Hi...this is with UC, don't know about
CD. But I parallel the healing described by my doc to a thermometer (since we all know how they work).
Basically, UC starts at the rectum/anal junction and goes upward in a classic continuous pattern. It can be limited or throughout. No matter how high it goes, the rectum will be inflamed first. Hence my push for both rectal and oral meds.
During a flare, usually the rectum is the worst in inflammation, but it seems that if it's being treated, it will gradually lessen in severity. If the higher part of the rectum is involved and going toward the sigmoid, etc...enemas are obviously going to reach those areas. The oral meds can get into the sigmoid and treat it from that end or help prevent it from working its way upward.
So, the both end approach or a very limited inflammation rectal approach, UC recedes in a downward healing manor, with the lowest part still harder to treat. Sometimes adding the suppositories continues a more concentrated amount of med to help deal with that.
So, think of the thermometer bulb the lowest part of the rectum and the raising temp the pattern.
A constantly reacting lower rectum can be part of one's disease pattern and for some it might never heal.
There's one form of UC where there's cecal involvement, and my theory is that if it's not treated, the lower area will continue to be in an extreme fussy state, not reacting as well to the rectal approach.
It's possible that for some with this form, a imited disease diagnosis that has been determined with only a sig-scope and missing the cecal inflammation they aren't being treated fully.
I don't know, but suspect, that for some....this form is like the candle at both ends and they eventually meet to become a pancolitis.
Symptoms such as diarrhea with very limited UC can be suspect of this.
To me...ANY and all areas should be treated...regardless. 5ASA meds exhausted and considered as to where they release. Low dosages can also be used initially and increased if necessary. Better than starting high and having side effects and saying 5ASA meds don't work.
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Airomir (asthma);Effexor XR 37.5 (depression)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4500 IU
~URSO for PBC(or PSC?) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!
Post Edited (quincy) : 8/27/2012 1:56:46 PM (GMT-6)