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Mesalamine suppositories

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Ulcerative Colitis
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Posted 5/18/2022 1:10 PM (GMT 0)
I’ve been on the suppositories since Friday now. The last 3 days I have had no leaking or anything in the morning, I hit around 1pm and it’s pretty much constant until nighttime.

I am using 1 suppository in evening, first few days I was leaking black first thing in the morning. Then I am doing another one in the morning.

Today I had an urgent movement and lost alot of black and blood. Is the black residue from the suppositories or is it just the colour they turn the blood/mucus.

I know it’s too early to tell as it can take a while for them to have an effect but when the inflammation starts to go down, will j leak less black stuff to eventually nothing or will the black continue even when the inflammation has improved.

Sorry for all the questions, this is all new to me and I’m just trying to gauge when I will know if they are helping. Been feeling positive the last few days then this afternoon was worse than it has been for a week and I haven’t done anything different
Posted 5/18/2022 5:00 PM (GMT 0)
Way too early to see a change, and yes, they turn the blood, mucus, stool combo dark purplish or purple black.

You have a long way to go. Maybe ask for a steroid foam enema to use during the day.
Hang tough,
q
Posted 5/18/2022 6:07 PM (GMT 0)
Thanks Quincy.

My only thing with the foam enema is, when I had it previously for nighttime use when I was pregnant, I had a hard time keeping it in. I was getting up after an hour or 2 and felt like it was just coming out. Is this normal?

I’ve got 1 weeks worth of suppositries left so when I request a renewal I will ask for the foam if you think it would be useful in the day - do you have problems with keeping it in in the day?
Posted 5/18/2022 7:19 PM (GMT 0)
When I used the foam enemas, I didn't use them during the day, but I had no problem with them during the night.

I forgot about the hemmie surgery...ask if it would be OK for steroid suppositories rx with refills....the powers that be should be flexible with options for you at this point.

q
Posted 5/18/2022 8:22 PM (GMT 0)
Enemas are hard to retain when you have significant inflammation in the rectum. As the inflammation improves they become easier to hold. I haven't used the foam personally (my doctor said it can sting) only the liquids.
One doctor told me if you can try and hold the enema for just 15 minutes (lying on the left side) that will already help.
Posted 5/19/2022 6:49 AM (GMT 0)
I will speak to my doctor this week. Do you think enema and suppository rather than suppository and oral would be more effective?

Also, those who use suppositries, when they started to work did you notice a slow, gradual difference in symptoms or was it quite quick

How long would you normally expect before the leaking of blood and mucus stops? I’m desperate for some kind of resolution before we go on our family holiday in the summer (the idea of wearing swimwear and being by a pool all day at the minute is not appealing)
Posted 5/19/2022 12:24 PM (GMT 0)
You need to stay on the oral route too. Hopefully Quincy will be along shortly to advise you about the rectal meds, I think you can use both rectal meds, but will leave it for Quincy to address.
Posted 5/19/2022 1:47 PM (GMT 0)
I think foam or an enema might be the best option. I have never used foam, but I have always had good luck with steroid enemas, even at my worst. I would use them at night (make sure you warm them up before you use them) and they make a big difference within a week's time. Once you are more stable you can try mesalamine foam or enemas. I suspect the suppositories aren't enough help for you right now.
Posted 5/19/2022 2:15 PM (GMT 0)
What is the difference with the foam enemas (which I had before) and a steroid enema? Are steroid ones more effective?

As my consultant hasn’t prescribed me these himself do you think my normal gp would?
Posted 5/19/2022 4:56 PM (GMT 0)
You need to stay on the oral...it's not an either/or regarding UC (in my opinion).

I don't have personal experience re using steroid enemas except one course of the foam. They were amazingly easy to hold in, I was flaring badly at that time, and they helped until I got back on to the mesalamine enemas.
However, the options are there and worth trying, using supps in conjunction with enemas, either being steroid or mesalamine.
It, as well, isn't either/or.

Call the doc's office, request more medication. At the very least, ask for the steroid suppositories or the steroid foam enema if your surgery site is healed enough.

I'm also going to stress be patient in the healing process...you weren't on meds for a long time.

q
Posted 5/19/2022 4:57 PM (GMT 0)
You can get mesalazine enemas in both foam and liquid versions (at least, in Europe).
Or you can get steroid enemas. The steroid ones probably work faster but being steroids are not suitable for long term use (~10% is absorbed systemically and that has associated risk of side effects, especially if used for too long)
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