Question for those using RECTAL 5-ASA therapy

I have just started using both enemas 4g and suppositories 1g in alternance each night to help maintain remission.

my question is:

when You have a stool the fallowing day of using the therapy, does the White color melted cream of the suppositary stick on your stool and on what distance in cm? approximately? Im asking this because I am surprised as how ''far'' up the suppositary seems to be melting in my colon and on my stools. I feel it covers at least 25 cm, maybe even more... Ive tried both salofalk and Pentasa suppositaries and the Salofalk seems to be melting far away. I currently have thin a bit soft stools.

I dont like the whitish color because it makes think of mucus... I know its not mucus at this moment, but I still dont like it...

please share your experience. thank you!

It has stuck on the stool for my kid. That is why we now only use the liquid or foam. The foam leaves no traces from what Ive seen, but can leave bubbles.

My IBD nurse told me when I first started using Asacol supps.(9yrs ago) that as long as it's in for 2 or 3 hours,it will be doing it's job.They've worked for me but I still get the problem you are having.

SupportiveMom said:

It has stuck on the stool for my kid. That is why we now only use the liquid or foam. The foam leaves no traces from what Ive seen, but can leave bubbles.

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i just called my pharmacist , she made some research and said the foam is not available in Canada... Are you sure the foam was 5-asa? what brand? I had foam before but cortisone only, ''Cortifoam''.

i'd like to try a 5-asa foam...

scottsma said:

My IBD nurse told me when I first started using Asacol supps.(9yrs ago) that as long as it's in for 2 or 3 hours,it will be doing it's job.They've worked for me but I still get the problem you are having.

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about how many cm do you see it on your stool? This is really surprising to me because I 'd never expected a suppositary to go so far up. (I think its a good thing). I just dont like the view of mucus-like residue because it reminds me of disease.

I've honestly not taken that much notice as it doesn't worry me at all.But it is clearly visable.Mucos for me is usually clear and identifiable.I do flare every so often,and I know the difference between residual supp. and mucos.Talk to your GI nurse or even your Pharmacist.Whats normal for me mat not be the same for you.Try not to worry though.This IBD has all sorts of quirky things to present to us,and because of it we are aware of every little twinge etc.more so than "normal" people.Have a good day.

Why the concern? The suppository will melt somewhat but is still coating the rectum. The reason you see it covering such a length of stool is that it has coated the rectum and is now covering the stool as it passes out of the rectum. If you see white coating the stool, it means the medicine has indeed coated the rectum like it should. I was concerned when large amounts of the suppository came out in solid pieces because I knew it wasn't doing what it was intended to do.

thank you scottsma, im not really worried. Im just really curious and wondering. maybe it wasn't clear in my posts. my mucus is very thick and white when I am sick, very much like supp residue and aggregate/penetrate on the stools, again just like the suppl do. Its just a little psychological conflict I have since this residue reminds me of disease. last night i used the enemas, and i got no residue this morning. seems to be only with supp.

Is just im am surprised that the suppl seems to reach far upper than rectum, as rectum is about 10 cm... I am glad of that because I have disease in sigmoid too and sometimes in left colon. this may make me reconsider the use of enemas which are far more complicated to administrate and reviews seems not to indicate superior maintain of remission even if dose is higher (4g) with enemas. But I'll have to research some more before I make my final decision.

It may also depend on which position you adopt after inserting the supp or enema. It is best to lie on your left side so that a) the enema is retained better and less likely to leak, and b) the suppository, when it melts, may travel further up the sigmoid colon due to gravity.

2thFairy said:

Why the concern? The suppository will melt somewhat but is still coating the rectum. The reason you see it covering such a length of stool is that it has coated the rectum and is now covering the stool as it passes out of the rectum. If you see white coating the stool, it means the medicine has indeed coated the rectum like it should. I was concerned when large amounts of the suppository came out in solid pieces because I knew it wasn't doing what it was intended to do.

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I went online tonight to ask if anyone noticed a difference with the different suppositories?
When I used Salofalk I saw lumps like 2thFairy describes, but with Pentasa I didn't notice lumps so I guess Pentasa melted/dissolved better. I also felt like Pentasa worked better for me too.

Anyone else notices a difference between the different suppositories?

With my canasa, I see more of an oil type substance when I go the next day. I have seen mucus mixed in the bm. But, am not sure how much and the mucus doesn't come every time except when I've been fighting a flare.

so its been over a month I tried both Pentasa and Salofalk suppositories and enemas. enemas are killing me and I cant do more than once a week, just no motivation. I find the solution really difficult to expell as I have weak hand/wrists. So I now prefer to use Salofalk supp.. Easy to insert as opposed to Pentasa imo. Saloflak is indeed greasy the next day and that is somewhat annoying, but its still better than using the enemas or having trouble inserting Pentasa. I notice that some days with the supp., I have residues and that other days, I have no residues. I think it depends on the consistency of the stools. Since using them, I notice an improuvement in my BMs. I feel pretty confident right now I can remain on my low dose purinethol, rectal therapy and SCD /ibd-aid diet to maintain remission. im going to have a nice summer :ysmile:

YaY!

since a week, im going even better as I dont even have my BM early in the morning, it comes in the afternoon or at night!. I even skipped a day this week, which is almost miraculous in my case. didnt change anything in diet or lifestyle. I notice that when my bM is in the afternoon, I see no more the white residue, they have completely incorporated the stool or penetrated my mucosa.

I do 4g rectal enema every night right before I sleep. Lay on my left side for half an hour blah blah blah. In the morning, or during the day, whenever I go to the bathroom, the white stuff is not shown as long as I leave it in all night. There have been times where I do not last more than 30 minutes or I go soon after. In those cases, when I sit on the toilet, the white stuff drizzles out first, then whatever else I need to get out comes. I hope this helped you a bit. oo:
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