Rowasa enemas for maintenance?

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run4pancakes
Veteran Member


Date Joined Oct 2008
Total Posts : 938
   Posted 10/30/2008 2:44 PM (GMT -6)   
Does anyone use Rowasa enemas for maintenance?  In February when I was diagnosed we tried a course for six weeks and I did great on them only to relapse when I came off.  Now I am finishing an eight week course which seems to have me pretty much in remission.  I am concerned as to what the course of action might be if I relapse again without them?  Does anyone take them to stay in remission?  If so, do you take them every day like during treatment?  I am also on Lialda four pills per day. 
 
Thanks!

jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10407
   Posted 10/30/2008 3:02 PM (GMT -6)   
Rowasa enemas are certainly appropriate for maintenance, and we do have people who use them regularly. Watch for Quincy to appear, she's our resident advocate for rectal meds for maintenance.
Judy
 
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.
"My life is an ongoing medical adventure"
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


Meesh
Veteran Member


Date Joined May 2006
Total Posts : 619
   Posted 10/30/2008 5:58 PM (GMT -6)   
If you dislike the enemas (they are SUCH a production), ask your GI is Canasa suppositories will keep you in remission. They're much easier to use, but according to my GI, you get about 1/2 the medication with the Canasa as you do with Rowesa. But that may be enough to keep you in remission once it is achieved. I have both on hand, nights when I just don't want to deal with the enema I can use the suppository. Once I get my UC completely in remission I intend to switch to the Canasa.

Meesg
46 yr old female, dx'd UC April 27, 2006; mild arthritis in lower back, dx'd May 2008; Osteopenia dx'd 6/08
10 Remicade infusions: 7/21/07; 8/18/07; 10/13/07; 12/15/97; 1/26/08; 3/8/08; 4/19/08; 5/24/08; 7/5/08; 8/15/08, 9/26/08; Current meds & supplements: Lialda, 4 tabs in the morning; Xanax as needed (rarely); Tylenol Arthritis Formula or Tramadol as needed for arthritis pain; Rowesa; multivitamin w/folate; Culturelle; Fish oil capsules, calcium chews and/or Tums; Vitamin D;
Past meds: Prednisone 4/06-4/08; Entocourt EC; Asacol; Colazal; Venofer (iron) injections Dec '07; Imuran (extremely bad reaction 2/07); Protonix; Lexipro


quincy
Elite Member


Date Joined May 2003
Total Posts : 30407
   Posted 10/31/2008 1:31 AM (GMT -6)   
lol Judy.

I wouldn't suggest going to the Canasa after a nightly course of enemas. You're best off to learn how to taper and increase the enemas than using the suppositories.

Actually, I find the supps more of a pain...and totally NOT effective for my UC.

To taper the enemas, once you feel you are 'normal'...do them for another week, then start to taper to every second night. Stay there for at least 2 weeks and if you are 'normal'...stay another week and then taper to every 3 nights.

For me, maintenance is every 4 or 5 nights.

The goal is NOT to go off them....you should be on maintenance at LEAST once a week.

If you have any questions/suggestions, I can offer a variety of ways to taper.

Remember that Rowasa comes in 2 gram dosages as well...so, you could eventually taper to them if you want to lower the 5ASA amount.

quincy
*Heather* Status..Asacol 6 (3 twice daily); enemas every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 4(Natural Factors Protec) bedtime + Primadophilus Reuteri Pearls occasionally
~multi-digestive enzymes as needed
~Ranitidine,Pariet (reflux);  Effexor XR 75mg(depression);  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 !!!
 


gaff
Regular Member


Date Joined Jul 2006
Total Posts : 442
   Posted 10/31/2008 7:07 AM (GMT -6)   
I have been using them for maintenance for years. If I stop using them, the bleeding returns.
gaff
left-sided UC since 11/05
 Rowasa, Colazal, Calcium, Centrum
Natren Healthy Trinity Probiotics


run4pancakes
Veteran Member


Date Joined Oct 2008
Total Posts : 938
   Posted 10/31/2008 12:08 PM (GMT -6)   
Thank you, quincy.  I don't mind the enemas, really, but it would be nice to not have to do them every day if I could get by with it.  Interestingly enough, my doc took me from every day to none the last time I was on them.  I'm wondering if a lack of taper was the problem?  I have a follow up next week, so I think I will talk this approach over with the doc. 

kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 10/31/2008 12:44 PM (GMT -6)   
q - I can't believe you prefer enemas to suppositories - they are so easy.  I am going from Canasa which is easy to Proctofoam which is harder but not impossible even for me.  It is a smaller applicator than Rowasa thank goodness and foamy so I like better.
ElaineNY
68 yr. old granny
New diagnosed with proctosigmoiditis - 6/2008
 Colonoscopy 10/28 showed only 2 cm. left to heal in rectum - going to try Proctofoam first.
Probiotic Align, Prilosec for GERD
Inderol for hypertension,Xanax,Lipitor, multivitamin, calcium w/D, Tylenol
 
 
 
 
 
 
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30407
   Posted 10/31/2008 1:22 PM (GMT -6)   
gee Elaine.....the suppositories may be easy to use, but the effectiveness is questionable. They do have their place, however, and if the Salofalk came in foam, I'd like that as well...but its dosage is low compared to what I use. 9 seconds from insertion to garbage can is not difficult.

Plus, no leaking...ugh.

q
*Heather* Status..Asacol 6 (3 twice daily); enemas every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 4(Natural Factors Protec) bedtime + Primadophilus Reuteri Pearls occasionally
~multi-digestive enzymes as needed
~Ranitidine,Pariet (reflux);  Effexor XR 75mg(depression);  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 !!!
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30407
   Posted 10/31/2008 1:27 PM (GMT -6)   
r4p...absolutely, the no tapering is the problem. Think about it..maintenance is an important part of dealing with UC...prevention of flares. Oh, I haven't bled with flares forever...and from 15 inches, my flares are limited to the lower 2 inches. I'll take that.

No, I don't like having to do the enemas...but 5ASA is my miracle med, and I'll take it as long as I can use it.

The longest I was on nigtly is 4 months....yes, I groaned, but did what I knew best. The payoff was huge, and looking back almost 20 years makes me a poster child for rectal meds..lol! My doc is pleased,

quincy
*Heather* Status..Asacol 6 (3 twice daily); enemas every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 4(Natural Factors Protec) bedtime + Primadophilus Reuteri Pearls occasionally
~multi-digestive enzymes as needed
~Ranitidine,Pariet (reflux);  Effexor XR 75mg(depression);  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 !!!
 


kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 10/31/2008 1:38 PM (GMT -6)   

q - you are lucky then - I could not administer the enemas very well - usually only got about 1/2 in.  As you know I have a problem reaching and can only do it over the toilet - therefore the suppositories are easier.  Squeezing the Rowasa bottle as extremely difficult and took a lot of time.  Anyway, I know the suppositories are questionable - Canasa has helped me some, however.  This last scope showed my last area to be rectal and low so the Protofoam should reach it fine.  My sensitivity to ALL medication is what my doc is going by now - he know (and I know) 6MP and steroids would be very bad for me and my reaction could end me up in the hospital.  See, I am one of those (most can't believe) that can take one Tylenol for a headache and 1/2 Xanax for the anxiety and can't tolerate more.  I truly wish I could have tolerated Colazal, Lialda or another pill but can't.  I feel so good today - not being on those!!

ElaineNY


68 yr. old granny
New diagnosed with proctosigmoiditis - 6/2008
 Colonoscopy 10/28 showed only 2 cm. left to heal in rectum - going to try Proctofoam first.
Probiotic Align, Prilosec for GERD
Inderol for hypertension,Xanax,Lipitor, multivitamin, calcium w/D, Tylenol
 
 
 
 
 
 
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30407
   Posted 11/1/2008 1:12 AM (GMT -6)   
I wouldn't consider myself lucky....it is what it is that I can use salicylate meds. i'm grateful to my doc for prescribing them rather than being with another doc who would have NO problem writimg a script of pred hell.
I certainly wouldn't have known any better...no internet then.

There aren't many rectal med options at this time...use what you can and if you can do Canasa plus the steroid foams..then using them is better than nothing.

It'll take you longer to heal possibly, and the lowest part of the rectum is the most difficult to treat.

You're learning what you can and cannot tolerate in meds...5ASA is still effective in low dosages, and if youre persistent with the Canasa and use the steroid foam as well...you'll probably get it controlled.

Considering your c-scope, I'd say you've come a long way!

The only part that sucks for some of us is that it's ongoing, increasing/decreasing....

quincy
*Heather* Status..Asacol 6 (3 twice daily); enemas every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 4(Natural Factors Protec) bedtime + Primadophilus Reuteri Pearls occasionally
~multi-digestive enzymes as needed
~Ranitidine,Pariet (reflux);  Effexor XR 75mg(depression);  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 !!!
 


kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 11/1/2008 7:14 AM (GMT -6)   

My doctor was very sure I understood that this can/will increase if I don't use medication FOREVER!

I will not be using both Canasa and Proctofoam.  Dr. said just use Protofoam for a month and see what happens.  Of course, if I get worse to call him. His report said MILD confined to rectum.  I do know that that area is hard to heal sometimes.  He also said DO NOT take fiber unless I was already using it before diagnosis because it could cause more problems - just wait until later (remission).  Since going to this doctor I have heard high praise for him so going to follow his instructions to the letter - no trying something different.

I had been trying LIalda one pill every other day and he said that would not help at all (all I could tolerate) - and was not worth doing any more. You know I don't really care how long it takes as long as going in the right direction.  Using Imodium when going out and on our vacation next week.  I will report back from Vegas when I can.

ElaineNY


68 yr. old granny
New diagnosed with proctosigmoiditis - 6/2008
 Colonoscopy 10/28 showed only 2 cm. left to heal in rectum - going to try Proctofoam first.
Probiotic Align, Prilosec for GERD
Inderol for hypertension,Xanax,Lipitor, multivitamin, calcium w/D, Tylenol
 
 
 
 
 
 
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30407
   Posted 11/1/2008 11:48 AM (GMT -6)   
It's a triala and error process...I still think that you could at least try the Metamucil Smooth (not suger-free)..it's smooooth and definitely helps bulk up the stool but makes it "more fluffy and slippery", so could be nice and easy on your butt.

Enjoy LV!

q
*Heather* Status..Asacol 6 (3 twice daily); enemas every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 4(Natural Factors Protec) bedtime + Primadophilus Reuteri Pearls occasionally
~multi-digestive enzymes as needed
~Ranitidine,Pariet (reflux);  Effexor XR 75mg(depression);  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 !!!
 


kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 11/1/2008 5:07 PM (GMT -6)   

q - Sounds so comforting.  I will always consider a fiber supplement as part of the package.  I tried it for IBS a couple of times and it just didn't do anything but give me gas and I only used a tiny amount too - just like all medication I have to try.

Right now the Align seems to be working fine - stool is formed but soft - no bad urgency but little cramping when I have to "go" which is only 2 or 3 times inthe morning.  My really only concern would be the blood - if I did not have blood I would consider it "normal".  But - having IBS I have to watch what I eat like chocolate last night - ONE tiny candy bar - snack size - yikes -gas, stomachache and then little nausea but nothing colon related!

I got the Proctofoam today.  I used it before - no problem except you have to be careful about filling the applicator.  It is a little tricky.  I retain it all night ok.

Leaving for Vegas on Thursday or Xanax to keep me calmer and Imodium as needed.

ElaineNY


68 yr. old granny
New diagnosed with proctosigmoiditis - 6/2008
 Colonoscopy 10/28 showed only 2 cm. left to heal in rectum - going to try Proctofoam first.
Probiotic Align, Prilosec for GERD
Inderol for hypertension,Xanax,Lipitor, multivitamin, calcium w/D, Tylenol
 
 
 
 
 
 
 


kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 11/3/2008 9:12 AM (GMT -6)   

Well, used the Proctofoam three nights - each morning looks like more blood but other symtpoms are the same.  Just hoping the healing starts soon.  If it gets worse I will have to call NP.  May switch to the Canasa for Vegas as I know that helps keep things where they are anyway - then back to Proctofoam when I return.

ElaineNY


68 yr. old granny
New diagnosed with proctosigmoiditis - 6/2008
 Colonoscopy 10/28 showed only 2 cm. left to heal in rectum - going to try Proctofoam first.
Probiotic Align, Prilosec for GERD
Inderol for hypertension,Xanax,Lipitor, multivitamin, calcium w/D, Tylenol
 
 
 
 
 
 
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30407
   Posted 11/3/2008 11:10 AM (GMT -6)   
remember that if you yo-yo too much, you'll not know what works...but maybe it's better for you to deal with it when you get back.

or

you can use the proctofoam in the morning and the Canasa at night.

q
*Heather* Status..Asacol 6 (3 twice daily); enemas every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 4(Natural Factors Protec) bedtime + Primadophilus Reuteri Pearls occasionally
~multi-digestive enzymes as needed
~Ranitidine,Pariet (reflux);  Effexor XR 75mg(depression);  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 !!!
 


kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 11/3/2008 2:31 PM (GMT -6)   

I know!  I would not have started the Proctofoam before vacation but I had used it for quite a while (2 months) last summer and it helped but not enough so doctor put me on the Rowasa.  I will do two more nights and if all ok - take it with me - if worse, leave it here and take Canasa just for the week and start over with the Proctofoam when we return. I know Canasa helps a little and better than nothing while gone. I will call the tell the doctor exactly what I am doing/have done.  He did not know I was going away.

ElaineNY


68 yr. old granny
New diagnosed with proctosigmoiditis - 6/2008
 Colonoscopy 10/28 showed only 2 cm. left to heal in rectum - going to try Proctofoam first.
Probiotic Align, Prilosec for GERD
Inderol for hypertension,Xanax,Lipitor, multivitamin, calcium w/D, Tylenol
 
 
 
 
 
 
 

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