Cortifoam versus hydrocortisone enemas

I think you are correct. Protofoam is low dose and only treats a very small area - I think it's more for hemorrhoids than proctitis but I've seen a lot of people here using it for rectal inflammation. I've personally never tried it, nor has anyone ever prescribed it for me. Cortifoam treats a larger area and the steroid dose is higher. Enemas are great but often if you're flaring badly you can't retain them long enough for them to make a difference. Cortifoam is easier to retain. I've never really had much in the way of side effects from rectal steroids luckily. I don't like using them regardless. Last time I flared, I was using them a lot and my rectum actually looked decent, the problem was, beyond the rectum looked terrible. The rectals only reach so far.

Cortifoam is recommended twice daily, not sure if it's got a higher dose in it or not, but guessing it probably does...it's the only rectal med that gets my CD proctitis under control.