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Hydrocortisone Enemas Making Things Worse

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Ulcerative Colitis
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UCinsouthfl
Regular Member
Joined : Mar 2014
Posts : 132
Posted 10/19/2020 8:21 AM (GMT -7)
Hi All...

I haven't been on in a while because I was in remission for a little over a year. (First full year of remission since first being diagnosed 8 years ago with uc.)

I currently take Entyvio every 8 weeks and it was working so well. I've been through the gambit with ASA's with no avail. I've tried Humira & Simponi. Humira kinda worked for a while.

Since starting this flare I first started with 20mg of Prednisone hoping to not go super high. I was hoping to do a quick dose and then ween right away. Just enough to shock my immune system into chilling out. Well that didn't work. I always keep hydrocortisone enemas incase, and sure enough the 20mg of Pred wasn't enough so I went to 40mg while also using the hydrocortisone enemas at night. (Been 1 week on 40 mg of pred, 2 weeks on the enema's.)

This flare is so weird though because I seem to have formed stools but I think I have severe proctitis. It is extremely painful to have a bowel movement feeling like there is almost something blocking, but I am able to barely get it out. I'm having a terrible time keeping the enema's in at night. In fact I've been unable too. My UC is always worse in the morning but this time it seems like the enema's may be the culprit. Normally they help but don't seem to be this time. (I also have internal hemorrhid's) I see my GI doc in a couple days but I'm at a loss. It is so painful to have a bm. Could it be the enema's?
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TP177
Regular Member
Joined : Feb 2010
Posts : 107
Posted 10/19/2020 8:41 AM (GMT -7)
I had the same experience with steroid enemas during a HORRIBLE flare. I think I was just so inflamed that anything going up there was going to cause more irritation. Am heading into Humira this week and after a quick flex sig, doc put me back on them to try and ease into remission, doing ok this time around but some of the same: cramping, have to go, but little luck. Again probably the inflammation. You're not alone, and everyone is weird with their symptoms, part of the frustration. Good luck!
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UCinsouthfl
Regular Member
Joined : Mar 2014
Posts : 132
Posted 10/19/2020 9:04 AM (GMT -7)
Ughh so frustrating! Hope the Humira works for you!!
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quincy
Elite Member
Joined : May 2003
Posts : 32483
Posted 10/20/2020 11:14 AM (GMT -7)
I don't think it's the enemas...having more severe proctitis gives those symptoms.
Can you take mesalamine? If so try the 4g enemas anyway.

I would also suggest you try to increase bms and soften stool. Add fibre supplement with meals...small amount. As well increase fruits, veggies, etc. What I always do is increase vitamin C supplements...i much prefer looser stool to the proctitis constipation.

Hang tough...
q
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UCinsouthfl
Regular Member
Joined : Mar 2014
Posts : 132
Posted 10/20/2020 12:22 PM (GMT -7)
Thank you so much. That is great insight.

I didn't think to try and increase bm's to avoid constipation. Will definitely give that a try!

I actually was able to withstand the enema much better last night. Mainly due to running the bottle under warm water first. It was much less of a shock to my system.

Thanks!
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quincy
Elite Member
Joined : May 2003
Posts : 32483
Posted 10/20/2020 4:32 PM (GMT -7)
Good on better retention...keep us updated.
q
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longtimeuc
New Member
Joined : Oct 2020
Posts : 3
Posted 10/21/2020 10:40 AM (GMT -7)
Yep, retention enemas need to be at body temperatue. When I was diagnosed in 1975 the job was given to a student nurse who didn't know. After 2 days of almost zero retention, one of the more experienced nurses showed her what to do and all was good. After 2 weeks in hospital and about 6 months OP treatment I went into full remission for 8 years.
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UCinsouthfl
Regular Member
Joined : Mar 2014
Posts : 132
Posted 10/21/2020 11:18 AM (GMT -7)
It has really been a game changer. I can't believe I was able to retain before!

After just a couple days things seem to be getting better.

Next step is starting to ween the 40mg of Pred.. The Doc is checking my entyvio levels and then see what's next.
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VanJordan
Regular Member
Joined : Dec 2019
Posts : 95
Posted 10/22/2020 8:17 PM (GMT -7)
Rectal meds don't work on me at all and they make me worse. They just create a lot of chemical and mechanical irritation that my inflamed rectum doesn't want. Other people have success. I can't even get a sigmoidoscopy during my flares because my rectum will get so inflamed it'll prolapse.

I envy people who can do rectal meds. They're not an option for me and I've tried many formats.
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Casey_LB
Regular Member
Joined : Mar 2015
Posts : 293
Posted 10/22/2020 11:04 PM (GMT -7)
You might try hydrocortisone suppositories for proctitis. Easier to take than enemas.
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Donnie Brasco
Regular Member
Joined : Apr 2014
Posts : 64
Posted 10/24/2020 8:41 PM (GMT -7)
Hey guys, I'm in a similar situation here. Been on Pred for 3 weeks 40 mg, bleeding and mucus stopped so I started to drop the dose 20mg now. and I'm doing ok. But my hemorrhoids are out of control, massive, and the anus is inflamed. For one week now I've done Hydrocortisone suppositories at night and day, plus Hydrocortisone Acetate 2.5% + Pramoxine HCI 1% cream - but very little progress if any. Stools are getting formed but having to force them through an inflamed anus is making situation worse. doing sitz baths after every bowel movement too. this stuff used to work.
I will try to fiber intake, and fruits and few vegetables.
I will meet with dr. on Monday - I'm thinking to do some type of invasive procedure for hemorrhoids, I can't be "shoving" them back in after every bm ... this time they're as big as a plumb, fills the inner of my palm. Any suggestions opinions are welcomed! I've been barricaded in my home for over a week now.
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Serenity Now
Veteran Member
Joined : Jan 2009
Posts : 2399
Posted 10/25/2020 7:42 AM (GMT -7)
Oh boy, that sounds unpleasant. I've never had one that big, but I have had smaller ones and as I recall, they took a loooooooooooong time to go away. I used anusol just to soothe things a bit but not convinced they actually contributed to them going away. The only thing really I did was stop "forcing" movements. I'm glad you are seeing your doctor tomorrow, I hope he/she will have a solution.
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Donnie Brasco
Regular Member
Joined : Apr 2014
Posts : 64
Posted 10/25/2020 8:02 AM (GMT -7)
oh it's so hard to control straining ... I do a good job at distracting myself, but it reaches the point the doo doo is there and not coming out.. thank you for the feedback.
FYI this morning I decided to try something new, manuka honey, i patted dry the hemorrhoids and layered it on them, and pushed them in :-| I'm gonna do this for a few days and see how it turns out. will keep you guys posted. I stopped used the creams today, I feel they not helping much or just very slow.
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Serenity Now
Veteran Member
Joined : Jan 2009
Posts : 2399
Posted 10/25/2020 1:00 PM (GMT -7)
Okay let us know how it goes, plus what your doctor says.
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tiredofallthispoop
Regular Member
Joined : Jan 2017
Posts : 208
Posted 10/26/2020 8:26 AM (GMT -7)
I use vaseline as a protective barrier, seems to help for me.
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Donnie Brasco
Regular Member
Joined : Apr 2014
Posts : 64
Posted 10/26/2020 12:54 PM (GMT -7)
I highjacked this thread :D - well so Manuka honey has helped, calms things down, stopped hemorrhoids from bleeding, but... no way in heck it will shrink them. mine have gotten to a bad point - I had appt with dr. today - recommended me a colorectal surgeon. will see her on Thursday - will keep you guys posted. As far as I know we have a couple options with hemorrhoids - they can put rubber bands at their base to cut off supply and hope they fall off (this has a spotty success rate) or the knife option. Anyone else know of other options?
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UCinsouthfl
Regular Member
Joined : Mar 2014
Posts : 132
Posted 10/26/2020 1:11 PM (GMT -7)
Hey Donnie,

Ahh Man.. terrible!

I stayed at 40 mg of pred until symptoms got a little better. It basically just locked everything up for me for a couple days and gave my butt some rest. At the same time continuing to use the hydro cortisone enemas at night and the Pramosone lotion 3 times a day for the hemorrhoids. I still have to be careful in the bathroom not to push to hard but its really difficult. (No phone in the bathroom.. I sit there longer than necessary.)
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Donnie Brasco
Regular Member
Joined : Apr 2014
Posts : 64
Posted 10/28/2020 1:30 PM (GMT -7)
i did something different these past few days and I'm seeing slow improvements:
- started taking Budesonide while decreasing Pred to 20 mg - I read online there's no interactions between the 2
- continued with manuka honey on hemorrhoids (layering it on them)
- suppositories at night only
- mint & white tea 2 times per day to decrease gasses (god knows how much gas screws us up)
- pomegranate to ease digestion (spitting out the seeds)
- probiotics (Align & VSL#3 - although this second one not taking it regularly, i forget to open the fridge)
I'm seeing formed poop, and not crazy urgency and less cramping. I need to stay the course and I hope to start feeling even better. (very light bleeding)
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UCinsouthfl
Regular Member
Joined : Mar 2014
Posts : 132
Posted 10/28/2020 1:33 PM (GMT -7)
Good to hear!

Stay the course!!
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Donnie Brasco
Regular Member
Joined : Apr 2014
Posts : 64
Posted 10/29/2020 2:03 PM (GMT -7)
went to colorectal surgeon today, she snapped 2 rubber bands on 2 of my "rroids" pretty uncomfortable ... still feel tension. but she said they'll fall off in 1-2 weeks as the rubber band cuts off blood supply and the rroids dry up.
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Serenity Now
Veteran Member
Joined : Jan 2009
Posts : 2399
Posted 10/29/2020 2:33 PM (GMT -7)
Sounds ouchy, but hope it works as quickly as possible. Thanks for the update.
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Donnie Brasco
Regular Member
Joined : Apr 2014
Posts : 64
Posted 11/19/2020 1:34 PM (GMT -7)
the 2 rubber bands fell off within 3-4 days, absolutely no improvement. I have no idea what or now dr. put them on. I felt no improvement. idk if it was because of me still being in a flare, but I was hoping one of the rroids to have decreased in size. so long story short, my experience with rubber bands no good
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