Hydrocortisone Enema Questions

Hi everyone. I’m new to the forum. Happy to have found it. I’ve had UC since 2019. My disease only extends to my sigmoid colon. I am on oral mesalamine and before this flare I was doing nightly mesalamine enemas. This combo seemed to be working great until I got food poisoning and it seemed to mess me up.

I found myself in a flare up recently consisting of stomach cramping and passing blood. I rarely have diarrhea with a flare so I’m thankful for that. My doctor prescribed a 2 week course of nightly hydrocortisone enemas and to begin to taper after 2 weeks and do mesalamine nightly enemas again. The hydrocortisone have worked great. Symptoms were gone after about 3-4 days. I am supposed to taper starting this Sunday. I am nervous because I don’t want the flare to start again. Is there anything I can do during the taper to better my chances of success? Has anyone used these and not flared once off of them? Any advice would be great. Thanks!

My doctor suggested I taper to every other day and then to every 2 days and no more after that. She also said to replace the hydrocortisone enema back with my mesalamine enemy on the days that I’m tapering down until I’m only on mesalamine again.

Does that sound like a plan that will help me from flaring again?

So when you say do them both for a week.... do you mean one of them at night and one in the morning?

I was diagnosed in September 2019. I flared once last summer and that’s when I started doing nightly mesalamine enemas and it came under control. This is my second time flaring since being diagnosed. For maintenance I take 4 Lialda and 1 mesalamine enema at night.

I did the nightly enemas most of the time. I would sometimes skip nights and I did try to come off of them once but I started bleeding again.
They are the 4g mesalamine enemas.

When I flare I have mild stomach cramps and bleeding. I have solid bowel movements even during a flare. I don’t have any symptoms at all now since being on the hydrocortisone

When you came fully off of the steroid were you out of your flare? I think this so what I’m most worried about because I’m just not very familiar with how steroids work and have never really used them in my life before now.

You could also ask your doctor to try Colazal instead of Lialda, since your UC is confined to proctosigmoid region. Colazal (brandname) was devised especially to treat left-sided UC. (It now has about 3 generics, known as Balsalazide disodium.) / Old Hat (40 yrs with left-sided UC; in remission taking Colazal)