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Newbie with a question about enemas

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Ulcerative Colitis
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Posted 4/3/2018 1:43 AM (GMT 0)
I have been taking laxatives for constipation for many years (at least 15 years) and this year in January they stopped working. I upped the dose and it worked for about 1 week, then stopped. Changed to stool softener and it worked but I wasn’t feeling well. Lots of gas and the stool looked like mucus. To cut a long story short, went to my doctor - had CT - referred me to a GI - had colonoscopy and he took multiple biopsies of left and right Sigmoid colon and rectum.

My Gi, phoned with the results of th biopsies which showed I have Ulcerative colitis of the rectum and Sigmoid colon, He asked me if I would be willing to try enemas and I said I would give it a try. I started on them (Mesalamine enemas) last Wednesday. Since then I have been extremely exhausted, absolutely no energy and have to take a couple of naps every day. I have no appetite. For the first couple of days I had black tarry stool - now it is OK.

I am going to call my GI tomorrow, but I am wondering if I should just stop the Mesalamine, because like I said I just feel dreadful.

I would appreciate any comments

Post Edited (Craftylady) : 4/2/2018 7:53:37 PM (GMT-6)

Posted 4/3/2018 8:21 AM (GMT 0)
talk with your doctor...if these didn't work, others may. If there is one thing most of us have learned about UC it is....nothing works for everyone, but something will work for everyone. Sadly, it seems to be something we must learn to live with and control. NEVER give up and try whatever it takes. Good luck...it IS a battle
Posted 4/3/2018 10:49 AM (GMT 0)
Uc causes fatigue, not enemas. Black tar-like stools sounds like a stomach ulcer or food poisoning...
Posted 4/3/2018 1:29 PM (GMT 0)
Oral mesalamine made me tired, killed any appetite I had beyond what the UC was doing, and then gave me migraines. Changing to nighttime helped with everything but the migraines.
Posted 4/3/2018 1:39 PM (GMT 0)
Thanks everyone for the responses. This is all new to me - I had never heard of Ulcerative Colitis until I had the colonoscopy and now am finding it very hard to deal with. I am going to call my GI today and see what he has to say. Thanks again.
Posted 4/3/2018 3:27 PM (GMT 0)
Did the GI not prescribe oral mesalamine as well?

If you have UC into the sigmoid, diarrhea is a symptom. How many times a day diarrhea/bms?

Are you on iron supplements?

q
Posted 4/3/2018 3:46 PM (GMT 0)
Right now he has just prescribed enemas. No I am not on iron supplements. The GI says he was very surprised when he found UC during the colonoscopy (and then confirmed by biopsies) because I never had diarrhea. It was always constipation - still do not have diarrhea.

I called my GI’s office but he isn’t in today, so I will have to call him tomorrow.
Posted 4/3/2018 4:10 PM (GMT 0)
Inflammation manifests itself as either constipation or diarrhea. location and extent being the primary qualifiers in which side of the crappy coin you get. Rectal inflammation is known for constipation. If you have sigmoid colon to whole large intestinal involvement then it's likely diarrhea
Posted 4/3/2018 4:45 PM (GMT 0)
Apologies...just looked at another post before this one and confused the two.....brain fart moment.

..i think you should stick wth the enemas regardless, and ask for the oral mesalamine as well.

I hope your doc will do a series of blood testing ..... make sure b12, vitamin d and iron associated tests ars included.

If the mesalamine is for sure a no go for you, there is steroid topicals. But if mesalamine is OK, thenmit would be good if you can stick with it. The reason I'm cautious is because there are many reasons for fatigue.

Keep us updated tomorrow.

q
Posted 4/3/2018 8:34 PM (GMT 0)
The mesalamine thing always confused me - I thought NSAIDS were a no-no for people with UC? Or is it different if it's enema form?
Posted 4/3/2018 8:41 PM (GMT 0)
That's a common point of confusion, which pops up here for time-to-time. Mesalamine (also known as 5-ASA) is NOT a NSAID (also known as ASA), even though they are chemically very similar componds. Similar chemicals can produce very different reactions within the body, and mesalamine versus NSAID is such a case.
Posted 4/3/2018 9:18 PM (GMT 0)
Google is a liar then....

MesalamineListen to pronunciation
Common brands: Canasa, Apriso, Lialda
Nonsteroidal anti-Inflammatory drug
It can treat and prevent flare-ups of ulcerative colitis.
Possible ways to take this drug
Precautions: by mouth
1 of 2
Drug precautions by mouthTaken by mouth
SIDE EFFECTS
INTERACTIONS
WARNINGS
2 of 2
Drug precautions in the rectumTaken in the rectum
SIDE EFFECTS
INTERACTIONS
WARNINGS
Brands: Canasa, Apriso, Lialda, Pentasa, Asacol HD, sfRowasa, and Delzicol
Availability: Prescription needed
Pregnancy: Consult a doctor
Alcohol: No known interactions with light drinking
Drug class: 5-Aminosalicyclic-Acid derivative
Posted 4/4/2018 5:35 AM (GMT 0)
It should add non-systemic. It's still not in the category.

q
Posted 4/4/2018 1:31 PM (GMT 0)
Again, 5-ASA, mesalamine, aminosalicylic acid, is an aminosalicylate; Mesalamine is not a NSAID.

"Aminosalicylates are a group of anti-inflammatory drugs, chemically related to aspirin, that are used to treat persistent inflammation of the digestive tract. They work by suppressing the body’s production of prostaglandins, which are naturally occurring chemicals that trigger tissue inflammation. Aminosalicylates are often used to treat Crohn’s disease, in which there is inflammation of parts of the digestive tract. They are also given to treat ulcerative colitis, in which only the large intestine is inflamed. The drugs can also be used to help to prevent attacks of these conditions."

Source: /www.aviva.co.uk/health-insurance/home-of-health/medical-centre/medical-encyclopedia/entry/aminosalicylate-drugs/

Here's a good image of the chemical makeup of Mesalamine/mesalazine versus other NSAIDs you might be familiar with: Aspirin, Aleve, etc. Similar in structure but outside the class of NSAIDs.
/www.ncbi.nlm.nih.gov/pmc/articles/PMC3794763/figure/f1-ijms-14-17972/

Here's the full article:
/www.ncbi.nlm.nih.gov/pmc/articles/PMC3794763/
Posted 4/5/2018 8:24 PM (GMT 0)
I did talk to my GI’s nurse and she conveyed my message to him. She phoned backa couple of hours later and said the doctor didn’t think it was a side effect of the Mesalamine. He said I should persevere and continue with the enemas and if by Monday I am still feeling exhausted etc., then he will order blood work for me.
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