question for quincy (or others Re: rectal meds)

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hekela
Veteran Member


Date Joined Nov 2006
Total Posts : 731
   Posted 3/24/2008 1:52 PM (GMT -7)   
aloha,
i will be seeing my GI sometime soon just to talk about how things are going and let him know i'm pregnant.
i also will mention that i want to be prepared for a possible post-childbirth flare.
i'm going to request, okay insist on, rectal meds of some kind so i'll be prepared at the first sign of anything amiss.

i want to do this now because i will only have medical insurance until 3 months after the birth.

so i'd like to know what recommendations you may have.
suppositories?
enemas?
how will they differ? i would assume the suppository would only treat the rectum and the enema would get further up, but anything else?
what's out there besides 5-ASA? (in the U.S.)

thanks very much!
29, happily married, stay at home mom to 2 year old son. due to have baby #2 9/17/08
UC (probably pancolitis, but no c-scope yet), diagnosed June 2006, started having major symptoms sometime in January 2006, about 3 months after childbirth. 2nd flare (minor) may 2007 after taking caprylic acid for 2 weeks.

-Prednisone 8/28/06-2/28/07. and again may '07, 8 week course.
-Prayer! asacol, probio, ground psyllium husk, prenatal, folic acid, cal-mag

may you live all the days of your life.


Beth75
Veteran Member


Date Joined Jul 2007
Total Posts : 2148
   Posted 3/24/2008 2:13 PM (GMT -7)   
my two experiences w/rectal meds.

My first flare - Rowasa: great help, relief was in a few days.

My last flare - Hydrocortisone e's: great help, relief was in a couple weeks.

My first flare was more blood than urgency and my last flare was more urgency than blood. The reason I did not take Rowasa for my last flare is b/c I am hypersensitive to 5ASA's and can no longer take them, otherwise, I would have been all over Rowasa!
Beth, 32 ~ Major Flare Sept/Oct 07 ~ almost in remission
UC dx'd March 2000 (30 cenitmeters as of 2005-proctosigmoiditis)
Azathioprine 200mg 1xday nightly; Calcium and Vit D 500mg 3xday, Multi Vit, Folic Acid 400mg 2xday, Prilosec, Probiotics.
Minimal Change Disease (Kidney Disorder) dx'd Sept 2007 - partial remission since 03/08
Prednisone 30mg 1xday (taper 5mg a week from 60 = ), Simvastatin 20mg 1xday, Diovan 160mg 2xday. Tekturna 300mg 1xday, Fursomide 20mg 1xday, Fosomax 70mg 1xweek. MCD may be from hypersensitivty to 5ASA drugs.
Pre-Diabetic from Prednisone use - Low carb/sugar diet & exercise.


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 23551
   Posted 3/24/2008 2:31 PM (GMT -7)   
I found that when I could tolerate mesalamines that at the first hint of a flare, Rowasa was better for me since it has more coverage. But when a flare started (initially) and after 2 weeks that the Rowasa didn't start to make any sort of dent in my flare that I would have to resort to Colocorts which is a steroid enema.
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma and Co-moderator for UC
~Left sided Uc-'92-Colazal(9 daily),6mp(50-100mgs),Prilosec,Biotin,Forvia,Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa**~Allergies-Singulair
~Secondary Reynauds Syndrome-'04-Norvasc~Fibromyalgia-'06~Sacroiliitis-epidural injections
To help Healingwell - click here: DONATE
 
 
 
 

 
 


hekela
Veteran Member


Date Joined Nov 2006
Total Posts : 731
   Posted 3/24/2008 2:50 PM (GMT -7)   
thanks! so i could just ask him for both to be safe.
29, happily married, stay at home mom to 2 year old son. due to have baby #2 9/17/08
UC (probably pancolitis, but no c-scope yet), diagnosed June 2006, started having major symptoms sometime in January 2006, about 3 months after childbirth. 2nd flare (minor) may 2007 after taking caprylic acid for 2 weeks.

-Prednisone 8/28/06-2/28/07. and again may '07, 8 week course.
-Prayer! asacol, probio, ground psyllium husk, prenatal, folic acid, cal-mag

may you live all the days of your life.


quincy
Elite Member


Date Joined May 2003
Total Posts : 30067
   Posted 3/25/2008 1:47 AM (GMT -7)   
I'm hardcore 5ASA for over 19 years.....so, I would suggest the Rowasa retention enemas. The steroid ones you could use to maybe boost or use in conjunction with the 5ASA enemas ... to use in the morning if your flare isn't responding as quickly as you might like.

Do remember, that using oral/rectal meds to treat a flare, have to be tapered to find a maintenance dosage.

If you can avoid going of pred...to me, that's a good thing.

Discuss the options with your doctor and as long as you have options...you're set.

The Asacol I use is constant, and I treat flares with the enemas (Salofalk) and taper to maintenance. It's a process that's subjective...ongoing to remain one step ahead...for others it's not quick enough.

I'm a med lifer...but my last c-scope proved what I'm doing is working perfectly.

Congratulations on your pregnancy.

Keep us posted as to how your appointment goes.

quincy
*Heather*Status: mini flare Dec 28... tapered to every 4th 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 ....zymactive 3 - 5x 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 !!!


hekela
Veteran Member


Date Joined Nov 2006
Total Posts : 731
   Posted 3/25/2008 10:05 AM (GMT -7)   
thanks quincy!
yup, i intend to remind him that the rectal meds could keep me from using pred again.
thanks for the reminder that they will become a maintenance med as well as my asacol.

:)
29, happily married, stay at home mom to 2 year old son. due to have baby #2 9/17/08
UC (probably pancolitis, but no c-scope yet), diagnosed June 2006, started having major symptoms sometime in January 2006, about 3 months after childbirth. 2nd flare (minor) may 2007 after taking caprylic acid for 2 weeks.

-Prednisone 8/28/06-2/28/07. and again may '07, 8 week course.
-Prayer! asacol, probio, ground psyllium husk, prenatal, folic acid, cal-mag

may you live all the days of your life.


expecting226
Regular Member


Date Joined Jul 2007
Total Posts : 402
   Posted 3/25/2008 10:29 AM (GMT -7)   
Hekela - One additional thought given that you are preparing for post-partum... If you are planning to breastfeed, be sure to ask which rectal med is alright for use while breastfeeding. Some rectal meds, including mesalamine and steroids, can still pass through the breastmilk.

Congratulations on your pregnancy! I hope all goes well.
Proud new mom of a beautiful baby boy!
Current Medications:
- Asacol (4 pills, 3x per day)
- Rowasa (1 enema daily, as needed)
- Folic Acid (1 mg, 1x per day)
- Calcium (600 mg, 2x per day)
- Prenatal Vitamin (1x per day)

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