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Hydrocortisone Enema Questions
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Ulcerative Colitis
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HaleyA
Regular Member
Joined : Apr 2021
Posts : 259
Posted 4/1/2021 1:29 PM (GMT 0)
Hi everyone. I’m new to the forum. Happy to have found it. I’ve had UC since 2019. My disease only extends to my sigmoid colon. I am on oral mesalamine and before this flare I was doing nightly mesalamine enemas. This combo seemed to be working great until I got food poisoning and it seemed to mess me up.
I found myself in a flare up recently consisting of stomach cramping and passing blood. I rarely have diarrhea with a flare so I’m thankful for that. My doctor prescribed a 2 week course of nightly hydrocortisone enemas and to begin to taper after 2 weeks and do mesalamine nightly enemas again. The hydrocortisone have worked great. Symptoms were gone after about
3-4 days. I am supposed to taper starting this Sunday. I am nervous because I don’t want the flare to start again. Is there anything I can do during the taper to better my chances of success? Has anyone used these and not flared once off of them? Any advice would be great. Thanks!
quincy
Elite Member
Joined : May 2003
Posts : 33769
Posted 4/1/2021 5:30 PM (GMT 0)
What is the tapering schedule suggested?
Welcome to the forum!
q
HaleyA
Regular Member
Joined : Apr 2021
Posts : 259
Posted 4/1/2021 5:37 PM (GMT 0)
My doctor suggested I taper to every other day and then to every 2 days and no more after that. She also said to replace the hydrocortisone enema back with my mesalamine enemy on the days that I’m tapering down until I’m only on mesalamine again.
Does that sound like a plan that will help me from flaring again?
quincy
Elite Member
Joined : May 2003
Posts : 33769
Posted 4/1/2021 5:46 PM (GMT 0)
I suggest you ask the doc for you to do both the steroid and mesalamine for a week...then start tapering the steroid.
Tapering is a process...and if you need to step up again, that's OK. Never flaring again shouldn't be a goal...learning about
and understanding UC and its symptoms and how to treat will serve you a long time, and hopefully, lifelong.
I know of many who flare seldom...but they are on maintenance meds. I still flare, but extremely mild because of my meds and continual monitoring of what my symptoms mean. Took a long while to get there, however.
When were you diagnosed?
q
HaleyA
Regular Member
Joined : Apr 2021
Posts : 259
Posted 4/1/2021 6:10 PM (GMT 0)
So when you say do them both for a week.... do you mean one of them at night and one in the morning?
I was diagnosed in September 2019. I flared once last summer and that’s when I started doing nightly mesalamine enemas and it came under control. This is my second time flaring since being diagnosed. For maintenance I take 4 Lialda and 1 mesalamine enema at night.
quincy
Elite Member
Joined : May 2003
Posts : 33769
Posted 4/1/2021 6:18 PM (GMT 0)
Hi...yes one in the morning and one at night.
You were on the nightly enemas continually? What ones and what dosage?
What were your symptoms while flaring and what are they now?
q
HaleyA
Regular Member
Joined : Apr 2021
Posts : 259
Posted 4/1/2021 6:24 PM (GMT 0)
I did the nightly enemas most of the time. I would sometimes skip nights and I did try to come off of them once but I started bleeding again.
They are the 4g mesalamine enemas.
When I flare I have mild stomach cramps and bleeding. I have solid bowel movements even during a flare. I don’t have any symptoms at all now since being on the hydrocortisone
momto2boys
Veteran Member
Joined : Jun 2013
Posts : 2651
Posted 4/1/2021 9:03 PM (GMT 0)
I have used them many times over the years, I have been fine alternating every other day l, but if you are nervous, try using the hydrocortisone ones for two nights, then mesalamine for a night, the 2 nights of the steroid, it that goes well switch to every other day and then the reverse, two nights of mesalamine and 1 of hydrocortisone. I’m sure you could use both, if I had to pick one I would use the steroid in the morning since it is more readily absorbed.
HaleyA
Regular Member
Joined : Apr 2021
Posts : 259
Posted 4/1/2021 9:16 PM (GMT 0)
When you came fully off of the steroid were you out of your flare? I think this so what I’m most worried about
because I’m just not very familiar with how steroids work and have never really used them in my life before now.
momto2boys
Veteran Member
Joined : Jun 2013
Posts : 2651
Posted 4/2/2021 11:05 AM (GMT 0)
I was not fully out of my flare when I tapered off the steroid enemas but much more stable so the rowasa was able to work more effectively. I am allergic to sulfites and have to use sfRowasa which isn’t always available so I have used the steroid enemas daily for as long as 3 months, the longer you use them, the slower you have to taper off of them.
Old Hat
Veteran Member
Joined : Feb 2007
Posts : 6012
Posted 4/4/2021 5:42 AM (GMT 0)
You could also ask your doctor to try Colazal instead of Lialda, since your UC is confined to proctosigmoid region. Colazal (brandname) was devised especially to treat left-sided UC. (It now has about
3 generics, known as Balsalazide disodium.) / Old Hat (40 yrs with left-sided UC; in remission taking Colazal)
HaleyA
Regular Member
Joined : Apr 2021
Posts : 259
Posted 4/5/2021 1:59 AM (GMT 0)
Thanks everyone for the advice and suggestions!
Charliei2016
New Member
Joined : May 2021
Posts : 4
Posted 5/4/2021 1:47 PM (GMT 0)
Hi! I was just curious if you had any side effects from the hydrocortisone enema? This is my first time taking a steroid too and I’m very hesitant about
it.
HaleyA
Regular Member
Joined : Apr 2021
Posts : 259
Posted 5/4/2021 3:44 PM (GMT 0)
Hi, I didn’t have any side effects at all. Hope you don’t either!
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