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*Jen*
Veteran Member


Date Joined Jul 2005
Total Posts : 514
   Posted 12/15/2008 12:08 AM (GMT -6)   
So, I gave birth 6 weeks ago and started flaring 2 weeks ago.  I was on 6 Asacol a day and have upped it to 12 a day for the last 5 days, but still flaring.  My GI wants me to get on 40 mg of pred and taper down 5 mg each week.  I have never been on pred before.  I was on Rowasa enemas until they stopped working, switched to Asacol which got me out of my last flare.  I know this flare is due to pregnancy/breastfeeding hormones as I flared at 6 weeks after I gave birth last time.  Last time around I used rowasa enemas and they got me back under control.  Now that my UC is higher up in my colon they don't work.  shakehead
 
My question is, what is the "next step" in meds after Asacol stops working?  My flare includes having bloody, mucousy D twice in the middle of the night with LOTS of urgency(during breastfeeding, so NOT fun), once in the morning after I have breakfast, and then usually once or twice in the evenings.  I've also started being really "sore" in my abdomen with stingy feelings, almost like I can feel my colon being swollen or stinging, usually at night.  Also, I have been VERY tired the last couple of days maybe due to blood loss.  Yeah, I have a newborn, but I have been napping LOTS and still am exhausted. 
 
Any advice on Pred would be appreciated as I've never been on it and am scared.  I have an appt. with my GI tomorrow to talk about it and make a decision on my treatment...  The other horrible part in all this is my son is intolerant to soy and dairy so he can't take any formula so I have to bf.  My GI said pred is fine for him, but I am scared.  Anyone have any info on this also that would be appreciated.  He is such a happier baby with my no soy/dairy diet that I would hate to have to put him on formula.  The other IMPOSSIBLE part in all this is that when you feel like this you feel like eating NOTHING, but when you are BFing you have to eat more than usual and with my restricted diet it is sooo hard.  I end up eating more sugar than I should be which I know is also effecting this flare.(That last part is just a vent because I am really stressed out about the diet part...)  I am only 8 lbs. from my pre-pregnancy weight which I know sounds great, but I worry about eating enough to keep my supply up.  I don't want my milk to dry up!  My son is a BIG eater.(again, just a vent...sorry!)
Diagnosed: 
Officially Diagnosed with UC in June 2003.  Have had stomach issues since 1989.  Unknown if they are related or not.  Have mild/moderate UC.  Have had 4 flares, the last one caused by hormones from stopping breastfeeding.  Currently back in remission!  Only taking 6 Asacol a day.   Will take Rowasa enemas as needed. Colozal did not work for me.  Luckily my UC is relatively minor and responds well to meds, but man do those flares hurt!
 
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30677
   Posted 12/15/2008 1:09 AM (GMT -6)   
Are you not using the rowasa at this time? You should try both the Rowasa nightly for at least a few weeks and the 12 Asacol.

Really...You should give it a fair try before resorting to the pred.

The other option is to use the steroid enemas if you've had absolutely no improvement after a few weeks.

Eat as normally as possible.....eat often and make sure you get enough protein.

Hormonal ups and downs from pregnancy and breastfeeding could definitely have your flare going wonky...I don't see (at this time) that adding another hormone will help...but I'm pretty much biased about pred if you haven't given the 5ASA a good try.

The enemas aren't meant to reach higher in the colon...but they will deal with the entire sigmoid. The asacol takes care of the rest.

Treat both ends!

quincy
*Heather* Status..Asacol 6 (3 twice daily); enemas every 5th night
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotics....(Natural Factors Protec, Primadophilus Reuteri Pearls, Natural Factors Ultimate)....1 each  @ bedtime
~various digestive enzymes as needed
~Ranitidine (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 !!!
 


Red_34
Elite Member


Date Joined Apr 2004
Total Posts : 23551
   Posted 12/15/2008 8:18 AM (GMT -6)   
I agree with Q about trying the steroid enemas first before resorting to pred. It wouldn't hurt to at least try them for a bit to see if they help.
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma and Co-moderator for UC
~Left sided Uc-'92-Colazal(9 daily),6mp(50-100mgs),Bentyl, Prilosec,Biotin,Forvia,Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa**~Year-round allergies-Singulair, Zyrtec~Secondary Reynauds Syndrome-'04-Norvasc~Sacroiliitis-epidural injections~bulging and herniated discs C5/C6 & C6/C7~3 epidural injections-worked great!, OA in my fingers 
To help Healingwell - click here: DONATE
 
 
 
 

 
 


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5185
   Posted 12/15/2008 12:39 PM (GMT -6)   
Sorry that this has happened to you, *Jen*! From experience I know that the steroid enemas relieve inflammation as far up as descending colon-- by systemic effect.  It takes a while for this to happen, though sigmoid colon & rectum will respond quickly because of topical contact with the liquid. However, if your inflammation has broken out in the right or transverse colon, you definitely need oral med to quell that quickly, which is probably why the gastro is thinking Pred. I'd say go hear her out at your appointment with an open mind-- since she subspecializes in pregnancy/IBD issues. Best wishes & let us know how you're doing as time permits. / Old Hat (nearly 30 yrs with left-sided UC ... [etc.])

*Jen*
Veteran Member


Date Joined Jul 2005
Total Posts : 514
   Posted 12/15/2008 1:28 PM (GMT -6)   
Thank you guys so much!! What would I do without my friends on this board!! I will hear my doc out, but think I should try the hyyrocortisone enemas with the 12 Asacol first before going the pred route. I'm actually feeling much better today(only had a bit of mucous this morning and no poopies last night!!) so I am PRAYING that I am coming out of this. I gave up on the rowasa enemas because they are VERY hard to keep in when I am getting up to bf in the middle of the night AND I now have external hemrroids(oh god the fun of this disease!!) so the idea of putting an enema in is NOT fun, but I do think I should try the hytrocortisone ones to see if they get this flare back under control. I used those with my first pregnancy when I had a horrible flare and it worked after one week, I had just convinced myself that the enemas wouldn't work as it is "too far up", but really...how do I know that? I don't. Thank you guys!! HUGE hugs!!!!!!
Diagnosed: 
Officially Diagnosed with UC in June 2003.  Have had stomach issues since 1989.  Unknown if they are related or not.  Have mild/moderate UC.  Have had 4 flares, the last one caused by hormones from stopping breastfeeding.  Currently back in remission!  Only taking 6 Asacol a day.   Will take Rowasa enemas as needed. Colozal did not work for me.  Luckily my UC is relatively minor and responds well to meds, but man do those flares hurt!
 
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30677
   Posted 12/15/2008 2:51 PM (GMT -6)   
You need to treat both ends...try not to think or believe that the enemas won't help or that they are supposed to help beyond the sigmoid. The Asacol will help with that.

quincy
*Heather* Status..Asacol 6 (3 twice daily); enemas every 5th night
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotics....(Natural Factors Protec, Primadophilus Reuteri Pearls, Natural Factors Ultimate)....1 each  @ bedtime
~various digestive enzymes as needed
~Ranitidine (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 !!!
 


*Jen*
Veteran Member


Date Joined Jul 2005
Total Posts : 514
   Posted 12/15/2008 9:09 PM (GMT -6)   
Great news from my GI. She said to continue with the 12 asacol and use the cortfoam enemas. They are suppose to "stick" better, which is good news as I couldn't keep the enemas in while BFing in the middle of the night. What was interesting is she said that in studies with mesalamine and hydocortisone enemas the mesalamine were actually more effective then the steroid ones..hmm...I thought the steroids would be more so. I'm feeling MUCH better today(so much less blood thank goodness), so the Asacol must finally be working. Hopefully with the enemas I will get back into remission very quickly. Thanks again for your help guys!!
Diagnosed: 
Officially Diagnosed with UC in June 2003.  Have had stomach issues since 1989.  Unknown if they are related or not.  Have mild/moderate UC.  Have had 4 flares, the last one caused by hormones from stopping breastfeeding.  Currently back in remission!  Only taking 6 Asacol a day.   Will take Rowasa enemas as needed. Colozal did not work for me.  Luckily my UC is relatively minor and responds well to meds, but man do those flares hurt!
 
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30677
   Posted 12/16/2008 3:56 AM (GMT -6)   
good news. Hey, maybe after the steroid foam enemas do their thing for a while, you can switch back to the Rowasa..to hold them in longer since you're not bfing any more.

I incorrectly stated in your other thread to stick with the Rowasa, assuming that's what you were on..oopsie.

Hope tomorrow is a feeling better day..
q
*Heather* Status..Asacol 6 (3 twice daily); enemas every 5th night
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotics....(Natural Factors Protec, Primadophilus Reuteri Pearls, Natural Factors Ultimate)....1 each  @ bedtime
~various digestive enzymes as needed
~Ranitidine (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 !!!
 


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5185
   Posted 12/16/2008 10:43 PM (GMT -6)   
Yep, Cortifoam can be an absolute blessing; Dr. Daniel Present recommends it to speed healing in the rectum even if additional meds are needed for higher up inflammation. You might want to read Julee70's recent post about buying mesalamine foam abroad-- since it's not sold in the U.S. It will give you some added info & also a good laugh about the aerosol container. Hope you feel better soon. / Old Hat (nearly 30 yrs with left-sided UC ... [etc.])

*Jen*
Veteran Member


Date Joined Jul 2005
Total Posts : 514
   Posted 12/17/2008 12:59 AM (GMT -6)   
Yeah, weird that they don't sell the foam for mesalamine here. I'll have to check out her post. I'll let you guys know how I do. I'm using it for the first time tonight. Hope I can figure out how to use it!!
Diagnosed: 
Officially Diagnosed with UC in June 2003.  Have had stomach issues since 1989.  Unknown if they are related or not.  Have mild/moderate UC.  Have had 4 flares, the last one caused by hormones from stopping breastfeeding.  Currently back in remission!  Only taking 6 Asacol a day.   Will take Rowasa enemas as needed. Colozal did not work for me.  Luckily my UC is relatively minor and responds well to meds, but man do those flares hurt!
 
 

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