About those rectal meds?? Me again!

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kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 3/23/2009 5:36 PM (GMT -6)   
confused  Well, I think you know my history and most is in my signature.  I know a couple here believe in medication from both ends - me too - generally.
Anyway, I have tapered from 40 mg. to 20 mg. prednisone and been there now for what is now almost 5 weeks.  Soon after starting on 40 mg. blleeding stopped - not all symptoms gone but much less - mostly low back pain.  No diarrhea, no cramping, urgency or nausea.  NOW - doctor put me on 6MP 24 days ago at 50 mg.  I went to see him and he said I could taper the prednisone to 15 mg. next week. I ask about suppositories as they are the easiest for me and he prescribed Anusol HC 25 each night.  I have MOSTLY proctitis and there is the discomfort, etc.
A week before I went to the doctor I was seeing some mucous streaked with blood occasionally only once in morning.  2 or 3 formed BM's every morning.
OK - been using the suppositories now for 8 days - one to three BM's a day - more dark/mucous on stool every day.  AND this morning a third BM was more red blood and less stool - small amount.  Not seen this since starting prednisone.  I took 1/2 Imodium to go get my hair done.
What is your take on this?  Just any ideas.  I will continue a few more days on what I am doing and then call the NP who works closely with doctor.  Seems like I am going backwards.  I don't want it to go too far in the wrong direction!
ElaineNY
 
Senior - New diagnosed with proctosigmoiditis - 6/2008  Cannot tolerate mesalamines, Canasa, etc. Tried, Colozal, steroid enemas, etc. - started working but severe side effects occurred.
Started on prednisone Feb.7, 2009 - tapering to 20 mg. for two more weeks and then down to 15 mg.etc.  Added 6-MP Feb. 28.
Added Anusol suppositories - March 16 - see doc in 3 months. 
Probiotic Align, Prilosec for GERD, Gas-X, vitamins, Calcium/D
Tylenol for knees and arthritis.
 
 
 


notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 16282
   Posted 3/23/2009 6:46 PM (GMT -6)   
I don't know Elaine. I hope the decrease in pred didn't cause you to flare a bit. I guess you will have to wait and see how you are doing in the morning. I can't believe you don't deal with this urgency, you're lucky.

Diagnosed with proctitis in March 2007 - Treated with Canasa 2x Daily
Diagnosed with UC December 08 but had symptoms months ago - Treating with Asacol 400mg (9 a day)


kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 3/23/2009 8:26 PM (GMT -6)   

I have had the urgency - before diagnosis and early on.  I truly believe the probiotic Align has firmed up my stool and helps me to control it better.  I have had IBS for years and bouts of diarrhea.  I learned to control my onset of cramping by totally relaxing - even driving the car when I had to.  I have been lucky that has worked for me but a couple times came really close to not making it to a bathroom.  I now have fast urges but am able to keep it in until I get to a bathroom.  I guess it depends on exactly where/how far up, etc. the UC is - mine is considered mild to moderate left - mostly rectal.  Oh, and when in doubt I always take my Imodium!!

ElaineNY


 
Senior - New diagnosed with proctosigmoiditis - 6/2008  Cannot tolerate mesalamines, Canasa, etc. Tried, Colozal, steroid enemas, etc. - started working but severe side effects occurred.
Started on prednisone Feb.7, 2009 - tapering to 20 mg. for two more weeks and then down to 15 mg.etc.  Added 6-MP Feb. 28.
Added Anusol suppositories - March 16 - see doc in 3 months. 
Probiotic Align, Prilosec for GERD, Gas-X, vitamins, Calcium/D
Tylenol for knees and arthritis.
 
 
 


mollymcbutter
Regular Member


Date Joined Mar 2009
Total Posts : 130
   Posted 3/23/2009 11:59 PM (GMT -6)   

HI Elaine, sorry you are having this flare going on.  I have used the suppositories in the past, not sure if I had more problems on them, but didn't help the ones I had.  My Dr. didn't think the suppositories quite got the medicine up far enough, so he had always wanted me to use the retention enemas, but none of that worked either, so don't do that now.  I always seem to have the urgency and go little bits, today was bad as it was about 8 times of that but generally not that much.  All seems to be okay on 6MP, but of course, have to wait quite a while to see if that is going to work.  I am tapering on my Prednisone down to 20 mg, maybe the tapering has caused my gut to be bad today.  I do use Probiotic VSL#3 can't say that that works either, Don't know about align, is that over the counter and priced reasonably..Molly

 

kops2da said...
confused  Well, I think you know my history and most is in my signature.  I know a couple here believe in medication from both ends - me too - generally.
Anyway, I have tapered from 40 mg. to 20 mg. prednisone and been there now for what is now almost 5 weeks.  Soon after starting on 40 mg. blleeding stopped - not all symptoms gone but much less - mostly low back pain.  No diarrhea, no cramping, urgency or nausea.  NOW - doctor put me on 6MP 24 days ago at 50 mg.  I went to see him and he said I could taper the prednisone to 15 mg. next week. I ask about suppositories as they are the easiest for me and he prescribed Anusol HC 25 each night.  I have MOSTLY proctitis and there is the discomfort, etc.
A week before I went to the doctor I was seeing some mucous streaked with blood occasionally only once in morning.  2 or 3 formed BM's every morning.
OK - been using the suppositories now for 8 days - one to three BM's a day - more dark/mucous on stool every day.  AND this morning a third BM was more red blood and less stool - small amount.  Not seen this since starting prednisone.  I took 1/2 Imodium to go get my hair done.
What is your take on this?  Just any ideas.  I will continue a few more days on what I am doing and then call the NP who works closely with doctor.  Seems like I am going backwards.  I don't want it to go too far in the wrong direction!
ElaineNY


quincy
Elite Member


Date Joined May 2003
Total Posts : 30591
   Posted 3/24/2009 1:11 AM (GMT -6)   
Elaine...sucks when it's two steps back, one forward. I wouldn't worry just yet about the bleeding unless it gets a lot worse...it could be the decrease of pred that's causing the symptoms, or you're definitely sensitive to something in the suppositories.


I would suggest to continue with the supps for at least another week to see what happens...if it gets worse, then maybe you'll have to stop them, increase the pred and taper more slowly.

I've suggested an alternating taper a few times..you might want to consider it for the pred.

Hope it improves.

quincy
*Heather* Status..Asacol  (3 x2 daily); Salofalk enemas nightly for flares, tapered to maintenance  mild flare nightly enemas
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(Natural Factors Protec, Primadophilus Reuteri Pearls, Natural Factors Ultimate). @ bedtime
~various digestive enzymes as needed; started Omega 3 
~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 3/24/2009 7:22 AM (GMT -6)   

Molly - seems we are about in the same place but I have only up to 3 BMs a day and usually only in the morning.  I tried primal defense and phillips for crohns and colitis and ended up getting most help from the Align probiotics.  You can get them at Walmart, Walgreens - I had to ask for them behind the counter.  They are about $1 for each day.  I think they have worked good for me but we are all different.

q -

"I would suggest to continue with the supps for at least another week to see what happens...if it gets worse, then maybe you'll have to stop them, increase the pred and taper more slowly.

I've suggested an alternating taper a few times..you might want to consider it for the pred."
 
I will wait until end of week or next Monday as that is the day I am scheduled to taper prednisone to 15 mg.  I will call and get ok from NP/doctor.  I won't do anything on my own but I love to give "suggestions"!  My feeling right now is that I went from 30 to 20 mg. and been on 20 mg. for a month now so maybe just up to 25 mg. for a week or so.  I will ask my NP who is absolutely wonderful and she will consult with doc probably.  I just hate going backwards!!  I love the prednisone for my arthritis/skin/energy, etc.  BUT - as my doctor says "don't get too used to it"!!  I know I have/want to get off it but it sure could be months.  Hope the 6MP will kick in early - been nearly a month now.  He talked about increasing to 75 mg. and I don't look forward to it. 
Thanks!  ElaineNY


 
Senior - New diagnosed with proctosigmoiditis - 6/2008  Cannot tolerate mesalamines, Canasa, etc. Tried, Colozal, steroid enemas, etc. - started working but severe side effects occurred.
Started on prednisone Feb.7, 2009 - tapering to 20 mg. for two more weeks and then down to 15 mg.etc.  Added 6-MP Feb. 28.
Added Anusol suppositories - March 16 - see doc in 3 months. 
Probiotic Align, Prilosec for GERD, Gas-X, vitamins, Calcium/D
Tylenol for knees and arthritis.
 
 
 


mollymcbutter
Regular Member


Date Joined Mar 2009
Total Posts : 130
   Posted 3/24/2009 7:32 AM (GMT -6)   
Hi Elaine, yes it does sound we are about the same with this.  Usually the BM's are like 3 and in AM also not the rest of the day.  I have only had the 6MP on board for 6 days, but I too, do not want to raise my dosage down the road so guess we will see.  I will have to look into the align, how much do you take? IS there a certain strength I ask for?
kops2da said...

Molly - seems we are about in the same place but I have only up to 3 BMs a day and usually only in the morning.  I tried primal defense and phillips for crohns and colitis and ended up getting most help from the Align probiotics.  You can get them at Walmart, Walgreens - I had to ask for them behind the counter.  They are about $1 for each day.  I think they have worked good for me but we are all different.

q -

"I would suggest to continue with the supps for at least another week to see what happens...if it gets worse, then maybe you'll have to stop them, increase the pred and taper more slowly.

I've suggested an alternating taper a few times..you might want to consider it for the pred."
 
I will wait until end of week or next Monday as that is the day I am scheduled to taper prednisone to 15 mg.  I will call and get ok from NP/doctor.  I won't do anything on my own but I love to give "suggestions"!  My feeling right now is that I went from 30 to 20 mg. and been on 20 mg. for a month now so maybe just up to 25 mg. for a week or so.  I will ask my NP who is absolutely wonderful and she will consult with doc probably.  I just hate going backwards!!  I love the prednisone for my arthritis/skin/energy, etc.  BUT - as my doctor says "don't get too used to it"!!  I know I have/want to get off it but it sure could be months.  Hope the 6MP will kick in early - been nearly a month now.  He talked about increasing to 75 mg. and I don't look forward to it. 
Thanks!  ElaineNY



WishfulMA
Regular Member


Date Joined Jul 2008
Total Posts : 197
   Posted 3/24/2009 7:50 AM (GMT -6)   

Hey Eliane! I am sorry to hear about your troubles. I was there! My 6MP has been increased to 100mgs and I am now on another taper of prednisone. Down to 10mgs. Right around the time you are at (one month into 6MP 50mgs and tapered pred) my bleeding came back. It def. was from the steriod withdrawal and the 6MP has not kicked in yet. It can take up to 3 months. I have now been on it for 2 months and 4 days ;). They did have to increase my dosage. The only side effects I am getting from the 6MP is loss of appetite, thinning of my hair and a bit quezzy.

I am using rowasa every other night too. So far I have not bled now since I went back on the prednisone 3/14.

We seem to have similiar cases. I would def include some sort of fiber in your diet as well to make your BM a little smoother and not as hard. That seems to always cut me up. Also I am now taking Rainbow Light Advanced Digestive Enzymes before every meal.

Good Luck! And dont be nervous if you have to increase the 6MP.


severe ulcerative proctitis - march 05 diagnosed
proctosigmoiditis - january 09 diagnosed
hospitalized - 3/08 for 6 days of IV steriods
hospitalized - 1/09 for 5 days of IV steriods / put on 6MP
past meds: colozol, sulfasalzine, hydrocortisone enemas, canasa, rowasa and prednisone 
current meds: 6MP (75mgs), Asacol 12 pills,  Rowasa Enema, Primal Defense Ultra Probiotic, fish oil, calcium w/ vitamin d 2x a day, prenatal vitamin & extra vitamin c and b12.
 
 


kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 3/24/2009 8:12 AM (GMT -6)   

I take only one Align as instructed but thought about trying two but so far my stool is formed - not hard - not too soft most of the time.  Remember, I have IBS also which affects digestion,etc. And hard to digest fats since I had my gallbladder out a few years back so I have to eat lowfat.  Still don't lose weight - mostly because of bad knees, lack of exercise and eating WHITE stuff - you know, bread, ice cream, cheese, etc. etc.

I WANT the loss of appetite - prednisone makes me want everything in sight to eat.  I fear I would never lose my appetite - I am very obese and it WAS from eating too much!! Had a perm yesterday and my hairdresser of many years said my hair if ok!  By the way, I wake up queasy about every day until I eat something!  I cannot use enemas - they all aggravate my rectum more than help - tried Rowasa, steroid and the foam.  I think the suppositories are doing the same.  Blood on tp today as well as in stool - haven't had that for weeks!

NP told me not to take fiber until healed as long as my stool is formed and smooth which it is.  In face, I am on a low residue type diet as much as possible - no wheat, no raw anything.

Well, we will see in a few days.  I might have to stop the rectal meds once again - yikes!

ElaineNY

 

 

 


 
Senior - New diagnosed with proctosigmoiditis - 6/2008  Cannot tolerate mesalamines, Canasa, etc. Tried, Colozal, steroid enemas, etc. - started working but severe side effects occurred.
Started on prednisone Feb.7, 2009 - tapering to 20 mg. for two more weeks and then down to 15 mg.etc.  Added 6-MP Feb. 28.
Added Anusol suppositories - March 16 - see doc in 3 months. 
Probiotic Align, Prilosec for GERD, Gas-X, vitamins, Calcium/D
Tylenol for knees and arthritis.
 
 
 


Mamas Boys
Veteran Member


Date Joined Oct 2005
Total Posts : 1460
   Posted 3/24/2009 11:05 AM (GMT -6)   

Hey Elaine!  Sorry to hear you're having issues again.  Have you been slowly starting to notice the mucus and blood over the last month since you dropped to 20mg or has it only been since you started the supps?  Maybe the supps are what it is doing you in.  If it's been since you dropped to 20mg - maybe you tapered too fast and need to raise the pred for a bit before you drop back down.  Maybe only by 2.5 or 5.  It took me a long time to taper off the pred cuz every time I jumped down a level I started flaring again.

The nausea in the morning can be from the 6mp (or standard colitis flare stuff).  I still have slight nausea every morning and I've been on Imuran for a few years now.


Mamas Boys
Colazal, Azathioprine, Remicade
Culturelle, MultiVitamin, Folic Acid, Viactiv
Status: Remission!!


kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 3/24/2009 11:27 AM (GMT -6)   

I will ask doctor about the tapering if this continues - bleeding started again after 2 weeks down to 20 mg.  Suppositories seem to be aggravating it a bit - giving it a few more days as I took Imodium and pepto yesterday so don't have a true reading on it all today.

As for the nausea - had that like 2 years mornings and sweating before diagnosed.  Docs thought anxiety, etc. etc. so after I went on Xanax it helped.  Now it is a lot less and occasionally!

ElaineNY


 
Senior - New diagnosed with proctosigmoiditis - 6/2008  Cannot tolerate mesalamines, Canasa, etc. Tried, Colozal, steroid enemas, etc. - started working but severe side effects occurred.
Started on prednisone Feb.7, 2009 - tapering to 20 mg. for two more weeks and then down to 15 mg.etc.  Added 6-MP Feb. 28.
Added Anusol suppositories - March 16 - see doc in 3 months. 
Probiotic Align, Prilosec for GERD, Gas-X, vitamins, Calcium/D
Tylenol for knees and arthritis.
 
 
 

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