Difficulty with Hydrocortisone

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RobLewis
New Member


Date Joined Aug 2009
Total Posts : 15
   Posted 8/25/2009 8:08 PM (GMT -6)   
Tonight was my first time attempting to give myself a Hydrocortisone enema. Obviously, I wasn't thrilled about having to do it, but after having active Ulcerative Colitis for over a year, and being unable to comfortably leave the house, I was ready to try anything.

Anyway, I tried to slowly squeeze the liquid in to myself, and when I thought I was about done, I took it out and looked at it. The bottle still had about 2/3 of the medicine in it. I was shocked that I had only used such a small amount, and moments later, I felt the powerful urge to "go."

So the first attempt was pretty much completely wasted, but I tried again. Once again, I only managed to get about 1/3 of the medicine out. I was able to stay in position and let it distribute throughout my colon, but I decided to stop there for the night.

I'm throwing tonight away as a practice night, but I was wondering if anyone had any advice on getting through the treatment easily. I'm not even sure if I'm going to be able to do this without being put to sleep and letting a nurse do it or something

kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 8/25/2009 8:20 PM (GMT -6)   
no fun for sure.  doctor told me 1/3 was good for first few times.  Also, lay on your left side, grin and bear it - the urge will pass and you can retain it longer each time. Don't give up!  I have been luck with the foam but it wll not go up as far.   Elaine

 
Senior - diagnosed with proctosigmoiditis - 6/2008   
No prescriptions as of yesterday!  Hoping for best and possibly adding other supplements.
 
Probiotic Align, Prilosec for GERD, Gas-X, vitamins, Calcium/D
Tylenol for knees and arthritis.
 
 
 


jujub
Elite Member


Date Joined Mar 2003
Total Posts : 10407
   Posted 8/25/2009 8:38 PM (GMT -6)   
Breathing through your mouth when the urge hits can sometimes help get you through it.
Judy
 Ulcerative colitis forum co-moderator
 
Moderate to severe left-sided UC diagnosed 2001. Flared for 5 years, finally in remission with Remicade since March 2006. Colazal,  Remicade, Nature's Way Primadophilus Reuteri.
Avascular necrosis in both shoulders is  my "forever" gift from steroids.
Chronic joint/connective tissue/muscle pain; TKR 05/09 
"My life is an ongoing medical adventure"
 


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 8/25/2009 9:06 PM (GMT -6)   
Was it foam that you used? It's not uncommon for some of the foam to be left behind...I only use foam and have had no issues getting pretty much all of it in and I administer it upright (while I'm sitting on the toilet)...I also use at my very least active time, right before bed.

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


RobLewis
New Member


Date Joined Aug 2009
Total Posts : 15
   Posted 8/25/2009 9:13 PM (GMT -6)   
It was the liquid form. At least, I'm pretty sure it's liquid. It's very thick

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 8/25/2009 9:20 PM (GMT -6)   
Then that too will likely leave some residue behind, but if you're concerned then you could ask your doc about switching you to a foam based med like cortifoam (it's the only rectal med I'll use).

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


Christine1946
Veteran Member


Date Joined Aug 2008
Total Posts : 5975
   Posted 8/25/2009 10:15 PM (GMT -6)   
     I have the same problem.  There is always about 1/4 of the bottle left in.  I don't discard the leftover amount.  Instead, I save the amount that remains and pour it into the bottle that has 1/4 left.  Therefore, I feel I don't waste it.
     The best postition for me is to kneel with my butt in the air...not a pretty sight, but I make sure I am by myself in the bedroom while doing this....and stick it in.  Try remaining in that position for a few minutes.  Then I lie on my side.  Sometimes it stays in and sometimes I can only hold it for a short while.  I take Canasa suppositories in the mornings.  I have better luck retaining them than the cort enemas.
 
Diagnosed with ulcerative proctitis in 1998 in hospital
Hospitalized (2nd time) in May 2008 for ten days.
Remission Nov 08 thru May of 09.
Slowly coming out of flare.  Meds: Colazal (6 per day), prednisone 10 mgm and tapering weekly, Cort enema nightly, Canasa in morning, Benicar 20 mg for BP, flaxseed oil 3 x a day, fishoil 2 x a day, probiotic 3 x a day, calcium with D 1x a day and multivitamin.
Doctor had me on 100 mgm of 6MP which drastically lowered my white count.  Now off the 6MP pending results of repeat white count. UGH.


redhah
New Member


Date Joined Jul 2008
Total Posts : 15
   Posted 8/25/2009 10:53 PM (GMT -6)   
I lay on my left side. Before I do the enema I squeeze the enema so the liquid is at the tip of the enema. Then I make sure to stick the end of the enema as far up as possible, squeeze the enema really hard and pretty fast and end up scrunching it up. I have found that when I am flaring pretty badly I can't hold the enemas in and I have the urge to go. Best of luck.
23 yr. old female
diagnosed age 15, current meds: Remicade every 8 weeks, iron
have taken: azathioprine, asacol,colazal, prilosec, prenisone, rowasa + cortisone enemas, flagyl + vancomycin for c-diff
hospitalized three times: 2002 April (2 weeks) 2003 December (1 week) 2006 (1 week), have had pick line,
have had 4 colonoscopies, had blood transfusion Feb 2008


Durango Kid
Regular Member


Date Joined Jul 2009
Total Posts : 330
   Posted 8/26/2009 1:19 AM (GMT -6)   
I'm currently doing the hydrocort enemas. I realy try to have a good BM prior to injection. I've had diffculty retaining a few times so sometimes I'll take an Imodium AD about an hour before and this really seems to help. Good luck! They help me alot....geez are they expensive though.
UC diagnosed  Dec. 2003 after quiting smoking
*Asacol (3)3x daily
*Fish oil
*Probiotics
*Multi-Vitamin
*Spinach & sunflower seed suppliment (this seems to   help!)
*Possibly lactose intolerant (still trying to identify)
*Currently flarring (only 2nd time) Pred 40mg  20mg daily for two  three four weeks then tapering off....
*Back on the hydro cortisone enemas noticing immediate relief.
Femoral Bypass 2006
*Cozzar (for blood pressure)
*Zetia/Welchol (for colesterol)
*Niacin 2000mg daily
 
 


songlady
Veteran Member


Date Joined Aug 2009
Total Posts : 3696
   Posted 8/26/2009 7:54 AM (GMT -6)   
I feel as if I could write a book on how to do retention enemas. (I don't think it would be a best-seller....)
It's enormously easier to do if I've had a BM just prior.
I put a little lube of some sort on my butt to help the thing slide in, then I lie on my left side, squish the air out of the bottle, insert the tip and I squeeze it slowly, folding up the bottle as it empties - I get most of it out that way. I breathe slowly and calmly, and I don't talk or move for at least 5 minutes (then usually I've fallen asleep - I do it right at "lights out" time.)
If it's cold weather so the enema bottles are cold, I warm them first, usually by just holding them in my armpit for some minutes while I'm reading. (Actually my wonderful hubby usually warms them for me!)
I find that horrible spasming "urge to go" feeling will usually pass if I can lie still, breathe, and not move at all.
Good luck to you!
Diagnosed UP 1983, Azulphidine
Diagnosed UC 1986 Prednisone almost 2 years
Asacol - 16 pills a day
Metamucil - 2 doses a day
Cortenemas or Rowasa from time to time
VSL#3, Ultimate Flora Critical Care
Canasa as needed


mindstyle
Regular Member


Date Joined Aug 2009
Total Posts : 62
   Posted 8/26/2009 9:57 AM (GMT -6)   
When I had to use Pred enema, my wife would help me administering it. But before that, I would make a quick trip to the loo and lie in doggy style (sorry, no better word) for about 10 mins, to get as much gas out. Once, I am almost certain that I am ready, she would administer it. You are lucky that the contents are thick, the one I used was exactly watery and my wife never managed to administer the complete bottle.
My GI told me, administer as much as you can and don't worry about what you can't. Did you ask them about foam (that feeling is no pleasant either)
Diagnosed with Ulcerative Colitis since 2006, at the age of 30 years

Currently taking
100mg of Azathiprine, twice a day
2250mg of Balsalazide Hydrochloride, 3X a day
10mg of Vit. B12, once a day
500mg Salazopyrine suppository once a day.

30mg/day of Prednisolone since 2009/08/21 to control recent flare up, will reduce the dose by 5mg each week. (hoping not to swell up)


Dr-A
Veteran Member


Date Joined Jul 2006
Total Posts : 2105
   Posted 8/26/2009 10:14 AM (GMT -6)   
1/3 is a good amount. People focus so much on getting the whole thing in and then expel it so it is wasteful anyway. I would rather get 1/3 than a whole bottle in and just expel it back out.

I stay in the bathroom while doing this. I don't do it in the bedroom, and stopped attempting that several years ago. (After I lay 15 minutes with the cortenema in you can get up and move to the bed anyway) I only use 1/3 at a time usually, maybe a half if I am feeling lucky. I never discard the unused part. Some people get hung up on the hygienics of that, but being a doctor and doing it for as long as I have I can say its completely safe for myself. It is your own rear end. Pour unused portions together and make full bottles.

Warming them up in sink first is great advice. Something that makes it even easier is taking one of your empty bottles, fill it with distilled water, warm that up, and use that 60ml of warm water first to see whats gonna happen. Usually that will provoke you to evacuate anything down there thats going to come out anyway when you try the regular enema. You can do this a few times if you need to. This makes it extremely easy to get the enemas to stay in. Lying on left side right knee up is usually pretty good position. On knees with rear end up in the air sometimes works, then just slowly move down onto left side once it goes in. Sometimes if I really want the stuff to migrate up through my colon, or if I am using a thinner enema I will prop my back up against a wall and stick my legs up in the air braced up with the wall.

Plenty of A&D ointment on the tip works best for me too. Tried several other lubes and they just didn't cut it. I think its the tevia brand that has the horrible made tips. They can cut the rectum and make things worse so if it is sharp going in don't even use it. Find a tip that is smooth and stick with it.
Proctitis DX 1999, Pancolitis DX 2008
Golimumab study (100mg every 4 weeks)
L-Glutamine 5000 mg + 600 mg pyridoxal alpha-ketoglutarate
Probiotis/VitD3 5000IU+Ca/1000mg DHA


RobLewis
New Member


Date Joined Aug 2009
Total Posts : 15
   Posted 8/26/2009 10:29 AM (GMT -6)   
Thanks for the empty bottle tip. That was pretty much my main concern; how to know if I was really ready or not. I do plan on getting more in when I try it tonight, but now I'm curious, would the treatment still work well if I only used 1/3 every time? Not that I plan on taking the easy route, because if I'm going to go through this, I'll do it right, but I'm just wondering if it will be worth worrying about if by next week I'm not getting more than 2/3 of the medicine

Dr-A
Veteran Member


Date Joined Jul 2006
Total Posts : 2105
   Posted 8/26/2009 10:50 AM (GMT -6)   
The more you get in the better of course, but my focus was always on retaining the smaller amount all night. Using water first you will be able to get alot more in and retain it easier. It's trial and error. See what helps... if you don't notice a differnce with just 1/3 overnight, use more.

Yeah, it always helps to have a bottle you are putting the leftover stuff into. No matter how much you squeeze you never get it all out, lol. Initially I was just throwing unused parts away and maybe going through three bottles before one got in and stayed.... Well, after running out of meds a few times during the months and having to pay out of pocket I learned my lesson. They are around $10 for on 60ml bottle.
Proctitis DX 1999, Pancolitis DX 2008
Golimumab study (100mg every 4 weeks)
L-Glutamine 5000 mg + 600 mg pyridoxal alpha-ketoglutarate
Probiotis/VitD3 5000IU+Ca/1000mg DHA

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