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Ulcerative Colitis
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Posted 3/12/2016 11:40 AM (GMT 0)
Hi, all
I have been using asacol enema for a while now but it doesnt seem to be getting me in remission( I have proctosigmoiditis). I just started prednisolone 30mg .

the asacol enema causes alot of pain n the morning after my first bathroom ., and I would go then like 3-4 times after that with little stool just some blood and some idont know mucus maybe , its yellowish and looks like sand.

should I try using predsol enema for a while ? MY doctor says that the mesalamine enema is better. or should I use pentasa enema instead of asacol.I really want to get into remission ive been in a flare for a long time now with this distal colitis.thanks
Posted 3/12/2016 11:44 AM (GMT 0)
You should switch to cortenemas. The mesal enemas never worked for me either and actually made things a lot worse! Cortenemas also tend to wrk very fast! Just be consistent!
Posted 3/12/2016 12:57 PM (GMT 0)
i agree - start using the steroid enemas while you taper off the oral (at least i assume you are tapering)

as far as mesalamine enemas being better ? they are a bit safer and can be used long term, but they are not necessarily better -
Posted 3/12/2016 3:13 PM (GMT 0)
Hopefully with prednisone, the enemas won't be as necessary, but in the longer-term, it would be good to find something that works for you. I personally, probably wouldn't start the predsol enemas while on prednisone. Not because there is a problem with doing so, but because it maybe overkill and you won't know whether the enema is actually helping or if all the progress is due to the oral steroids. I think I'd get the pentasa for the time being and give that a try, pick up a prescription for steroid enemas and use them as I tapered down from prednisone.

I guess it depends how severe your symptoms are though, and how much improvement you make on the pred. I usually have a major improvement with oral steroid within a few days.

The problem with steroids, both oral and rectal, is that they are not long-term solutions. Even if the steroid enema helps, you may only have luck while you use them, and then you flare when you're off. You can't use them every day forever... You do need to find something that you can use for maintenance, that's why I think it would be smart to keep looking for other options.
Posted 3/12/2016 5:34 PM (GMT 0)
The asacol enemas arw only 1g. Id suggest you ask the doc for a 4g dosage...where you are, it could be either salofalk or pentasa.

A steroid enema might help boost the healing, but if you can stay on the mesalamine, that yould be better.

The symptoms you have in the morning is of flaring, and the 1g dosage isn't enough to do what it needs to do.

q
Posted 3/12/2016 5:58 PM (GMT 0)
@quincy actually the asacol enema that i have is 4g and the pentasa enema is 1 g ,. Unfortunately the country im in they dont have salofalk .

I@juststud i just started the oral steroids yesterday .im going to taper them hopefully nextweek.
Posted 3/12/2016 6:17 PM (GMT 0)
Thanks for the clarification....i was thinking foam asacol. Don't meet many using the liquid...i should have asked.

How long have you been in the 4g nightly?
q
Posted 3/12/2016 6:31 PM (GMT 0)
Its been along time on and off then back on it . But now its been like about a month and half using it nightly maybe more . It used to have a better effect but now i feel that it isnt that much help and maybe its causing the pain in the morning.
Posted 3/13/2016 5:38 PM (GMT 0)
You can skip for a night and see if you have the same effects in the morning.
You are flaring, however....
Can you describe the pain? And do you have it during the night as well when you are retaining the enema?

How many times a day do you have bms?

q
Posted 3/13/2016 5:48 PM (GMT 0)
I used the pentasa enema yesterday , it didnt go so well .I got alot of bleeding in the morning.

the pain is like painful diarrhea, I dont know if that helps.

at night its better , I can retain the enema no problem . I just get gassy at night.

I go to the bm 6-7 times a day but mostly in the morning which I go like 3-4 times .
Posted 3/13/2016 6:27 PM (GMT 0)
Since the Pentasa is only 1g, it might not necessarily be the mesalamine. One thing, however, is that the Pentasa has 40ml more liquid than the Asacol.

You could do a few things.. ask for a foam asacol enema, ask for a steroid foam, ask for a steroid liquid, ask for steroid suppositories and let the other meds do their thing and increase the enemas once you're tapering the pred and more stable.

Have you had stool samples done?

q
Posted 3/14/2016 11:05 PM (GMT 0)
no, I havent done any stool samples , but I am scheduled for one for next week( to see for activity). but the doc said that it takes a few weeks to show the result as they send it abroad.

I have colifoam and steroid liquids . I have the asacol enemas but here they dont have asacol foam unfortunately .
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