Hydrocortisone vs Mesalamine Enemas

Hi, i am on third month of a flare. Stools are getting formed but of course the end part of the colon is freagging inflamed. I am starting to feel down :/ Urgency and the stool is really all over the place. I see some spotty blood mixed with mucus so ulcerations are ongoing. Now i’ve never done Hydrocortisone Enemas. Dr. Prescribed because i complained about hemorrhoids as well. I have them in my hand and hesitating. What should i expect? I’m worried if it will cause more damage to my already inflamed colon.

Hydrocortisone is pretty powerful, thins the skin and has tons of side effects, but so does Pred, probably 10 times worse.. so yea i get your point.
Im on mesalamine 4g a day, budesonide, and i just started entyvio. First infusion a week ago, so entyvio will take long time to kick in. Taking some vsl3 and align

Yes, the budesonide is oral - 3 pills per day
the steroid (hydrocortisone) is enema
the mesalamine is oral pills
I don't want to jump into conclusions, we know how UC is, you feel great one day and you think you got it under control, then BAM! tomorrow you feel like crap again... but I tried the hydrocortisone enema last night and looks like major difference. I'll keep you guys posted.

Thank you for this. I will be researching. Totally with you on the bottom-up vs top-up. It makes sense. But you say instant coffee in the enema? I feel my colon may not like that lol. Man, i need to start back and research these alternative options.
Hydrocortisone enemas are actually wirking for me, but it wears off by end of day, so im worried i may become dependent. Once i feel i’m doing ok i will start tapering and not stop all at once