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Best rectal meds for left sided colitis?

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Ulcerative Colitis
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Posted 8/15/2019 3:49 AM (GMT -6)
Hello can I please get opinions on the best rectal medication for left sided colitis. I am currently using Budenofalk foam and it provides slight relief but I don’t think it gets up high enough. I have tried salofalk foam in the past with no relief.

I just wondered if anyone has any suggestions on the best way to get maximum benefits from rectal meds. I am currently taking Xeljanz and after a scope yesterday it seems I still have moderate/severe inflammation the whole way through the left side of my colon all the way up to the splenic flexure.

Prednisone isn’t helping and I’m at a loss as to what is next. I would rather treat it rectally if I can so any advice would be greatfully received.

Worth mentioning I am in the UK and I think a lot of the medications have different names here.
Posted 8/15/2019 5:24 AM (GMT -6)
You can try 4gm mesalamine enema. Each country has different brands of enema and i just googled you have Salofalk and Pentasa enemas available in UK. I know pentasa is 1gm in 100ml enema and i guess salofalk is 4gm in 60ml enema. I recommend you to try with salofalk enema as you said your inflammation is moderate/severe. Enemas were proved to reach splenic flexure and treats entire left colon.
Posted 8/15/2019 8:11 AM (GMT -6)
The liquid does seem to go higher, and the mesalamines do offer prospect for longer term safe use.
Posted 8/15/2019 10:59 AM (GMT -6)
My perspective...it doesnt matter if the enema goes higher than past the sigmoid if other oral topicals are used. I suggest you also use oral mesalamine and 4g mesalamine retention enemas.

Always worth a try.

q
Posted 8/15/2019 2:11 PM (GMT -6)
Thank you all for your replies. It’s been very useful. I am also on the highest oral dose of mesalamine. I’m taking 4800mg Mezavant XL. Hoping something kicks in soon!
Posted 8/15/2019 5:57 PM (GMT -6)
Mesalamine enemas (Rowasa) have worked great for my son. Pull him out of a flare every time and it is his left side that is usually worst.
Posted 8/15/2019 10:01 PM (GMT -6)
I would try the mesalamine enemas. However, if prednisone isnt helping, I dont know if mesalamine would. It wouldn't for me. What did your doctor suggest?
Posted 8/16/2019 9:50 AM (GMT -6)
Sara14 Doctor has perscribed more Budenofalk 2g once a day I believe this is the steroid foam. It worked when I first started using it but it doesn’t seem so effective now. I tried the salofalk foam in the past and it did nothing I believe that is the mesalamine one. Doctor wants me to continue foam whilst we wait for funding approval for vedolizimab.
Posted 8/16/2019 11:46 AM (GMT -6)
Similar to my situation but I am on remicade. I have tried every rectal remedy and zero help. I have major urgency in the morning, with small blood at times. Nothing is improving it. The real issue is when do you move biologics just due to rectal inflammation?
Posted 8/18/2019 11:38 PM (GMT -6)
I'd do 2-4 weeks of hydrocortisone enemas to get things under control and then switch back to the budesonide enemas to see if they work better once hydrocortisone puts the fire out (so to speak).
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