Rowasa, cortenema, and entocort are all medications used to treat mild to slightly moderate flares of UC. Most (with the exception of entocort) are meant for left-side only treatment. Entocort treats the small intestine and large intestine. Rowasa has the least odds for side effects and is the safest of the three. The other two are steroids and carry the standard steroid related side effects and risks. I tend to think a short term usage of entocort/cortenema is fine, however, long term usage can have much longer lasting affects.
Medical therapies may impact negatively upon aspects of growth in children with IBD. Corticosteroids, for example, can lead to numerous side effects, including nutritional consequences . Increased appetite and fluid retention are commonly seen after commencement of steroids. Consequently, apparent improvements in weight during a course of corticosteroids may reflect fluid retention and not an improvement in the underlying nutritional status. Steroids also lead to enhanced bone resorption and decreased new bone formation, adversely affecting bone health [48, 49]. Further, daily corticosteroid therapy can suppress IGF-1 activity, contributing to inhibition of linear growth and impaired final height .
Anti-inflammatory rowasa/mesalamine can be used to treat flares and also used indefinitely as a maintenance treatment. They are 90% topical and few experience side effects from them, and 10% systematic absorption. It is typically a 60ml suspension with 4.0-grams of mesalamine that treats the left side (rectum, sigmoid colon and descending colon). sfRowasa availability is very spotty, and obtaining them is difficult (as reported by posters here). The regular rowasa (with sulfite) is easily obtainable.
Cortenema is a 100mg/60ml enema that treats the left side with a steroid: hydrocortisone. It's meant for short term usage. Steroids are generally more powerful than mesalamine, hit an inflamed area hard and treat it fast. A short, 8-week course can at times be enough to stop a mild, run-of-the-mill flareup and return us to our normal maintenance treatment. All steroids have an approximately 10% systematic absorption, so it is possible to have mild steroid side effects, like acne, increased irritability/moodiness, increased appetite, etc etc.
Entocort is a 3mg oral pill with a delayed-release coating containing a steroid that is meant for short term usage, 8-weeks or less. Budesonide's claim to fame is it has less side effects when compared to other side effects (hydro-cortisone/pred/etc) The treatment area would begin within the small intestine, and includes the full length of the large intestine. So this medication treats the largest area of the three mentioned.
Moderator Ulcerative Colitis
John, 40, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasaShower-thought: Most people are surprised when they see blood on their toilet paper. UC patients are surprised when there isn’t any.