HI All,
I tried a Pentasa enema for the first time last night and managed to hold it in through the night.
However, this morning I have horrendous diarrhea worse than yesterday and worsened left sided pain. Is it possible to have a reaction?
Hi Lou
That is not good, go back to your Dr immediately, he may choose to change the medication.
X
We chatted on another thread. Pentasa is an anti inflammatory drug commonly used in treating UC but a common side effect is that is CAN make the diarrhea worse and, infrequently, can make the general symptoms of UC worse. I won't post a link as it will throw the post into moderation but look up Pentasa side effects and it will tell you this. The trouble is that your GP is just floundering around at the moment throwing drugs at you before you have a formal diagnosis of what your condition is. All I can say is to hang in there until you can get the colonoscopy. If it is UC then the medics will probably start you on Prednislone (corticosterioids) with Pentasa but you will need to be patient. It can take several weeks, months even for symptoms to come under control as the colon slowly starts to heal and then several more weeks to recover from the adrenal issues that can result as steriods are withdrawn. I think I recommended you take a look at the info sheets on Crohn's and Colitis UK. There is no doubt that UC is a horrible, disgusting and debilitating disease that many of us are having to learn how to manage.
Dr has given me predsol instead but maybe I should give the Pentasa another try. I'm really nervous of taking prednisolone because the Dr thinks I either have ulcerative colitis or possibly diverticulitis. They think it's more likely I have UC but I am nervous of taking the prednisolone in case it makes me worse if I do have diverticulitis sad
Did he give you tablets or enema or both?
Pred is good at reducing inflammation, the pentasa is normally for maintaining UC rather than solving it so I'd say the Pred is a good idea.
Normally works best when the tablets are taken with the enema together to blitz the inflammation.
I took predsol this time and the Pred foam the time before. Predsol is a lot of liquid to enema but it did help somewhat.
Yes they gave me 300g prednisolone tablets and the 250mg enema. The thing is I'm nervous of taking them because they haven't yet completely ruled out diverticulitis although they said this is unlikely.
Sorry 30g, not 300g
Phew!
Don't be nervous, the colonoscopy will show what is wrong. Pred at 30mg is typical, oh should see results quickly. When I take both tabs and enema together it blitz's the inflammation quickly. Remember to take the tabs after food!
NB. We share the same second name 
Funnily enough I had a slightly better bm this morning less bleeding and mucus so wondering if although I had some side effects to the Pentasa it may have actually helped somewhat. Thank you for your advice. I am trying my best to be patient, I think at least when I have a date set for the colonoscopy I will feel better about it all. Having a look at the crohns and colitis website now.
Thanks
Lou
Managed to get through to Endoscopy and although the Consultant in hospital said I would have a colonoscopy within 1 - 2 weeks the Endoscopy department have overruled and said 8 weeks 
I've asked that they keep me on the cancellation list.
It's a good second name 
That's reassuring about the prednisolone, just want to feel better now.
Glad you are feeling a little better. They do get busy but if it's all in he same hospital (is it?) it's likely to be the consultant or a colleague doing the procedure so worth a chat to him or his secretary. He should be able to decide if someone needs to be seen quickly. A lot of people cancel colonoscopies through fear so you may get lucky and get a cancellation. I read your other posts about the Prednisolone. Although it's standard treatment for UC you might want to hold off until you know for sure. It is a very powerful drug but it can have some unpleasant side effects and the withdrawal period and beyond can be very difficult.
Yes it's all the same hospital. I'll give them a ring on Monday to see if I can speak to one of the Secretary's or failing that my GP wants to see me on Monday and she used to work in the gastroenterology department so she might be able to get in touch with them on my behalf.
Oh, sounds like I've done the right thing then by holding off from taking the prednisolone orally, I was going to try the predsol enema last night but thought I'd wait and see how things are today. There is less bleeding although the pain is still bad, but I'll see how I go. If I can hold off from using the enema I will.
Is there still withdrawal and side effects when using the predsol enema, or is it only when you take the prednisolone orally?
Thank you for giving me advice, it's been really helpful. How long have you had ulcerative colitis for? Are you keeping well at the moment?
I took a look at the info sheets on the crohns and colitis uk website, they are really helpful. I downloaded the ulcerative colitis booklet and could see they referenced some alternatives i.e. omega 3, curcummin so I've started taking just small amounts of them just until I get a diagnosis.
I don’t know about withdrawal symptoms when cortico-steroids are administered via enema. The drug will still be entering the blood stream but one would imagine in smaller quantities to target the rectum and lower part of the colon rather than the whole colon.
The issue with taking steroids is that they override the function of the adrenal glands whose job it is to produce the hormone under normal circumstances. That’s why the drug has to be withdrawn slowly, so that the adrenals start to do their job again. It’s very common for people to suffer extreme tiredness during and after the withdrawal period while adrenal function re-normalises. It had taken a good three months for me to get my energy levels back after each course of Prednisolone.
I was diagosed with mild to moderate UC in 2015, was getting back to normal by March last year but a course of antibiotics for an infection made it flare again in June. However I am now feelng a lot better and have been drug free since October. My GI consultant seems to find it odd that I am doing well without drugs - he wants me to be on a holding dose of Mezalasine - but I dislike the side effects - it makes me dizzy and I am not convinced it doesn’t make diarrhea worse. I don’t take anything or do anything special diet wise. I’m a vegetarian and eat a very plain diet with minimal wheat, gluten and diary and only drink the occasional cup of tea or coffee so that may help.
I found the people at Crohn’s and Colitis UK extremely helpful when I was first diagnosed. Their helpline staff are incredibly supportive and provided me with lots of information about how to manage the disease.
Keep in touch and let me know how you get on with phone calls and GP next week.
Oh I can see why it's important to wean off the steroids slowly then. Glad to hear you are feeling a lot better now and that you are managing medication free. I'm vegetarian too. Going to try cutting out dairy and gluten to see if it might help.
That's interesting what you said about antibiotics because the first flare I had (although wasn't half as bad as I am now) was after taking amoxicillin for a dental infection. I then went on numerous courses of antibiotics last year for a dental abscess before eventually having the tooth removed. Im wondering if all the antibiotics havent helped along the way.
Thank you for all your advice. I'll let you know how I get on.
Lou
Thank you. It wouldn't surprise me at all if all those antibiotics weren't the culprits triggering your immune system to respond my attacking the colon. Antibiotics destroy good as well as bad bacteria. I know some people find taking probiotics helps. Good luck with the docs tomorrow.
Went well at the Docs today. I've had less bleeding again so Dr said stay off the steroids and take the enemas if I need to. She's happy to see if this will settle down a little now at least until I have the colonoscopy. In the meantime she's got in touch with the hospital and I might be able able to get a flexible sigmoidoscopy done quicker than the colonoscopy so she's given the Consultant there my number to see if they can try and get me in sooner.
So it's sit and wait at the moment, hopefully will get a diagnosis soon. I'm sticking to bland low fibre foods which seems to be helping.
Lou
That sounds right. If things are settling down a little after administering drugs rectally it does suggest that the problem may be confined to the rectum and/or sigmoid colon - the lower horizontal section of the colon before it turns and runs up the left hand side of the abdomen. A flexi-sigmoidoscopy only takes around 10 minutes compared to 30-40 minutes for a full colonoscopy so it may help get a quicker appointment. That’s what I had at first and it was enough to diagnose UC and get me on meds to start treating it. The GI doc had me back a weeks later for a full colonsoscopy to determine the extent of the inflammation and ulceration so you may need another endoscopy but it’s a start in finding out what’s wrong. Good luck.
Bleeding is back this morning, don't know whether to just try the predsol enema just to settle it down. Think I might have to.