Dificulty retaining Mesalamine enama

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nola66
New Member


Date Joined Aug 2009
Total Posts : 8
   Posted 8/26/2009 11:51 AM (GMT -6)   
Hi, first post. I'm having  dificulty holding in the mesalamine enema all night. Even holding it in at all.  The first enama is a total blow out, then if I do a second I can keep it in for 3-5 hr. Do I need to "prep" with some kind of enama first, or start with smaller amounts then increase untill I can retain the full 4gr/60ml dose? I do take a Nu-Lev tablet before with no succsess. I will note that I have no problem with the canasa suppositories that I take in the day time. I'm determined and would appreciate any advice or recommendations. Thanx

RobLewis
New Member


Date Joined Aug 2009
Total Posts : 15
   Posted 8/26/2009 12:44 PM (GMT -6)   
When you say the first enema is a total blowout, do you mean you can't hold it in? If so, use an empty bottle, fill it with warm distilled water, and use it first to see what happens. That should provoke you to get rid of anything that's inside you at the time

Dr-A
Veteran Member


Date Joined Jul 2006
Total Posts : 2105
   Posted 8/26/2009 12:55 PM (GMT -6)   
I suggest looking through this thread: http://www.healingwell.com/community/default.aspx?f=38&m=1574145

I don't want to retype everything again, but there are some good tips in there.
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


nola66
New Member


Date Joined Aug 2009
Total Posts : 8
   Posted 8/26/2009 3:01 PM (GMT -6)   
Yes, I can't hold in the contents of the enema. Not even for more than a 45-60 seconds. But, the second attempt is succsessful. I'll try this tonight with the warm distiled water. And I'll look up that link. I thought the Nu-Lev tablets were supposed to calm everything down... Thanx again.

sirenshooter
Veteran Member


Date Joined Jun 2009
Total Posts : 2011
   Posted 8/26/2009 4:54 PM (GMT -6)   
Sometimes when I first started (if you make it the inital half hour on your side) I would lay on my back with a pillow under my butt so gravity would help out a bit. Also, Nulev has absolutely no effect on me either.
19yr old female diagnosed with UC (pancolitis) in 2005 at age 15
125mg Azathioprine 1xday / 1 Mesalamine enema every night /
2000mg Fish Oil 1xday / 500mg Turmeric 3xday /
450mg Boswellia 2xday / 400IU Vitamin E 1xday
Arthritis in both knees
Also: asthma, acid reflux, and Reynaud's Syndrome


nola66
New Member


Date Joined Aug 2009
Total Posts : 8
   Posted 8/26/2009 6:31 PM (GMT -6)   
I spoke to my doctor and he sugested just going with the suppositories at night only and continuing my Lialda for daytime. After a week or so, start back with the enema at night and return to the suppositories and lialda for daytime. Reason being spasams in the rectum area need to be controled first? I think the distiled water first method is a better idea. I'll list more of my info when I get things figured out.

quincy
Elite Member


Date Joined May 2003
Total Posts : 30591
   Posted 8/27/2009 1:02 AM (GMT -6)   
omg...please don't do an enema to purge before you do the retention medication enemas. your colon will just get used to that process.

The suppositories are an alternative and shouldnt give you the urge to go because it won't give the added weight in the sigmoid...which can trigger the bm.


You should, however, use the suppositories night and in the morning to give a higher amount of med to the rectum.

You should then try the retention enemas again eventually.....


quincy
*Heather* Status: ...Asacol 3 twice daily; Salofalk enemas every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


lemonhead
Veteran Member


Date Joined Dec 2007
Total Posts : 1028
   Posted 8/27/2009 5:45 AM (GMT -6)   
Are you pushing out all the sir before you insert the enema. If I don't do that, I can not retain it either. 

diagnosed with left-sided UC in 1997. (45cm)
Currently on 10mg Prednisone
12 caps of colazal    9 caps Colazal
2  1 rowasa enemas nightly
35, female


Christine1946
Veteran Member


Date Joined Aug 2008
Total Posts : 5963
   Posted 8/27/2009 6:47 AM (GMT -6)   
     I have this problem also.  My GI doctor said to use the Cort enema and hold as long as possible.  If it comes out, then insert the Canasa suppository.
 
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.


Dr-A
Veteran Member


Date Joined Jul 2006
Total Posts : 2105
   Posted 8/27/2009 6:56 AM (GMT -6)   
quincy said...
omg...please don't do an enema to purge before you do the retention medication enemas. your colon will just get used to that process.

The suppositories are an alternative and shouldnt give you the urge to go because it won't give the added weight in the sigmoid...which can trigger the bm.


You should, however, use the suppositories night and in the morning to give a higher amount of med to the rectum.

You should then try the retention enemas again eventually.....


quincy


What is the difference in purging 60 ml of medicine rather than 60 ml of water? It has helped me many times to be able to retain meds down there when I was so inflammed nothing would stay in. It gives people an option that would otherwise just stop trying altogether due to the problem.
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


nola66
New Member


Date Joined Aug 2009
Total Posts : 8
   Posted 8/27/2009 7:54 AM (GMT -6)   
Quincy, the first enema is not acting as a purge for a bm. Iagree with using the suppositories at night and day, that makes sense to me. The distiledwater enema makes sense; I won't waste medicine on a spasam, then I can retain the medicine as Dr-A stated.

fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 8/27/2009 9:00 AM (GMT -6)   
You can also just try using half of the enema to see if you can hold that.
Status: Remission since May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently meds: Apriso (4 0.375g pills ONCE!! daily), mesalamine enema twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (currently tapering; 12.5 mg).


quincy
Elite Member


Date Joined May 2003
Total Posts : 30591
   Posted 8/27/2009 12:59 PM (GMT -6)   
Whatever....I'd still never have my arse believe that it needs to purge nightly before the med through a mechanical means. If I had to go..I'd rather wait for the process to happen naturally or because of inflammation BEFORE the enema and wait for the urge to go after the enema while groaning, biting the sheets, pinching my husband and squeezing my butt cheeks, do deep breathing or huffing or whatever it takes to get through it...it passes after a minute or so. 

But, I've been doing them for 20+ years and have only had to let go of 3.

If anyone chooses the method of an enema before.....more power to you. But I disagree with it because of the "habit" of it.....ESPECIALLY if one is only purging the med or water and no stool.
 
I think it would be better to stick your butt in the air waiting for the urge to pass than run for the toilet...use suppositories.....take antispasmodics.....fibre supplements.....relaxation exercises...anti anxiety meds....calming teas.....or half the enema as fruitgirl suggested.
 
Best to learn the process of retaining....

quincy


*Heather* Status: ...Asacol 3 twice daily; Salofalk enemas every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 

Post Edited (quincy) : 8/27/2009 1:05:17 PM (GMT-6)


nola66
New Member


Date Joined Aug 2009
Total Posts : 8
   Posted 8/27/2009 2:08 PM (GMT -6)   
"Best learn the process of retaining..." Just spoke to my GI and that was his advice, exact words. And "using half of the enema". This regiment is new to me so I'm trying to learn as much as I can. Thanx all.

quincy
Elite Member


Date Joined May 2003
Total Posts : 30591
   Posted 8/27/2009 3:41 PM (GMT -6)   
Verified....sometimes it's sweet.
*Heather* Status: ...Asacol 3 twice daily; Salofalk enemas every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


Dr-A
Veteran Member


Date Joined Jul 2006
Total Posts : 2105
   Posted 8/27/2009 7:11 PM (GMT -6)   
LOL, trust me I know how to retain an enema. When it's not gonna stay its not gonna stay, no matter how tight you clinch your butt. My GI in ATL actually gave me this idea around 7 years ago and I use it when needed. It really has nothing to do with any "habit". For me, sometimes it's either run out of medicine and hope you can go a week without it because you wasted 7 down the toilet, or do what I need to make sure it's staying in. I was grateful when I got this advice so I will gladly pass it on for the right situations.
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


quincy
Elite Member


Date Joined May 2003
Total Posts : 30591
   Posted 8/28/2009 12:18 AM (GMT -6)   
share, share, share....always options. I just disagree strongly with that one for what I believe is illogical and unnecessary process.

We all do what we want anyway.

q
*Heather* Status: ...Asacol 3 twice daily; Salofalk enemas every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


nola66
New Member


Date Joined Aug 2009
Total Posts : 8
   Posted 8/28/2009 6:55 AM (GMT -6)   
Overall, I appreciate all the experienced advice given. Thanx!
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