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Are Enemas the missing piece for me?

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Ulcerative Colitis
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Posted 2/26/2015 6:38 PM (GMT 0)
First the good news--

Entyvio has gotten me off 3 years of Prednisone, firmed up my BMs, allow me to sleep through the night and eliminated bleeding. 

Now the not so good news--

Mornings suck, still have a lot of urgency for the first few hours after I wake up.  I've mapped out the bathrooms on the car ride to work because I need to stop 90% of the time.  BMs are more flat than rounded.

Currently, I use Canasa every night.  I am assuming that the BMs are flat because of some lower inflammation. I'm worried about tinkering with a formula that is keeping me blood free but recognize that I am nowhere near remission.  Willl enemas do a better job of reducing the lower inflammation than canasa?  Can I expect the urgency to reduce as well? 

Posted 2/26/2015 6:46 PM (GMT 0)
That's great news on your finally kicking prednisone and healing.

Can't hurt to try enemas as they might help with your urgency. I took enemas nightly along with remicade for at least 8 months. I was only able to reduce the enemas after a year on remicade; they were still treating lower inflammation.

Enemas are 4 grams and go further suppositories do. Most canasa are 1 gram.
Posted 2/26/2015 7:58 PM (GMT 0)
heck yeah, add them into the regiment !

have you not tried them before ?
Posted 2/26/2015 8:05 PM (GMT 0)
If the mesalamine enemas don't work for you then there is always the hydrocortisone enemas. The steroid enemas always worked quickly for me. I was allergic to 5ASAs so I never really used mesalamine enemas.

It sounds like you still have a good amount of inflammation with the urgency and flat shaped bms.

Enemas do treat a larger area then the suppositories so if you inflammation is above the suppository area then it's not getting the treatment that you need.
Posted 2/26/2015 8:30 PM (GMT 0)
I say go for it! Everyone is right in saying they treat a larger area. Sometimes I like to roll around after I get the medicine in so I can coat everything. Whether that makes it better or not, idk lol
Posted 2/26/2015 9:02 PM (GMT 0)
Ipoop-how soon did you start to notice the enemas working?

Stud-I've tried them in the past but things were way too messed up for me to keep them in for more than a few minutes. Canasa has always been the easiest for me to retain. I'm in a much better place today than in the past so hopefully I can keep them in for the night.

KS-yeah, I'm thinking I still have some lower inflammation and also dealing with anxiety over not being able to make it to a bathroom. I think my mind tends to force the issue when I have the urge to use the bathroom.

Elephant-There is someone on the site that used to do a handstand to make sure the enema was coating everything!
Posted 2/26/2015 9:16 PM (GMT 0)
I would do canasa in morning!
Posted 2/26/2015 9:22 PM (GMT 0)

Indycat23 said...
Ipoop-how soon did you start to notice the enemas working?

Well, I had been using nightly rowasa enemas since my initial diagnosis of uc, 2.5 years, even before remicade. I used enemas nightly for the first 8 months of remicade, and then was finally able to taper enemas to weekly.
Enemas work pretty darn fast for most, often within 3-4 consecutive days of nightly use, but a few weeks might also be normal.
Posted 2/26/2015 9:28 PM (GMT 0)
I am happy you're having so much luck with Entyvio! I think you should give the enemas a good try. I personally never see much improvement with anything but I use them regardless :)
Posted 2/26/2015 9:34 PM (GMT 0)

Indycat23 said...
Elephant-There is someone on the site that used to do a handstand to make sure the enema was coating everything!

Well luckily I don't think you'll need to incorporate any gymnastics!
Posted 2/26/2015 9:38 PM (GMT 0)
Thanks everyone for your comments. The key for me is going to be sticking with the regimen. Canasa is so much easier to administer. I feel enemas require much more effort but hopefully I will be able to keep it up for a month to at least see if it is making a difference.
Posted 2/26/2015 9:42 PM (GMT 0)
The enema of your enemy is your friend. Certainly wouldn't hurt to try.

I think if you are doing your best to heal, then perhaps it is up to time.

Take care.
Posted 2/27/2015 1:55 AM (GMT 0)
If you have less inflammation than before, you may have better luck holding the enemas.

There's lots of great advice on retaining enemas on this site. One I read was to do half the bottle, lay down and see how you feel, wait 10-20 minutes, then do the second half. The second "dose" may be too much but better to Hold in half a bottle for 10-20 minutes than a whole bottle for 3 minutes.
Posted 2/27/2015 2:31 AM (GMT 0)
If you have trouble retaining the enema you could start with only sticking half the goo in. Might help build your confidence that you can retain it. I notice after a few days improvement from the enema (over the suppository). I hate em, but...also love em. We have a complicated relationship tongue
Posted 2/27/2015 3:02 AM (GMT 0)
Tips for using meslamine/rowasa enemas:
  • When you first start using enemas, use them in the bathroom very close to a toilet as they can come up very quick and unexpected. As you get better at them, and more confident, you can administer them in bed.
  • Add extra Vaseline (petroleum jelly) to the tip of the enema.
  • Warm the enema up to body temperature before administering. Put it in a pocket for a while before using, or warm it up under an armpit.
  • Squeeze all of the air out of the bottle before administering. You do not want to inject any air into your bowel as it will both be uncomfortable and make it likely you will need to urgently evacuate the enema fluid.
  • Lay an old towel down as any drips of the enema fluid can stain clothing, carpet, etc.
  • Use one of the positions described in the instructions.
  • Administer the enema slowly, too quickly and you will be less successful. If you wish, you can do one half the bottle first, wait a few minutes, and then administer the rest.
  • Stay reclined on your left side for about 20 minutes to allow the enema fluid to be absorbed. Retire for the night.
  • It takes practice to hold the enema in for 7 hours. Do not get discouraged, and keep trying. Even if you evacuate part of the enema, some will likely remain and heal you. As you heal, it will be easier to retain them for longer lengths of time.
Posted 2/27/2015 3:27 AM (GMT 0)
You ever tried an antispamotic like Bentyl? Some have success with it. I take oxycodone for the pain and it also slows the GI, preventing spasm in tender areas. You become dependent on oxy but it allows me to work.
Posted 2/27/2015 4:09 AM (GMT 0)
IPoop has great advice. I'd add that you could take Gas X about 30 min before the enema to help keep it in.

Also, find the position that works best for you. I tried the ways they suggested in the insert in the box but it turns out I have to do my enemas standing up.

Once you get the hang of it, it really will be no big deal. For me, it's routine, kind of like brushing my teeth. I have to remind myself to stop reading my magazine for a moment and focus. Two years ago I never would've thought that I could stick something up my butt without even paying attention.
Posted 2/27/2015 2:23 PM (GMT 0)
Thanks everyone for the comments and advice. I'm going to start this weekend. Hopefully I have healed enough to maintain them for the night. When I was in bad shape I remember the struggle to hold them in and then the race to the bathroom.
Posted 2/27/2015 2:35 PM (GMT 0)
you might try the pseudo camp-out in the bathroom - take away some of the poo/goo spew possibility in your hasty travel - if you have room, just get comfy for a bit, at least till the urgency factor subsides a bit - and it might be fun - smores optional depending on fire code turn
Posted 2/27/2015 2:42 PM (GMT 0)
Juststud--I'm thinking the crackling fire would really relax me.
Posted 2/27/2015 6:33 PM (GMT 0)
ooooh, that would be nice !
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