Investigative Journalism

Hi..what do you mean you might have to lose regarding the Pentasa oral? lower the dosage? or quit it?

Dark maroonish blood can happen with proctitis when the blood tends to pool, especially when mixed with suppository or enemas. It can be a darker or really red red when pooled and mixed with mucus as well. The longer it sits there, it can tend to go a bit darker. Bright red is usually from hemmies or a fissure.

I think you should stay with an enema maybe every 3 or 4 days to deal with the patch in your sigmoid...but taper it and use the supps nightly in between.

It's possible you're correct regarding your symptoms. A plan is a good thing, and options to deal with issues as they arise is even better.

What did your doc say regarding removal of the hemmie?

or is that what you'll be waiting to deal with once you're in the US?

I also do advise you to not push anything until you're moved and make sure you take enough medications with you to deal with the time between then and when you get a GI appointment.

FYI...proctocedyl is NOT available in US.

q

how often are you using the enema now?

q

Its a plan..see how it works and keep us posted.
q

I wouldnt suggest to drop the Pentasa in one jump...taper it slowly. Pentasa is in 500 mg dosage? So one pill drop is good.
I'd stick with the enema considering you still have a patch of inflammation in the sigmoid. The foam will still treat the rectum and doing the supp during the day will still continue with treatment. Your plan is logical considering the activity and low dosage of the meds.
q

Previous Flare Ups:

Not much frequency, had blood and mucus along with formed stools. Minimal symptoms but general discomfort with blood driving my anxiety to extreme levels of Hypochondria.

Metronidazole and Max Dose Pentasa usually gets me into remission.

I've had 4 flare ups in 8 years; after the first one in 2007, I had it in 2009, 2014 and 2015.

This Flare Up:

The flare up this time round has been strange in that it has been a mix of the other flare ups.

1. It started with urgency and high frequency up to 5 times a day without blood with loose stools not Diarrhoea on a work trip to Orlando.

2. Then it became moderate bright red blood in the toilet with accompanying mucus but formed stools no Diarrhoea.

3. Then after using Asacol suppositories I went into remission for 4 weeks. It was clearly a Proctitis flare up.

4. Then the bleeding returned with about 2 to three normal bowel movements a day.

(This came a week or so after the Sigmoidoscopy which found grade 2 Hemmoroids, mild Proctitis and a small patch of mild inflammation on Sigmoid)

Today's symptoms:

Right now the blood is no longer bright red, it might be that it is mixed in or on the stool or that it is so minimal that the faces fades it out. I no longer see dripping blood or much blood on tissue. But as I'm paranoid the brown faces look reddish to me when I inspect the toilet and the tissue after each bowel movement.

I still wake up at 5am for a bowel movement and normally I only go after breakfast at 7am but frequency in the morning has stopped and I now go morning and after lunch, I never go in the evening; however I do get mild right sided soreness (I've had right sided inflammation before) which hopefully is being treated by the Pentasa tablets.

The hemmoroids have played havoc with my anxiety and subsequently the Colitis gets worse and better depending on my mood.

Right now if I am honest; I don't think any of the Enema, Suppositories and Tablets have a bearing on whether I bleed or not although Proctosedyl instantly worked. The stools have formed and I don't have many symptoms except for some bleeding on the stool intermittently every few days and rectal soreness after a bowel movement.

The only inconvenience is waking up early for a bowel movement, rectal soreness after a bowel movement and the odd specks of blood I see which is maroon and closer to stool colour and isn't bright red so much.

I wish I could try Metronidazole again; I know I used it in July but it's the one thing that genuinely works when combined with Pentasa max dose. Historically I've not used Enema's and Suppositories to get into remission.

Meds Taken:

Metronidazole for a week in July
Permanent: Pentasa 4g a day
Salofalk Enema: 1g for a month
Asacol or Pentasa Suppositories: On and Off
Probiotic: VSL3 everyday
Proctosedyl: One suppository on 5 occasions

*Asacolr Suppositories alone put me in Remission for a month in between this flare up but I relapsed.

Yes VSL3 everyday. And I'll be alternating Enema every 2 days. And doing Supps everyday until I see my new GI.

Everytime I get a "good plan" - I stop bleeding for a few days; then see minor specks on the stool or tissue and freak out. This morning I woke up and hard form stools at 5am, then again at 7am - as I don't sit and wait for it to all come out anymore... I get up and go due to the Hemmies. Then just now at 3pm, I have normal but explosive stools after a heavy lunch and on inspection some tiny specs of blood on one of the stools. I am exasperated.... but will stick to the plan.

Supps 1g everyday and 4g Pentasa.

The Enema tube is hurting my hemmies, so need to do that only twice a week.

I should sitz bath - which is the warm bath and sitting down isn't it? I think maybe doing 1g of suppository once a night is enough, and stay at max dose Oral. My symptoms are light now so don't want to over do it unless I need to.

I've had right sided inflammation before though and don't want that back and MaX dose 5ASA have always got me into remission without the recital in the past. Plus the more recitals I use the more I irritate my Hemmies.

I could drop the oral to 3g a day and up the Supps to both day and night. I just had a normal BM so Supps do work. But I'm sore as hell.