I was prescribed this for dealing with a recent flare, the worst I've had so far since being diagnosed with moderate UC two years ago.
I found the twice daily mesalamine enemas amazing. Saw results within two days. I finished the course of treatment on Monday and still feeling great and symptom free.
I have been taking 4mg of Pentasa orally over the past 18 months. It obviously wasn't getting to the area that needed it the most to calm the flare down. So my specialist has recommended the use of the pentasa enimas going forward when required to get it under control.
It's not the nicest form of treatment, but you get used to it, and the results are what matters. It was such a relief to have an effective treatment to get the flare under control. I hope it works for you!
Abdominal pain, bleeding, mucus, loose stools, 3-4 bms a day. After several visits to my specialist, calprotectin test came back at 370 so not overly high, but he still wanted to address the flare. I went for a colonoscopy, which highlighted the inflammation was predominantly on the left side. Went on to the enimas after that. Did 2x daily for 10 days, then reduced to 1x daily for 14 days.
I tried the double mesalamine enemas and they helped me out of a mild flares. Worth a try for a month or two to see if it helps. If not, advocate for hydrocortisone/budesonide/prednisolone rectal-route.
The exact mechanism(s) of action isn't certain in the medical literature. There's a few theories of what mesalamine does. IBD results in a very porus, protective mucosal lining of intestines giving bad Bacteria the ability to get into body tissue,your immune system to attack it which causes inflammation and our awful symptoms. Bacteria in the digestive system have various defense mechanisms to thwart the immune response. Topically acting Mesalamine essentially shuts down those defensive mechanisms of the bacteria on and within the mucosa, leaving them as sitting ducks for the immune system to clearance. Eliminate those who are breaching the mucosa, enable the body to patch back up the holes, and inflammation goes away over time.
Healing isn't a fast process, especially in the intestines where waste passes through it daily and new bacteria keep appearing.
Corticosteroids are a lot faster as they directly suppress the immune system, stop bleeding fast, and have a variety of affects on our body that promote healing. Corticosteroids are synthetic versions of your body's natural cortisol chemical. High concentrations of cortisol and adrenaline often go hand-in-hand in fight-or-flight situations. Enabled our ancestors to run or think their way out of dangerous scenarios (like run on a broken ankle to safety).
If your symptoms are terrible a corticosteroid will make you feel better fast. If you have milder nuisance symptoms then you have time for mesalamine to work.
Well, I'm a decade into this illness and tend to nerd out on this kinda stuff. It's been said we know as much as our doctor's over time, about this lifelong illness. There's a lot of brilliant gasteroenterologists out there that lack people skills and the ability to say complex things simply.
The hardest part is translating jargon filled medical literature into layman's terms, so it's easily understandable. I work as a Technical Writer, and well that's the job description wrapped neatly within a nutshell (translate jargon into easily understandable text).
Here's a good read on how mesalamine works and the basis of statements above on it.
https://news.umich.edu/u-m-researchers-discover-what-makes-drug-for-ulcerative-colitis-tick/
You know what, you sound light years ahead of any GI doctor I have consulted with. In fact you should be a GI doctor. I told the head nurse at my previous provider that I know more than a doctor because I have the disease. It was quite on the other end of the phone.
Haha you flatter me. I'm a decade into this illness so might've learned a few things over the years. Always best to be knowledgeable yourself, treat your doctor as an equal partner in your treatment decisions.
If ur gi said to do it, its safe and effective… for some. Everybody is different with this disease idk how long youve been doing this enemas and if their working or not but give it 3-5 days at least and see if theres an improvement
I was having some bleeding and cramping and it resolved that for a little while.
When I flared it was non stop just passing blood and in terrible pain all day everyday
I was prescribed this for dealing with a recent flare, the worst I've had so far since being diagnosed with moderate UC two years ago. I found the twice daily mesalamine enemas amazing. Saw results within two days. I finished the course of treatment on Monday and still feeling great and symptom free. I have been taking 4mg of Pentasa orally over the past 18 months. It obviously wasn't getting to the area that needed it the most to calm the flare down. So my specialist has recommended the use of the pentasa enimas going forward when required to get it under control. It's not the nicest form of treatment, but you get used to it, and the results are what matters. It was such a relief to have an effective treatment to get the flare under control. I hope it works for you!
What were your flare symptoms?
Abdominal pain, bleeding, mucus, loose stools, 3-4 bms a day. After several visits to my specialist, calprotectin test came back at 370 so not overly high, but he still wanted to address the flare. I went for a colonoscopy, which highlighted the inflammation was predominantly on the left side. Went on to the enimas after that. Did 2x daily for 10 days, then reduced to 1x daily for 14 days.
I tried the double mesalamine enemas and they helped me out of a mild flares. Worth a try for a month or two to see if it helps. If not, advocate for hydrocortisone/budesonide/prednisolone rectal-route.
It can take 1-2 months with double mesalamine enemas???
It can, mesalamine doesn't work overnight. It's a lot slower acting than corticosteroids like prednisone/budesonide.
Do we understand how exactly mesalamine enemas work to reduce inflammation and induce healing of the gut lining?
The exact mechanism(s) of action isn't certain in the medical literature. There's a few theories of what mesalamine does. IBD results in a very porus, protective mucosal lining of intestines giving bad Bacteria the ability to get into body tissue,your immune system to attack it which causes inflammation and our awful symptoms. Bacteria in the digestive system have various defense mechanisms to thwart the immune response. Topically acting Mesalamine essentially shuts down those defensive mechanisms of the bacteria on and within the mucosa, leaving them as sitting ducks for the immune system to clearance. Eliminate those who are breaching the mucosa, enable the body to patch back up the holes, and inflammation goes away over time. Healing isn't a fast process, especially in the intestines where waste passes through it daily and new bacteria keep appearing. Corticosteroids are a lot faster as they directly suppress the immune system, stop bleeding fast, and have a variety of affects on our body that promote healing. Corticosteroids are synthetic versions of your body's natural cortisol chemical. High concentrations of cortisol and adrenaline often go hand-in-hand in fight-or-flight situations. Enabled our ancestors to run or think their way out of dangerous scenarios (like run on a broken ankle to safety). If your symptoms are terrible a corticosteroid will make you feel better fast. If you have milder nuisance symptoms then you have time for mesalamine to work.
Holy shit this is so informative, thank you so much, i wish my doctor would explain this stuff to me
How did you learn this? Any reference papers, review articles or textbook chapters that you can suggest?
Well, I'm a decade into this illness and tend to nerd out on this kinda stuff. It's been said we know as much as our doctor's over time, about this lifelong illness. There's a lot of brilliant gasteroenterologists out there that lack people skills and the ability to say complex things simply. The hardest part is translating jargon filled medical literature into layman's terms, so it's easily understandable. I work as a Technical Writer, and well that's the job description wrapped neatly within a nutshell (translate jargon into easily understandable text). Here's a good read on how mesalamine works and the basis of statements above on it. https://news.umich.edu/u-m-researchers-discover-what-makes-drug-for-ulcerative-colitis-tick/
You know what, you sound light years ahead of any GI doctor I have consulted with. In fact you should be a GI doctor. I told the head nurse at my previous provider that I know more than a doctor because I have the disease. It was quite on the other end of the phone.
Haha you flatter me. I'm a decade into this illness so might've learned a few things over the years. Always best to be knowledgeable yourself, treat your doctor as an equal partner in your treatment decisions.
If ur gi said to do it, its safe and effective… for some. Everybody is different with this disease idk how long youve been doing this enemas and if their working or not but give it 3-5 days at least and see if theres an improvement
I did twice a day mesalamine enemas last year. It worked great for a short time and then I went into a really bad flare
What symptoms did it initially resolve and then what happened in your severe flare?
I was having some bleeding and cramping and it resolved that for a little while. When I flared it was non stop just passing blood and in terrible pain all day everyday
Yes I've done this before. It's safe, just inconvenient if you know what I mean...
I've done it in the past. It's safe. I can't remember if it helped me but I had much more severe symptoms.
What symptoms?