immune suppressants. You need to have your blood monitored. You should definitely be using rectal meds as well.

I get my levels checked monthly. I was also on 150mg for a few years or so with no issues with my blood work.
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