Cortifoam Help

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JerryGarcia
Regular Member


Date Joined Feb 2008
Total Posts : 68
   Posted 2/24/2008 2:35 PM (GMT -6)   
Thanks to some great advice and support from members I have been started on a course of Cortifoam (or Colifoam as it's called here in the UK) to try and help pull me out of a week log flare.

My question is, how long should I expect before I will see any results? My Doc has said that I need to see him by the end of the week and that if the foam isn't working, I'll need to do a course of Pred.

I'm currently going about 5-8 times a day but only really morning and evening. There has been a lot of blood in the morning and a little in the evening. I've been taking the Colifoam for 2 days and not much seems to have changed so far.

I really want to avoid pred because of the long term side effects but will have no choice if it seems the foam is futile.

Any help or advice would be very much appreciated!
DX with UC Jan 07
Currently taking Colazide (allergic to Asacol and Pentasa) 6 a day
Also taking VSL3 X1 a day


quincy
Elite Member


Date Joined May 2003
Total Posts : 30842
   Posted 2/24/2008 2:46 PM (GMT -6)   
Hi JG....I'm not understanding why you're doing it that many times a day? How much are you supposed to use each time?

Where exactly is your UC?

 what were your symptoms before you started taking the Colazide and Colifoam?

What exactly is the prescription direction from the doctor?
 
I don't think you're too bad at this time since you're not going throughout the day...would you say you're improving?
 
I would wait it out for at least a month before even considering pred....and please know you do NOT have to go on it if you don't want to.
Were you on it in the past? or is this the first "threat" of it?

quincy


*Heather*Status: mini flare Dec 28... tapered to every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....bromelain 1 - 2x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 2/24/2008 2:56 PM (GMT -6)   
Q, Jerry's pooping 5-8 times a day, and hasn't specified how many times/day he's taking the coliform just that he's been taking it for 2 days :)

Jerry, 2 days isn't near long enough to see improvements but give it time and when you see your doc at the end of the week and the foam still hasn't kicked in just tell your doc you want some more time for it to starte working before you rush into taking pred...depending on the severety of the inflammation often depends on how long before the foam kicks in....hang in there.

:)
My bum is broken....there's a big crack down the middle of it!  LOL  :)


quincy
Elite Member


Date Joined May 2003
Total Posts : 30842
   Posted 2/24/2008 3:04 PM (GMT -6)   
D'oh!!! hahahahahaaaaaa....not enough coffee I guess.

OK.....Jerry..ignore that question and please tell your doc you want to wait it out for at least another month rather than him insisting/threatening you to be on pred within a week.

I use 5ASA meds strictly..enemas/oral....and I was once nightly on the enemas for 4 months.

So, hang tough...it takes time.

quincy
*Heather*Status: mini flare Dec 28... tapered to every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....bromelain 1 - 2x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


JerryGarcia
Regular Member


Date Joined Feb 2008
Total Posts : 68
   Posted 2/24/2008 4:23 PM (GMT -6)   
Ah, very reassuring to hear that, thanks :) Oh and I'm taking the foam twice a day at the moment.

I'll stick it out and tell my doc that I want to wait and see how things go before taking oral steroids.

Sorry I probably should have given my background... I was given a course of pred when first diagnosed, before 5-ASA meds or rectal meds were even mentioned. That was a 6 week tapering course (40mg down 5mg a day) which cleared everything up. I was then given some pentasa to try which was a no go (made me physically sick 24/7), same with asacol.

I spent the rest of the year med free bar some probiotics and mutaflor once a day. I was visiting to toilet from 1-5 times a day, never with pain and never with blood. Only time I would describe things as they were before UC was when I spent 2 weeks on a beach in September, that was total remission!

Anyway, I thought I was coming into a flare just after Christmas so went to my GP who suggested trying Colazide (Basalazide) 2 pills 3x a day. That seemed to do the trick for a few weeks until last friday when I saw blood in the bowl. It's been like that for week (lots of blood in the morning, less but still some in the evenings) with varying amounts of pain. I'm really hoping the steroid foam will help clear things up because I really don't want another course of pred (what with the worrying potential bone density issues).

Should I be worried about loosing the blood at all? Is there anything I should be eating/drinking to help the healing process or to replenish iron/blood)

Thanks :-)
DX with UC Jan 07
Currently taking Colazide (allergic to Asacol and Pentasa) 6 a day
Also taking VSL3 X1 a day


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 2/24/2008 5:06 PM (GMT -6)   
Glad you're able to use the foam 2 times/day ( I hope one of the times is right before bed so you can keep it in for a long period of time)...hopefully it will kick in soon, be patient (and tell your doc to be as well)....Keep taking probiotics daily and make sure it's a good one with no added sugars and a ton of preservatives, the one I take only contains a little potatoe startch for preservation (primadophilus reuteri made by natures way, has guaranteed intestinal release, affordable and only one/day is needed) take probiotics regardless if you're in remission or flaring.

The blood thing in my experiance with my crohns-colitis has been sketchy...I didn't have much of any bleeding the first 10 yrs of my IBD and then I started to bleed and it seemed to come and go with no rhyme or reason, at one point it got really bad and I started taking bee propolis which has kept the bleeding completely at bay.

Good luck and hang in there :)


My bum is broken....there's a big crack down the middle of it!  LOL  :)


quincy
Elite Member


Date Joined May 2003
Total Posts : 30842
   Posted 2/25/2008 12:09 AM (GMT -6)   
No, don't worry about the blood at this time...stay on the meds till you start to improve.

Make sure you have a good varied food intake that includes proteins with zinc and iron. You're female..correct? with periods? No problem to take supplements with some iron....as well, make sure you take multi B, calcium with mag and D.

The probiotics are a good idea.

I was going up to 20 times explosive bloody diarrhea, the doctor wasn't concerned because the meds, although slow, were helping.

You can have your iron levels taken....

Hang tough...you don't have to do the pred if you don't want to....

keep us posted.
quincy
*Heather*Status: mini flare Dec 28... tapered to every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....bromelain 1 - 2x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


JerryGarcia
Regular Member


Date Joined Feb 2008
Total Posts : 68
   Posted 2/25/2008 6:15 AM (GMT -6)   
I'm Male, I'll ensure I take plenty of supplements though :-)
DX with UC Jan 07
Currently taking Colazide (allergic to Asacol and Pentasa) 6 a day
Also taking VSL3 X1 a day


julee70
Regular Member


Date Joined Oct 2007
Total Posts : 486
   Posted 2/25/2008 8:09 AM (GMT -6)   
Just another opinion on how long it can take for colifoam/cortifoam to work: I've had it take 2 weeks before I could really see a difference. After that, I felt that I was seeing some read and gradual improvement over the next week.

I wouldn't expect to see instant results and I would forget about the prednisone "option" for next the few weeks. If you assume that you'll be doing much better in two weeks, that's probably a good frame of mind to be in! :)
-------
UC for the last ten years
Current Meds: 6MP since 2006
Past Meds: You name it; I've tried it.


lemonhead
Veteran Member


Date Joined Dec 2007
Total Posts : 1028
   Posted 2/25/2008 8:51 AM (GMT -6)   
the only thing about the cortifoam is that if your UC extends past a certain point the cortifoam won't reach it. I used to use it and LOVED it, but my UC extends up to 45 cm, and the corifoam would not reach that for.....so enemas. And I take 2 at a time to make sure it gets up there.
diagnosed with left-sided UC in 1997.
Currently on 10mg Prednisone
12 caps of colazal
rowasa enema nightly
35 years old, white, female


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5187
   Posted 2/25/2008 10:47 AM (GMT -6)   
Cortifoam is great for fighting ulcerative proctitis, but if you have inflammation higher up, in the sigmoid &/or descending colon, you really need to take the liquid steroid enemas. In U.S. they are called Cortenema (hydrocortisone). There is also a budesonide enema available which is supposed to have fewer systemic side effects, but it may be less helpful. So-- no need to go right back to Pred if your UC is left-sided. However, if you say you are allergic to Pentasa & Asacol, I'm puzzled as to why the doctor put you on a 3rd oral 5-ASA drug. Balsalazide breaks down to mesalamine in the colon-- the same ingredient as what you wrote you (apparently) are allergic to. In any case, the Cortifoam takes a week to 10 days of use before improvement in symptoms starts making a difference-- so the doctor should not rush you off it. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily for maintenance of remission)

JerryGarcia
Regular Member


Date Joined Feb 2008
Total Posts : 68
   Posted 2/25/2008 5:58 PM (GMT -6)   
Well I'm not sure why my GI put me on Balsalazide to be honest. I had never heard of it and was a bit wary of taking it at first due to the horrible side effects I experienced from the Pentasa and Asacol (approx 8 hours after taking either med I would get the most unbearable nausea and sickness making it impossible to eat or sleep for more than an hour at time). Having read quite a few posts here over the past year it seems I'm not the only one that has had this issue though. I definitely have zero (noticeable) side effects from the Colazide anyway so who knows.

I'm aware that the Colifoam will only work up a certain way, but I was under the impression that the Colizide could catch the rest of the inflammation (if there is any higher up).

This disease has soooooo many types of treatment available, it really is a life's mission trying to discover what works for you.
DX with UC Jan 07
Currently taking Colazide (allergic to Asacol and Pentasa) 6 a day
Also taking VSL3 X1 a day


Silent Lucidity
Veteran Member


Date Joined Nov 2007
Total Posts : 625
   Posted 2/25/2008 7:38 PM (GMT -6)   
Jerry,two days is not anywhere near long enough to know if the Colifoam will work for you.It will(in the long run)do a lot of good,regardless of how far your UC extends.It should always be looked at as part of a treatment regime,not "the answer".No offense to anyone here,but I find that too many people are somewhat dismissive of rectal meds.Your Colon is a very long part of the oesophageal tract.To get at all the inflammation,very often(most times probably)takes oral and rectal meds.

Have you seen a Gastroenterologist yet?It seems that you're only being treated by your GP?This is too specialist a case for a GP and you need to get an outpatient referral to a local Hospital.I don't think he has much experience of IBD,just by the fact he's suggesting the "sledge hammer"drugs,after two days on Colifoam!

Besides which,and I don't mean to belittle your plight here,but you're really not in a severe flare.I don't suffer greatly from Pred side effects,so I use it for expedience.However,if you don't wish to use it,you can still attain remission,just with a little more time involved.

JerryGarcia
Regular Member


Date Joined Feb 2008
Total Posts : 68
   Posted 2/26/2008 4:42 AM (GMT -6)   
Hey Silent Lucidity,

Ya I totally agree, whilst the flare isn't severe (hasn't got me off work) I know that it could all to easily take hold fully and then would become very hard to treat with anything other than Pred. Also, it's hard not being able to do things I enjoy and having to put my social life on hold is confusing for friends that don't know about my illness.

I have a GI but he takes a couple of weeks to get an appointment with, so my first port of call is always my GP (who has limited knowledge of the disease. But is also a very understanding doc (how many docs would give a repeat prescription for VSL3 ?

I also don't suffer pred side effects , but it's the long term issues that scare me. It seems the more you take, the less resistant your condition can become to other medication?

I'm going to stick at the Colifoam and see if I can see any improvement over the next 10 days. If not I'l try adding the emema as well and will only go to pred if all else fails.

Just out of interest, how many courses of Pred have you taken since diagnosis?
DX with UC Jan 07
Currently taking Colazide (allergic to Asacol and Pentasa) 6 a day
Also taking VSL3 X1 a day


Silent Lucidity
Veteran Member


Date Joined Nov 2007
Total Posts : 625
   Posted 2/26/2008 5:55 AM (GMT -6)   
Jerry,I've actually lost count on the Pred,but I'm definitely into double figures now.I had a bone density scan a couple of years ago,and everything was fine.

I'm not going to try and sell the Pred route to anyone,it's a matter of personal choice.All I will say,is that the longer a flare goes on,the harder it becomes to treat.Have you considered Azathioprine?I've had good success on it in the past and may go back on it.Admittedly I suffered a few more colds on it and sometimes felt a bit fatigued,but you may not get those problems.It's known as a "steroid sparing" drug,so may be the option if you wish to avoid the Pred.However,bear in mind that it takes 3 to six months to "kick in".
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