Hydrocorisone enemas - advice and experiences please

since my bm's have jumped up to now 15 times a day since last week mostly blood and mucous and I have been on pred for two weeks, I contacted my GI and he is prescribing me hydrocortisone enemas.  I did the rowasa previously and those greatly helped me my since my uc is in the lower part of my rectum.

I just googled it and it does say to be careful if you have kidney disorder but looks like it is from the angle of high blood pressure causing kidney problems and not the same as MCD.  Will continue to look at today.

GI did talk to my nephrologist and says that maybe after I get MCD into remission can possibly try the mesalamine drugs again....maybe it is a coincidence, don't know if I want to ever chance that though. 

Also, GI having me do a stool sample to rule out possible infection, b/c pred is not helping my UC as of yet.

So I will be taking even more steriods.  Awesome!  Maybe i'll turn into the Hulk!

Thanks in advance!

If the active UC is in the lower part of your rectum, ask GI if you can try Cortofoam (10% steroid rectal foam) instead of the hydrocortisone enemas. Dr. Daniel Present, 1 of the foremost IBD gastros in the U.S., recommends use of Cortifoam 2X daily for 7-10 days to "jump-start" healing in the rectum before proceeding to retention enemas. There are fewer chances of side effects with this med because very little is absorbed systemically. I would think that's also important since you're already taking 60 mgs of oral steroid daily, which is the maximum permissible daily dose, according to my gastro, who subspecializes in IBD treatment. Actually, if you are anywhere near NYC, you might pursue a consultation with Dr. Present. If any gastro could get to the heart of your problem, he would likely be the one. 15 bms daily while on 60 mg Pred is too much! I think your situation warrants the attention of a very experienced/saavy practitioner in IBD gastroenterology. Present is also a professor at CUNY Medical School-- he really knows his stuff. I really doubt that he would handle your case in the way it is now being managed.  / Old Hat (nearly 30 yrs with left-sided UC; currently on 6 Colazal daily for July flare in descending colon; should be back in remission again soon)

At this point I don't think your main focus should be on 5-ASA drug questions. It should be on connecting with an experienced IBD subspecialist gastro. If you are within an hour's reach of Boston, then definitely look into one there ASAP. It doesn't make sense to depend on this guy who says he's going to "read up" on your kind of problem: that's a pretty outrageous statement to make! He should not be experimenting or throwing the whole medicine chest at you. A 31 yr-old woman with kidney complications needs more reliable treatment than he seems capable of giving. There have been threads on this site in the spring where some members mentioned Boston IBD gastros. One who is also an educator/researcher there is Sonia Friedmann, listed on WecareinIBD.org Website. It takes a doctor with that level of expertise to sort out complicated IBD problems. You deserve better care than you've been getting! I would not think of staying on 60 mg daily Pred indefinitely, nor would my gastro put a patient on it w/o an exit strategy. Take care-- we only get one body in this life. / Old Hat (nearly 30 yrs with left-sided UC; currently on 6 Colazal daily for July flare in descending colon; should be back in remission again soon)

Beth- I just saw an awesome doctor at Beth Israel Deaconess in Boston- Dr. Mark Peppercorn. He's the head of the GI Department at the hospital & a Harvard Medical Professor. I went to him for a 2nd opinion consult- my own GI recommended him. It went so well.... For me, he just basically backed up what my own GI has been doing, but it was nice to hear it from him. We spent almost 2 hours going over my history, he did an exam, & we discussed any & all treatment options- everything from surgery to aloe vera juice! I have never met with a more thorough guy. He only sees peole who have a confirmed diagnosis. My GI also recommended Dr. Sands at Mass. General, but he didn't have any appointments until December. Either of those 2 doctors have been highly recommended, not only by my GI but by other people on boards I've come across. Definitely call- you have nothing to lose & everything to gain!

PS- oh yeah, I've used the hydrocortisone enemas too- when I first started to flare on Remicade I used one nightly to try to stave it off. I was able to retain them ok for about a week or so, all the while my symptoms getting slowly more severe. Then I just was not able to hold them in any longer. I've used all kinds of enemas for UC, & that's generally how it goes- once the inflammation reaches a certain point, I just can't hold them in. So I usually stop using 'em after 3-4 nights of hopping right onto the toilet after I insert it. I know a lot of people have had great luck with rectal meds, but I'm not one of them.

Thanks Eva!! I was responding to the other posts before yours was up. I am going to check out all the Doc's.

I know this is stupid but I how do I get a 2nd opinion consult and get my HMO to pay for it. Every time I call my HMO I don't know if they give the right info or not (I have BCBS) and they told me my copay for my biopsy was $250 but I just got the bill and it is $20.67 (much better).

I have had a PPO until a two years ago when it became so much more expensive than the HMO and now it is really high priced. I guess I will just call my primary tomorrow and tell her that is what I want and if she wont do it, I'll find another primary that will.