Yes but as the previous poster suggested then it may be time for a new strategy. Rectal and enemas have a place in maintenance therapy for mild to moderate IBD. Nowadays they are viewed as pretty useless for anyone with chronic or acute inflammation. A recent survey by David Rubins team found that for anyone on a biologic then mesalamine / pentasa made zero added difference in keeping their CD in remission and asacol only a tiny insignificant added difference in keeping their UC under control.
We have to move away from these archaic strategies where you keep adding milder meds so the patient effectively gets sicker and sicker. Anyone with IBD at a moderate or severe level should now be given biologic therapy, if they choose to take this up, to alter the course of the disease as opposed to putting out fires of flare ups every 6 months. In years we will look back at these older strategies and say "Did we really expose patients to that sort of treatment plan??' I sometimes look back at older posts on the UC and CD forums and you can see how much pain and suffering the posters were going through in the hope that a rectal med would suddenly kick in and alter the course of their disease. This was not going to happen.
It is often said by GIs that long term chronic low grade inflammation is a lot harder to get into remission than an acute severe flare up from out-of-the blue. If your immune system has been quietened down then the level of suppression needed to maintain this is usually significantly lower than that required to put out the flare in the first place. CRP and calproctin levels should be relied upon for nothing if they are normal and you are still having flare symptoms linked to IBD. Diseases do not follow rules..
Post Edited (damo123) : 12/25/2021 8:39:46 AM (GMT-7)