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Best rectal meds for left sided colitis?

Chronic Illness Forums
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Ulcerative Colitis
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VickyUC
Regular Member
Joined : Jun 2019
Posts : 30
Posted 8/15/2019 2:49 AM (GMT -7)
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.
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UCmee
Regular Member
Joined : Sep 2017
Posts : 73
Posted 8/15/2019 4:24 AM (GMT -7)
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.
,_,
Male 34 years
Dx'd with Left Sided UC March 2013 initially was on budesonide 9mg for 3 weeks tapering 3mg each week and mesalamine 2.4 gms
Initial flare last about 8 months and currently flaring
Rx: 2.4 gm of mesalamine(1.2 gm×2) daily , probiotic daily
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DBwithUC
Veteran Member
Joined : Feb 2011
Posts : 4530
Posted 8/15/2019 7:11 AM (GMT -7)
The liquid does seem to go higher, and the mesalamines do offer prospect for longer term safe use.
11/08: ischemic colitis and scope perf colon. 12cm colon/ileocecal resected. IV antib:sepsis.
01/10: Dx: Mod. UC pancolitis. Rx: Lialda 3x.
02/11: Major flare w/antib:sinus. Rx: 40mg Pred taper. 6mp.
07/11: Histol remiss rt/trans; worse sigmoid. Rx: Rowasa & hydrocort
---
Curr: 1-2 soft-formed stool, no urgency: Lialda 2x, NO PRED, probiotics, Vit-D/C
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quincy
Elite Member
Joined : May 2003
Posts : 31939
Posted 8/15/2019 9:59 AM (GMT -7)
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
*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/Oxeze/Airomir (asthma); Effexor XR 75mg (depression); Rosuvastatin 10mg (cholesterol); Telemesartin 80mg (BP)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care + Genuine Health Advanced Gut Health 50 billion @ bedtime)
~Metamucil capsules 6 @ 2x daily with meals; Vitamin D 4500 IU
~URSO 500mg @ 2x daily for Primary Biliary Cholangitis
~Sjogren's (secondary)...symtomatic treatment
"TREAT (FROM)BOTH ENDS" worth it !!
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VickyUC
Regular Member
Joined : Jun 2019
Posts : 30
Posted 8/15/2019 1:11 PM (GMT -7)
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!
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MomOfUCBoy
Regular Member
Joined : Jun 2016
Posts : 50
Posted 8/15/2019 4:57 PM (GMT -7)
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.
Teen diagnosed with pancolitis in 2016 in rem
--Current: Daily: 4 Lialda daily, VSL3DS, 4 Metamucil capsules, turmeric, multi vit w methyl folate. SFRowasa as needed.
--Diet: Gluten-free, organic, no emulsifiers or preservatives, Low FODMAP
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Sara14
Veteran Member
Joined : Mar 2007
Posts : 5570
Posted 8/15/2019 9:01 PM (GMT -7)
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?
35 years old; diagnosed UC March 2007 (prob. pancolitis; couldn't get scope all the way thru).
9-29-16: chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Remission since Dec. 25, 2016 until I started smoking again May 2018 after 9 yrs quit. Maintenance: Delzicol, 6, 2xday; Rowasa nightly. 10 mg pred. Started Remicade 7/25/19.
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VickyUC
Regular Member
Joined : Jun 2019
Posts : 30
Posted 8/16/2019 8:50 AM (GMT -7)
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.
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Hugo18
Regular Member
Joined : Mar 2017
Posts : 130
Posted 8/16/2019 10:46 AM (GMT -7)
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?
2017- January-diagnosed distal colitis
2017-March hospitalized for pan colitis
Currently on remicade
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noodlesnoodles
Regular Member
Joined : Nov 2015
Posts : 335
Posted 8/18/2019 10:38 PM (GMT -7)
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).
30 year old female
Ulcerative Pancolitis (w/ backwash ileitis)
Current meds: Xeljanz, 20mg MTX injection weekly, Apriso, Canasa, B12 injections monthly, iron infusions
-TPMT deficiency-
Failed Remicade, Entyvio
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