need help figuring how to do these enemas

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sore_guts
Regular Member


Date Joined Jun 2007
Total Posts : 185
   Posted 5/22/2008 3:11 PM (GMT -6)   
So I think its time to give the enemas a try again.  I've got the script called in now I just have to figure out how to successfully do this.  I've tried them once before and couldnt get much "up there".  So if anyone has any suggestions on what you do to make it easier I would love to hear them.  My symptoms are quickly progressing negativley and I'm afraid this is my last hope before the awful prednisone again so I really want to be able to do this.  A couple of questions...
 
Should I do the enema right before bed or can I do it a couple of hours before?  I'd like to try before I get tired and before my husband is in bed with me
 
Can I not stand up after?  Will it all fall out?
 
How far in does the tip of the enema have to be in?
 
What happens the next morning?  Would I be able to go to work or will I be tied to the bathroom?
 
 
 
 
sore_guts
 
36 year old female with left-sided UC
400 mg Asacol 4 pills 3 times/day lialda 1 pill 3 times/day
making some very light attempts using Rowasa enemas just cant seem to do these
iron supplements 3 times 1/day
multi-vitamin 1/day
Digestive Advantage Colitis formula 1/day
 
 


ediekristen
Veteran Member


Date Joined Apr 2007
Total Posts : 1366
   Posted 5/22/2008 3:54 PM (GMT -6)   
I had trouble getting it all in too... I've never done the medication enemas, just the ones for preps but I think it's pretty much the same concept. I've found if you put the bottle in some warm water to get the enema liquid to room temperature and soften up the bottle, that helps alot. The feeling of cold liquid going up my intestines really creeps me out and it seems to make my reflex to go to the bathroom go off automatically.

It won't fall out if you stand up, but you might have a really strong urge to go to the bathroom, and for me it helps to stay laying down so it doesn't all rush to the bottom and try to come out. I understand that with the medication enemas you need to keep it in, so it would probably be best to do it shortly before bed that way you will be laying down and then eventually fall asleep which will slow your bowels and then they won't be trying to push it all out.

As for the next morning, as I said I've never actually had experience with these ones but I don't see why you would be having to go to the bathroom a bunch; they're not the laxative type enemas like you would use for a prep, so you should be fine there. Hopefully someone who uses these will be able to give better insight. I tried to get my previous doc to prescribe the enemas but his nurse told me that since I was on prednisone I couldn't take them because they were also a steroid enema.. When I told her I wanted to take the Rowasa enemas, not the Proctofoam, she said it was the same thing. Which they're not. But I just gave up trying with them.
Female, 22, Ulcerative colitis (pancolitis) since 1999; GERD; gastritis; osteopenia in hip & lumbar region of the spine from long term prednisone use.

Current Meds:
10mg Lexapro (for depression/social anxiety)
Digestive Advantage: Crohn's and Colitis formula (2 pills per day, started 5/14/08)
125mg Azathioprine
4800mg Asacol (Four 400mg tablets, three times a day)
 
 
 


Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4061
   Posted 5/22/2008 9:41 PM (GMT -6)   
Are you using the Rowasa enemas?

ediekirsten gave some good advice. You can also warm up the bottles by putting them near a space heater for a minute or two. For me, it's easiest to do them right before bed, and to not get up at all afterwards. The instructions suggest you lay on your left side for at least half an hour after administering the enema. Maybe you could ask your husband to wait a few minutes until he comes in bed, or you could go in earlier so you can do the enema before he's in there.

The tip doesn't have to be in super far, just far enough to get the meds in. I usually put it in about 3/4 of the length of the tip (I use the generic Rowasa, which I think has longer tips than the brand name stuff).

I'm not tied to the bathroom the morning after using them. I do usually have to go immediately after waking up and usually 1 or 2 more times before I leave for work, but that has become my norm since getting UC regardless if I do a Rowasa or not.

Good luck! Let us know if you have any other questions.
24 years old
Diagnosed with UC March 2007; yet to go into complete remission
Asacol 4 tablets 3x/day
Rowasa (generic) - nightly; Canasa (1,000 mg) in the morning
Nature's Way Primadophilus Reuteri 2/day; Chewable multivitamin; Metamucil; Viactiv


Dr-A
Veteran Member


Date Joined Jul 2006
Total Posts : 2105
   Posted 5/22/2008 10:13 PM (GMT -6)   
I never worry about getting the whole 60 ml in. I get on my left side, pull the right knee up insert the tip all the way in, squirt in about half, pull out, straighten out my legs, roll over just a bit to where I am at around a 45 degree angle propped up against the side of a wall lying down or a pillow just under my side, and hold there for 15 minutes. If it is in for 15 minutes I can get up and go about my day. If you are really set on getting that full bottle in, just do half, see if it is gonna hold, let some absorb and then do the other half. It took me years of pooping out money to realize this. Warming it up a little does help too. I usually just hog the bathroom and shut the door until I get myself situated. You'll also be less tempted to run at the first urge from the bedroom all the way to the bathroom if you are already in there.

If I am in a flare and having trouble holding the stuff in, I will start with 60 ml of warm distilled water and just keep putting it in until that urge comes, release and repeat, after a bottle or two you will notice the water will all want to stay in and you'll have to get up and get it out. Then just follow with the med enema. I'd get some extra type of lube, I use A & D ointment.
Proctitis DX 1998
Lialda 1x day
Hydrocort Enema As Needed


NMcP
Regular Member


Date Joined Mar 2008
Total Posts : 212
   Posted 5/23/2008 1:59 PM (GMT -6)   
I too use the left side trick. I never get the entire contents of the bottle in there. I probably get 1/2 to 3/4 in there. I definetely do it before I get to sleep. Then I just roll over onto my back and watch tv for awhile. The hubby likes to watch late night tv. he gives me my privacy for the meds, then he watches tv with me. I don't think I could wander around after i get 'em in there.

jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10407
   Posted 5/23/2008 2:19 PM (GMT -6)   
When I was doing enemas at bedtime, I'd get comfy in bed on my left side, do the enema, then just reach back and drop the empty in the waste can right beside my bed. That way I could just lay still and let it settle without having to get up and walk to bed. It helped me retain it.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Asacol, Rowasa, Pentasa, Prednisone, Entocort, Azathioprine
Avascular necrosis in both shoulders is my "forever" gift from steroid therapy.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


quincy
Elite Member


Date Joined May 2003
Total Posts : 30513
   Posted 5/24/2008 12:55 AM (GMT -6)   
I did the same as Judy for years...but do lay on my left side to insert it in bed, get up and discard the container and then get back into bed. I rarely do much activity after doing the enemas...even after this length of time.

Quiet is definitely better to help retain it.

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 !!!


sore_guts
Regular Member


Date Joined Jun 2007
Total Posts : 185
   Posted 5/24/2008 5:58 AM (GMT -6)   
I picked up the prescription yesterday - it is the generic form of rowasa.  I didnt get to try it last night because I'm on call and worked till 1 am.  That was not good for my gut.  It was gurgurling all night.  So I want to try tonight.  Now I am wondering if I should have asked for a steriod enema instead because things are getting worse.  I have so much urgency, but most of the time its just blood and mucous.  I hope this will help me. 

 
sore_guts
 
36 year old female with left-sided UC
400 mg Asacol 4 pills 3 times/day lialda 1 pill 3 times/day
making some very light attempts using Rowasa enemas just cant seem to do these
iron supplements 3 times 1/day
multi-vitamin 1/day
Digestive Advantage Colitis formula 1/day
 
 


Eva Lou
Veteran Member


Date Joined Sep 2006
Total Posts : 3442
   Posted 5/24/2008 6:09 AM (GMT -6)   

I haven't used them in a long time, but I would get in the kneeling position, like kneeling on your knees & bending the front of your body forward. You know, with your butt sticking up in the air! In the bathroom- something about doing an enema in bed totally grosses me out. Stick the tip in as far as you feel comforable doing, then slowly squeeze the contents. Sometimes I'd stop mid-squeeze & take a few deep breaths, realx, then squeeze the rest of the med in. Then I'd just stay in that position 'til the urge to go passed- usually about 5 minutes. Sometimes I'd have to jump up & get right on the toilet, could not hold it at all. But when I was doing Rowasa's regularly, I could nearly always hold it all night. It got to the point where I'd do the enema around 7:30, then veg out & watch tv or read 'til bedtime. I found it much harder to retain the steroid enemas than the 5ASA ones- maybe cause the inflammation was worse when I tried the steroid ones. But good luck! they're really nio big deal- just another undignified thing you have to deal with in UC.


diagnosed with UC '02
meds-
Asacol- 8 tabs/day
Remicade infusions
Imuran- 100mgs/day
Culturelle
 
 
 
 


DocGonzo
Regular Member


Date Joined Dec 2006
Total Posts : 151
   Posted 5/24/2008 7:54 AM (GMT -6)   
Well here's a method that always worked for me:

Lie on your left side, legs bent. Shake the enema bottle for 30 seconds or so, open it, push out the air (you can do this beforehand) and then gently insert the tip into your anus (this is the hardest part for some people, you just have to relax). Slowly squeeze the bottom of the bottle to avoid triggering the "urge to go" reflex (the slower you empty the enema the better). If you feel you can't take in all of it - don't. It's better to get some in and keep it than all of it and then immediately release it. Slowly remove the tip and stay in the same position (lying on your left side with legs bent) for at least 30 minutes. This is important because you want the liquid to spread across the left side of the colon as evenly as possible. After 30 minutes you can turn around and go to sleep, you can even empty your bowels if you need to and still get a good effect from the enema. Of course, it would be best if you can keep it all night.

lemonhead
Veteran Member


Date Joined Dec 2007
Total Posts : 1028
   Posted 5/24/2008 8:59 AM (GMT -6)   
I shke it up, then squeeze out the air.  Brush my teeth and go potty (because you don't want to get up for a while) come back and squirt some more out to make sure I get all the air out I can.  Lie down on my left side, turn on the tv, get comfy and put some prepH on my bottom.  Insert the med all the way in (sometimes it help the insertion if I push like I'm having a bowel movement.)  After insertion, then let the medicine rip, push it out as hard as you can so that it goes as far as it can into your body.  Then relax and watch tv.  After an hour, I find it no problem to get up and move around.  The next morning, you will probably find some white colored poo, but that is normal.  Good luck and I hope you feel better.

diagnosed with left-sided UC in 1997. (45cm)
Currently on 10mg Prednisone
12 caps of colazal    9 caps Colazal
2 rowasa enemas nightly
35, female


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 5/24/2008 10:00 AM (GMT -6)   
I only have experiance with foam enemas...I've had success with inserting while sitting on the toilet...I've only ever used them right before bed, never had issues with leakage or anything.

Good luck!

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


sore_guts
Regular Member


Date Joined Jun 2007
Total Posts : 185
   Posted Yesterday 11:43 AM (GMT -6)   
So I tried it last night.  I thought I got about 1/2 the bottle in when I really felt like it was about all I could take.  So I took it out only to discover I only got about 1/4 of the bottle.  But it was more difficult mentally I think than physically to not get up and have to get it out.  I had strange "poop" dreams all night.  Like I dreamed I was at a party and pooped myself while sitting on the couch and didnt want to get up because then everyone would see it.  Then when I did get up and went to the bathroom and completley filled the toilet it wouldnt flush.  Then I had a dream about finding dog poop in my bed.  So, hopefully this whole process will get easier in time.  I'm gonna try again tonight and hope to get 1/2 the bottle in this time and try not to think about it so much cause those poop dreams all night were not fun.

 
sore_guts
 
36 year old female with left-sided UC
400 mg Asacol 4 pills 3 times/day lialda 1 pill 3 times/day
making some very light attempts using Rowasa enemas just cant seem to do these
iron supplements 3 times 1/day
multi-vitamin 1/day
Digestive Advantage Colitis formula 1/day
 
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30513
   Posted Yesterday 1:52 PM (GMT -6)   
but you held in what you put in...right?

A good start.

Poop dreams .... you'll have to check out dream interpretations.

Keep us posted.
q
*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 !!!


bluepurl
Regular Member


Date Joined Feb 2008
Total Posts : 56
   Posted Today 7:47 PM (GMT -6)   
good luck, it gets easier and you should see results relatively quickly, which makes it worth the trouble.

I do pretty much the same as lemonhead said, but I squeeze slowly instead of quickly. i put a waste basket nearby the bed, so after I'm done, i drop the empty bottle in there and throw it in the main trashcan in the morning. after I insert the meds, I keep the same position for 30 minutes, and usually fall asleep like that. eventually, you'll figure out a way that works best for you, and your mind won't be preoccupied by it.
Get me a box of kittens, stat!
28 year old Jersey Girl
Asacol x 12, nulev x 4, generic rowasa at night
Thought it was IBS since 2002. Diagnosed left-sided UC 4/08. Plan to start SCD. Determined to get into remission before paintball season ends


sore_guts
Regular Member


Date Joined Jun 2007
Total Posts : 185
   Posted 5/27/2008 9:02 AM (GMT -6)   

Yes, I was able to keep in what little I did get in.  I didnt try agian last night - husband came to be with me.  I keep asking him to wait and he says I dont care you can do it in front of me - no big deal.  Well it is to me.  There is very little modesty left after 8 years of marriage and 2 childbirths.  Its just one thing I dont want to do in front of him.  But tonight he goes back to work - he works nights so I'll get a change tonight.

I'm actaully a little relieved I didnt do it last night cause I had a lot of gas.  I always do at night for some reason - even before UC.  It gets worse when I lay down.  I think my poop dreams the night I did the enema were related to being afraid that I would fart while sleeping and poop the bed!  So I wonder is it safe to pass gas at night after using the enema?


 
sore_guts
 
36 year old female with left-sided UC
400 mg Asacol 4 pills 3 times/day lialda 1 pill 3 times/day
making some very light attempts using Rowasa enemas just cant seem to do these
iron supplements 3 times 1/day
multi-vitamin 1/day
Digestive Advantage Colitis formula 1/day
 
 


Dr-A
Veteran Member


Date Joined Jul 2006
Total Posts : 2105
   Posted 5/27/2008 10:37 AM (GMT -6)   
Not safe to pass it just after getting the enema in. After its been in for a bit you should be fine with some gas relief.
Proctitis DX 1998
Lialda 1x day
Hydrocort Enema As Needed


quincy
Elite Member


Date Joined May 2003
Total Posts : 30513
   Posted 5/27/2008 5:18 PM (GMT -6)   
just don't push or you'll push out the med. It's a good way to practice your kiegel exercises.. eyes  

Oh, and they will smell a tad more potent from the enemas...so, doing it under the covers could wake you up when you turn over nono
 
My cat sleeps with me, and I don't want to find her asphixiated the next morning  skull   so I try not to do them in bed when I'm "conscious" tongue

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 !!!


tamtam10
Regular Member


Date Joined Aug 2007
Total Posts : 78
   Posted 5/28/2008 7:20 AM (GMT -6)   
Oh my... i had to do them for about 28 days straight not my favorite med. However it took me about a week to figure out how to hold it. I was supposed to keep it in all night. I always did them before bed. It was easiest for me to lay in the bathroom. I laid there for at least 5 minutes after. As far as how far in ( mine did not have a very long tip so i guess whatever you are comfortable with). Administer it slowly. this will some what eliminate the urge to go.

Good luck!
TamTam10
 
Diagnosed with Pan Colitis 2004 (age 23).
Asacol 12 per day
Prednisone, off 2006
6mp 75mg per day (got off becuase I am starting Remicade)
Canasa when needed
Remicade second infusion Aug 21st

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