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Ulcerative Colitis
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Posted 4/16/2018 12:36 PM (GMT 0)
Morning! Well I guess I have put it off long enough. The Canasa suppositories just don’t seem to be working so now I am going to try the Rowasa (mesalamine) enemas. Ugh, not looking forward to this because my bum is so sore and hurts. Just wondering if any other UC warriors have had success with the Rowasa? Thanks.
Posted 4/16/2018 4:19 PM (GMT 0)
Yes, Rowasa is one of the more effective medications we have for UC, with numerous success stories over the years here.

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 4/16/2018 4:30 PM (GMT 0)
Great advice from iPoop.

A few things I would add, make sure you empty your bowels as completely as possible before putting the rowasa in. Any residual gas/stool will make it harder to retain, and will block the medicine from going higher into the descending colon.

The other thing for me is I try to put the nozzle thing in as far as I can before injecting, but also make sure that I get a bit into the very lowest part of the rectum (as I am taking it out) since that can be a bad area for inflammation and oral meds don't get down that far.
Posted 4/16/2018 5:58 PM (GMT 0)
Yes to the above suggestions.

Just adding about making sure to empty out before using. If you have to go....go, if not, dont worry about it and think it's something you should be doing.
If you are using during the day....use after the majority of bms.

Lubricate the nozzle, and relax before inserting. Its smaller than a finger, so wont hurt as much. Using an external cream or ointment will help afterward. Is your anus very sore as well?

q
Posted 4/17/2018 7:27 AM (GMT 0)
Yes to Quincy, my bum is VERY sore. To the point I am uncomfortable and can’t sleep.
Posted 4/17/2018 12:29 PM (GMT 0)
If you're incredibly sore then you might want to start with a steroid suppository, foam, or enema as they heal quicker and then transition to a rowasa.
Posted 4/17/2018 1:43 PM (GMT 0)
If your bum is sore from constantly going (almost like a diaper rash irritation), something that has helped me in the past is clotrimazole lotion. It's available OTC, at least in the U.S.
Posted 4/17/2018 1:49 PM (GMT 0)
Consider to try canesten cream....could be a yeast infection.
Use something externally during the day....and after you use the meds.


q
Posted 4/17/2018 10:28 PM (GMT 0)
I started using Rowasa recently after not using it in a long time (a few years). Right now I have severe inflammation in the last 20cm of my colon, and at first I wasn't able to retain it at all. I switched to Proctofoam for a month, and that helped me quite a bit. Since about the end of the first week of switching back to Rowasa, I have generally been able to retain it all night.

I started using Calmoseptine after getting a fistula, and I think it's the greatest thing since sliced bread. It has a nice cooling sensation, and I use it anytime I get sore back there. It doesn't seem to be stocked in many stores, but Walgreens does carry it. I highly recommend it.

(Pro-tip: Stretch a cottonball and stick it between your cheeks after applying the Calmoseptine, to keep it off your underpants. smilewinkgrin )
Posted 4/17/2018 11:59 PM (GMT 0)
Thank you all for your replies and suggestions! So tonight was my first time using the Rowasa.
I made sure it was warm and squeezed all of the air out of it. Applied Vaseline to the applicator.
I inserted it while sitting on the loo. For some reason I could not get the entire bottle to empty. Guess I
got about half. When I pulled the applicator out there was blood on it. Just not sure this is going to be my cup of tea. Pretty discouraged. Thoughts please.
Posted 4/18/2018 12:47 AM (GMT 0)
Sounds like you did well for your first attempt. Were you able to retain it all night?
Posted 4/18/2018 1:24 AM (GMT 0)
I had trouble with Rowasa at first as well. All of the suggestions above helped me, but also, I find it best to lay a towel on my bed and lay on my left side when administering it. I do not even think of moving for awhile afterward, even to my back, just because that seems to irritate things. I have to breath through some cramping and try really hard not to empty it. The cramping usually subsides after a few minutes and then I am good to go for the night. It will get easier, I promise! When my inflammation has been really bad, I will do the enema at night and Canasa in the morning to cover the rectum.

Marie
Canasa, Rowasa, Lialda 3-1.2 grams/day, vitamin D, probiotic, L glutamine
Proctosigmoiditis Diagnosed 2011 after the birth of my first child
Posted 4/18/2018 1:33 AM (GMT 0)
Best to put it in while laying on your left side. If you're sitting upright, gravity will not be your friend.
Posted 4/18/2018 6:48 AM (GMT 0)
I was able to retain the Rowasa overnight so that’s a start. However, I am also plagued by hemorrhoids. Can you use OTC meds (Preparation H etc.) while using the Rowasa? Has anyone ever used Cortaid for hemorrhoids? Mine are pretty painful.
Posted 4/18/2018 3:44 PM (GMT 0)

Imbeccak said...
I am also plagued by hemorrhoids.

Prep H never did anything for me. What helped me was switching from toilet paper to flushable wipes, and doing "sitz baths" when needed to keep things super clean. That and trying to sit on the toilet for as short a time as possible and to avoid straining. The anti-fungal creams several have mentioned (generic name is clotrimazole) can keep the skin irritation down a lot too.

I wouldn't put anything on just before doing the enema, because it will get pushed in internally, which it's not meant to do.

Anyways, congrats on retaining the enema!
Posted 4/18/2018 5:13 PM (GMT 0)
Does anyone use a fiber supplement, like Metamucil? Do you find it helpful? I’m afraid to try anything high fiber for fear of accidents. Ugh, what a way to live. :-(
Posted 4/18/2018 5:28 PM (GMT 0)
Yes and yes. Capsules, added to meals. Start with one at one meal for a few days, increase by adding one to another meal....and so on.

q
Posted 4/18/2018 5:38 PM (GMT 0)
Quincy - no problem with urgency taking Metamucil? How many do you take, 6 a day, 2 each meal?

Post Edited (Imbeccak) : 4/18/2018 12:01:33 PM (GMT-6)

Posted 4/18/2018 6:41 PM (GMT 0)
Psyllium is water soluble. It's the fibre that is not water soluble (like bran for example) that tends to be harder on inflamed guts.

Post Edited (C_G_K) : 4/18/2018 12:46:38 PM (GMT-6)

Posted 4/19/2018 1:14 AM (GMT 0)
Psyllium husk is both insoluble and soluble fibre. One needs both.....

I eat two major meals a day.....breakfast and supper. I take 6 with each meal. I didn't start with that, it took about a month to build up to that.

q
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