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megger
Regular Member


Date Joined Oct 2008
Total Posts : 62
   Posted 1/5/2009 1:53 PM (GMT -6)   
I was diagnosed in October with moderate-severe Pancolotis after having a colonoscopy. I am currently taking 12 Asacol daily (3 - 4 times a day), as well as Entocort enemas nightly.
 
Just recently I have been unable to administer my enemas - at first the medication would just come flowing back out and now I can't even insert the bottle tip. My rectum is very tight now and I can barely have a substantial bowel movement more then a few "rabbit turds".
 
Does anyone else experience this? Or have any clue why this could be happening???
 
 

quincy
Elite Member


Date Joined May 2003
Total Posts : 30603
   Posted 1/5/2009 2:08 PM (GMT -6)   
Hi..welcome to the forum!

It sounds like both tightness and inflammation...have you been using the Entocort enemas nightly since October?

You might have a side effect from the steroid enemas where the anus/rectum is reacting causing more inflammation.

You might consider to ask the doc to put you on a 5ASA enema such as Rowasa or Salofalk if you're not in the US.

You could use KY or other water soluble lubricant to insert the nozzle of the enemas.

Lay on your left side, put the nozzle at the anus and try to relax the sphincter. Put the nozzle in a bit more, relax, etc until it's fully into the rectum.

I believe it says to direct the nozzle to the front of your body...don't have the directions..but that will help it from resting against the back of the rectum wall making it easier to come back out.

Relax while you're administering the med...withdraw, cap the nozzle and just lay there until all sensations have passed.

You could also ask the doc for a prescription of dicyclomine which is an antispasmodic...it could help with relaxing the sphincter a bit if you use it about an hour before bedtime.

quincy
*Heather* Status..Asacol  (3 twice daily); flaring since Dec 22, tapered every 2nd nite (Jan 3)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotics....(Natural Factors Protec, Primadophilus Reuteri Pearls, Natural Factors Ultimate).... @ 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 !!!
 


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 1/5/2009 2:20 PM (GMT -6)   
One time (of the many times) I was scheduled for a colonoscopy but my anus (I have CD) and rectom were so inflammed the doc couldn't get the scope in due to severe inflammation, sounds like that's what your issue is...you could try a bit of ky jelly on the part of the nozzle you insert and try to be as relaxed as possible, since tensing up will make it that much harder.

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


megger
Regular Member


Date Joined Oct 2008
Total Posts : 62
   Posted 1/5/2009 3:15 PM (GMT -6)   
Thanks for the suggestions!

I had thought that maybe the tightness could be a side effect of the steroid enemas... I will ask my Dr. about the 5ASA enemas...

I was taking the enemas for 3 weeks before the tightness started.

I have been using a lubricant and following the instructions to administer the enemas also...

quincy
Elite Member


Date Joined May 2003
Total Posts : 30603
   Posted 1/5/2009 10:43 PM (GMT -6)   
One can be oversensitive to either the steroid or the propellants or other ingredients in the enemas. Always a possibility.

What are your symptoms otherwise? Any improvement since using them?

You could try doing the enemas every second night to see if it improves.

What lubricant are you using?

When do you see the doc?

Have you checked your anus (yep, squat over a mirror) to see if there's any external inflammation, redness..etc? Sometimes one could have something else going on plus UC inflammation.

q
*Heather* Status..Asacol  (3 twice daily); flaring since Dec 22, tapered every 2nd nite (Jan 3)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotics....(Natural Factors Protec, Primadophilus Reuteri Pearls, Natural Factors Ultimate).... @ 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 !!!
 


megger
Regular Member


Date Joined Oct 2008
Total Posts : 62
   Posted 1/6/2009 10:00 AM (GMT -6)   
My only symtoms otherwise are small amounts of blood (mostly on the toilet peper when I wipe) and sometimes colon pain ( a dull irritating ache more then anything)...

I see my Dr. on Thursday. Right now i only see a General Surgeon and am in the midst of a referral to a GI. I had some blood taken on new Years Eve, so I will find out the results Thursday.

I will ask him about the steroid enemas and trying a 5ASA enema. I also want to ask him about Mezevant. He wants to take me off Asacol because I am taking such a high dose and put me on Pentasa instead. I'm up for trying new meds, especially since I'm not 100% yet.
Moderate-Severe Pancolitis
Diagnosed October 2008
12 Asacol (3 pills 4 times a day)
Entocort enemas nightly since Dec 2008
 

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