when I first started on Rowasa the doc told me to take 1/2 imodium 1/2 hour before and to only use 1/2 the bottle the first few times until I got used to holding it. Then gradually increase to the whole bottle. It really helped. After the 2nd night I stopped the imodium and by the end of the week I was using the whole bottle. Keep at it - any time in is better than none and eventually you get used to holding in that initial urge and just sleep through the night. And yes - as others have said - warming the bottle first and expelling the air is a huge help.