I would love to know what the hold up is on getting foam in the US. Everything I have read indicates they are easier to retain than enemas and don't require lying still when you are having retention problems.
My last GI told me that Canasa and enemas should never be used for maintenance. I could kick myself for not asking him why. Canasa is an FDA approved maintenance med..most oral 5ASAs never went through the 24 month trial to get approved.
The guidelines for UC as published by the American College of Gastroentorology recommend rectal meds above oral meds alone for distal disease for both maintenance and induction. They recommend rectals be used with orals for induction. No recommendations are made for oral 5ASA delivery types.
I thought this article was interesting:www.ncbi.nlm.nih.gov/pmc/articles/PMC1773399/
because it concludes with this sentence:"The patient often declares a preference and that is the key to compliance." I guess advertising to patients is money well spent