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David Wendt
New Member
Joined : Mar 2017
Posts : 9
Posted 10/5/2020 10:35 AM (GMT -7)
I started Mesalamine enemas 7 days ago as I am in a flare up. It feels like my rectum is still inflamed and I'm still having BM's 5 times a day in the a.m. It literally feels like I'm trying to poop a football through a garden hose. I just got off a Prednisone ween about 2 weeks ago. I am tired of running to the toilet especially at work. How long before the enemas are going to help?
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momto2boys
Veteran Member
Joined : Jun 2013
Posts : 2351
Posted 10/5/2020 2:00 PM (GMT -7)
It will take a couple of weeks at least. How long were you on Pred and what dose did you start at? You might want to switch to hydrocortisone enemas and alternate those with rowasa. Sometimes they work a bit faster than rowasa does.
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David Wendt
New Member
Joined : Mar 2017
Posts : 9
Posted 10/5/2020 2:55 PM (GMT -7)
Was on a 30mg Prednisone which I started over 2 months ago and finished about 2 weeks ago. Still had flare going so my Doc put me on the enemas. Im on Lialda too (4 pills daily) but that doesn't seem to work for me. Been on Liald for 3 years now. I was on Azathioprine but got violently ill taking those. Not my first go around with UC but can't seem to get any relief lately. Also keep getting Cdiff infections as well (already had to bouts this year). Im to the point that im losing weight because I don't want to eat. This flare is really draining me mentally and physically.
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The_Swan
Regular Member
Joined : Jan 2019
Posts : 126
Posted 10/5/2020 3:14 PM (GMT -7)
For me usually about couple weeks, but I use it twice a day at the beginning of the flare.
Hope you will get better soon!
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TroubledTurds
Veteran Member
Joined : Jan 2004
Posts : 8580
Posted 10/5/2020 9:34 PM (GMT -7)
that's a pretty low dose of pred - did you start at a higher dose ? taking you off while still flaring is questionable -

imo, it's not likely the current enemas will gain you a whole lot - i agree with mom > " switch to hydrocortisone enemas and alternate those with rowasa. "

TT
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David Wendt
New Member
Joined : Mar 2017
Posts : 9
Posted 10/6/2020 5:52 AM (GMT -7)
When I was first diagnosed in 2016 I was on 60mg per day of Prednisone. This time I had just finished being treated for a Cdiff infection so he wasn't sure if the infection was causing my troubles or if it was an actual flare up going on. After I weaned off the Prednisone I was still having issues so he put me on the Rowasa enemas. I've been on the Rowasa for a week now and haven't noticed a change yet. The constant feeling of having to go is brutal.
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TroubledTurds
Veteran Member
Joined : Jan 2004
Posts : 8580
Posted 10/6/2020 6:17 AM (GMT -7)
how much rowasa are you using ? same question for the lialda ?

TT
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garyi
Veteran Member
Joined : Jun 2017
Posts : 2070
Posted 10/6/2020 7:10 AM (GMT -7)
If you've been diagnosed with C. diff also, and it's reoccurring, it may be the source of your flair. It was for me. I had a 14 day course of Vanco, and my miserable symptoms, looking much like a UC flair, only subsided at the end of the second week.

Antibiotics both target, and can aggravate, C. diff, as you probably already know. They include:

Fidaxomicin
Metronidazole
Vancomycin

You need a GI or infectious disease physician, who is really experienced with C. diff.

When C. diff infections return, it's serious!. Doctors sometimes recommend a treatment to help repopulate the colon with healthy bacteria using a colonoscope. The procedure is called fecal microbiota transplant (FMT), it sounds worse than it is, and it has been very successful for many.

Good luck!
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momto2boys
Veteran Member
Joined : Jun 2013
Posts : 2351
Posted 10/6/2020 10:50 AM (GMT -7)
If you are also potentially dealing with c-diff, that's a whole other ball game. For sure get yourself to a GI who specializes in c-diff and try treating that again. If you have c-diff the steroids could make it worse. Perhaps you could try something like the enemas at night and canasa during the day. I had to do this in my last flare up so I could function. The trick is using them after what you assume is your last BM of the morning.
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David Wendt
New Member
Joined : Mar 2017
Posts : 9
Posted 10/6/2020 5:01 PM (GMT -7)
Thanks for the Cdiff info. My doc did a stool sample to make sure the Cdiff was gone before starting me on the Prednisone.
I am currently taking (4) 1.2gm of Lialda per day and I'm 1 week into the 4 week course if 60ml Mesalamine enemas.
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3timechamp
Veteran Member
Joined : Oct 2009
Posts : 1655
Posted 10/6/2020 5:04 PM (GMT -7)
Ask Dr about Cortenemas. During my 32 yrs of UC they worked magic
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Donnie Brasco
Regular Member
Joined : Apr 2014
Posts : 64
Posted 10/14/2020 10:55 PM (GMT -7)
I’m in a flare myself, going for 1.5 months now, on 40 mg of pred for 2 weeks now seeing results but the mesalamine enemas i feel are doing nothing for me as well - they used to do magic before, now as if they aggravate it more. I do not plan to decrease pred until bleeding has fully stopped.
I’m also increasing pomegranate fruit intake (spitting out the seeds) helps so much with bloating and digestion, try it! and Aloe Vera leaf fillet - i get the big thorny leaves from the farmer market and fillet them at home. Acquired taste smile
My biggest problem is the last part of colon, still have the urgency but getting better.
Question: i read here about suppositories, and I requested them from my Dr. and she prescribed Hydrocortisone ones. I though there were steroid ones.. hydrocortisone is for hemorrhoids no? Should i use these?
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Sir Egg Benedict
New Member
Joined : Jan 2018
Posts : 17
Posted 10/15/2020 2:43 AM (GMT -7)
They definitely take awhile. My first time using them during a bad flare, I had to first use steroid enemas for awhile.. 4-5 weeks, and then transition to mesalamine. Even after that, it was well over a month before they started having a big effect -- but once they kicked in they kept me in remission for well over a year.
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 1550
Posted 10/15/2020 10:19 AM (GMT -7)
You could try hydrocortisone enemas. They work pretty fast for me.

I think I would ask to get another c diff test to make sure it's really gone (sometimes there are false negatives) and then try another course of pred, start at a higher dose and don't start tapering until you start to see improvement and then slowly taper. I hate pred, but it does work miracles.

Last time I was on it a couple years ago I was on 40 mg for 2 weeks with no improvement and thought I was going to end up in the hospital. Doc bumped me up to 60mg and I saw major improvement within 2 days and felt like I had my life back.

You probably should be thinking about another maintenance med since Lialda isn't enough anymore. Probably time to move to a biologic. They really aren't as scary as they sound. I was very resistant to biologics but am happy I did now.
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