Tenesmus "the urge"

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NMcP
Regular Member


Date Joined Mar 2008
Total Posts : 212
   Posted 8/20/2008 3:02 PM (GMT -6)   
I know there are topical treatments for Tenesmus, (cortifoam, canasa, rowasa, etc). If I am already flaring, I just blow those out. Asacol doesn't seem to make it down that far.

Is there anything else you guys know of that would help alleviate the urge to go?

I'm on a very short round of prednisone (2 - 3 weeks tops) and the urge, blood, etc are now gone. I'm wondering what other treatments (besides Asacol, etc) are out there for tenesmus.
Age: 48
location: Seattle, Wa
currently in small flare, tail end of colon
Diagnosed with UC in June 2006
Medications: Asacol 3 pills 3 x/day, Cortifoam at bedtime, Canansa in the morning
No. of colonoscopies: 1
Originally diagnosed with moderate UC, pancolitis


jujub
Elite Member


Date Joined Mar 2003
Total Posts : 10407
   Posted 8/20/2008 3:22 PM (GMT -6)   
Usually the rectal meds are the most effective. Starting them while you're on pred will hopefully work well for you. The pred should decrease the irritability of the rectal area, allowing the rectal meds to work their magic and keep the inflammation from coming back.

I'm unable to tolerate steroids or mesalamine, so rectal drugs are not an option for me. I found it helpful to lie down on my side with my knees bent for a while when the pressure became painful.
Judy - Southern US 
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from Entocort.
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.


NMcP
Regular Member


Date Joined Mar 2008
Total Posts : 212
   Posted 8/20/2008 3:43 PM (GMT -6)   
The prednisone kicked in and now I am "urge free". The rectal meds do help, but once I cross a certain boundary (I'm not really sure what that boundary is yet), the rectal meds don't do the trick anymore.

My maintenance treatment was 2 asacol 3x per day and canasa every other evening. When I started to flare, it was 3 asacol 3x per day, canasa every night. Then it went to 3 asacol, 3x per day, cortifoam every night, then canasa in the am. THEN it went to 3 asacol, 3x per day, cortifoam 2x per day. It wasn't getting any better. So last week it changed to 3 asacol 3x per day, pred, cortifoam at night, canasa in the am. The combination finally seems to be totally doing the trick!

My goal next time is to go directly to a treatment that works and not good around with combinations that don't really work for me.

My first GI explained to me that tenesmus comes from the inflammation and irritation to the "nerve" down there. (I'm not sure what that nerve is). The topical treatments alone didn't seem to do that much. So I was wondering if there were some other type of medication that would calm down that nerve.

I was thinking that if you get a root canal, there is novacaine and they also give you valium sometimes. Is there anything comparable for the bum area? I know, weird question, but I can't imagine I am the only one who has experienced a lack of effectiveness with topical treatments.
Age: 48
location: Seattle, Wa
currently in small flare, tail end of colon
Diagnosed with UC in June 2006
Medications: Asacol 3 pills 3 x/day, Cortifoam at bedtime, Canansa in the morning
No. of colonoscopies: 1
Originally diagnosed with moderate UC, pancolitis


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5185
   Posted 8/20/2008 7:35 PM (GMT -6)   
Hydrocortisone retention enemas (Cortenemas) are stronger-dose steroids than Cortifoam and also disperse farther-- to the sigmoid colon, so they relieve tenesmus. Also, if you have inflammation in the descending colon, their systemic effect can fight that as well. There is a 5-ASA rectal foam available in Europe, the U.K., & Australia, but so far it is not being marketed in N. America. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily for maintenance of remission)

NMcP
Regular Member


Date Joined Mar 2008
Total Posts : 212
   Posted 8/20/2008 7:45 PM (GMT -6)   
How long do you have to hold in the Cortenemas? I have a tough time with Rowasa. I can do canasa suppositories just fine. The cortifoam was tough to hold in at first, but it seems to be getting easier each day.
Age: 48
location: Seattle, Wa
currently in small flare, tail end of colon
Diagnosed with UC in June 2006
Medications: Asacol 3 pills 3 x/day, Cortifoam at bedtime, Canansa in the morning
No. of colonoscopies: 1
Originally diagnosed with moderate UC, pancolitis


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5185
   Posted 8/20/2008 8:01 PM (GMT -6)   
For optimal healing one should retain the Cortenema for 7-8 hrs. This is harder to do in the beginning of treatment, but gradually gets easier as your mucosa starts to heal. In fact, there is a well-respected IBD gastroenterologist who advises UC patients to use Cortifoam once AM + once PM for 10 days & then change to Cortenemas. His thought is that Cortifoam will speed healing in the rectum, thus making the liquid enemas easier to hold in. Makes sense to me. / Old Hat

munchkindd
Regular Member


Date Joined Oct 2007
Total Posts : 348
   Posted 8/20/2008 8:30 PM (GMT -6)   
If you can't retain them the first few times, don't give up, keeping trying, it will get better and eventually you will be able to retain it all night. It's definitely hard at first, but worth it in the end.
*******Donna*******
 
South of Boston, Ma
 
diagnosed with uc 27 years ago.  Enojoyed 20 year remission with just minor blips here and there (approximately 16 of those years without any meds)
 
In a flare for 2 very long years which Asacol didn't help at all.  Finally in remission again since Jan 2008, can't believe it..............
 
currently on Sulfasalazine 2 tabs 3x day. Folic acid, mesalamine enema once a week. Omega 3, Probiotics, multi vitamin, calcium supplement, Biotin 5000mcg, Fibercon.
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30705
   Posted 8/21/2008 2:34 AM (GMT -6)   
You could ask the doc for novocain supps...
*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 !!!

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