Strategy for nightly enema

Posted , 3 users are following.

Following a recent sigmoidoscopy which revealed colitis was prolonging my diarrhoea, i was proscribed octasa tablets and a salofalk enema.

Following my 2nd go with the enema last night , i have realised that a degree of experimentation is needed to make the most of this treatment.

My daily routine is normally 5 am to 8 pm so i administered my first dose at 8 am, waited 30 minutes before relaxing and then thought,to my cost, i could go about my evening as usual. But alas no. I soon had to use the loo to let it out. Last night i waited till 9 pm and managed to stay the course till midnight when i was woken from my sleep for the loo.

My question is just this. Since the package leaflet is not too revealing is there a way to take these that can maximise the benefit and minimise the disruption to my sleep for the next 26 days. Tonight i am going back to administering at 8 pm to see if this helps.

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8 Replies

  • Posted

    Hi Greyone

    I had the same issue when using the enemas. I haven't used salofalk before is it a foam or water based?

    I used Asacol before which was water and I had the same issue I couldn't keep it in. I was changed to a foam based one Budalkfoam I think its called and that seemed to help.

    I would take it and lie on my side for 30 odd minutes just relaxing. I found if I did too much after taking it. it was trying to come back out.

    I believe its very much trial and error for everyone as everyones routine is different I found doing it later about 10ish I was usually good to 6am.

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    • Posted

      Thanks for the feedback. The package leaflet doe snot say water or foam , but going by the feel , it is water.

      I think my problem is that i do not like sleeping with a small volume of liquid inside me. I think that is why i woke up 3 hours later. But at least this 2nd time i did lie still in bed afterwards a try to sleep. I will have to persevere and see if it gets any easier over the coming nights.

      Thanks for letting me know about the foam based preparations.

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    • Posted

      Hi Laura27471.

      Today i had a review meeting at my local hospital and I finally got to ask a few questions. I asked about the type of enema and to cut a long story short the consultant said he usually prescribed the foam enema because it was easier to carry it through the night. So a special thank you to mentioning that and i can at least ask my doctor to change my prescription if i do have it again. KUDOS to you.

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  • Posted

    The thing to understand is that your colon (and rectum) are inflamed. While the colon continues to be inflamed it cannot do it's job of extracting water from the sloppy waste matter that flows into it from the small intestine. That's why you get diarrhea.

    UC almost always involves rectal inflammation and while that's inflamed it can't hold in the amount of waste that wants to come out.

    You only had a sigmoidoscopy. It's possible there may be inflammation further along the colon adding to the speed of transit.

    The Octasa is to control the colon inflammation and the Salofalk the rectal inflammation. Until the Octasa becomes effective it's unlikely the Salofalk will be either. Does that make sense?

    The online instructions for Salofalk say best results are achieved if the bowels are emptied before administration of the enema.

    Can you gauge how quickly food is passing through your system? No point using the Salofalk if you have had a meal not long before which is going to pass rapidly through your GI tract. On average food takes about six to eight hours to reach the colon. You many need to rethink your meal times until the Octasa has had a chance to work. It could take a few days or a few weeks depending on the severity of the inflammation.

    Hope this helps.

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    • Posted

      Thanks for the recap though without too many big words.

      The only thing that concerns me is the need and my ability to keep the enema inside me for the entire night. My record as of last night was 3.5 hours so just under half way there. Sometimes I sleep and wake up and think "must get rid of this" But usually i just cant sleep afterwards and then doing something , even just watching TV seems to trigger the need.

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    • Posted

      You may be worrying too much. Don't forget that the Salofalk will soon be absorbed into the lining of the rectum (and sigmoid colon if you can get the application to reach that far). I had mesalazine pessaries which in theory would take longer to dissolve and be absorbed than the drug applied in a liquid suspension. I seem to recall the doctor saying try to keep it in for 30 minutes.

      Of course, the extent of the inflammation will dictate how quickly and efficiently the drug is absorbed . Online instructions say try to retain the enema all night but you can only do what's possible. As I said, before, as the oral Octasa kicks in, things should become easier.

      Learning how to manage UC can be a steep learning curve and stress can play a big part. When UC is active, needing to empty the bowel 24/7 is very common.

      An initial diagnosis of mild to moderate UC often requires the patient to take an immuno-suppressant such as Prednisolone or Azathioprine in addition to mesalazine. That your doctor has only prescribed the anti-inflammatory mesazaline suggests that the UC is mild so hopefully treatment with oral and enema meds will soon get things under control.

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    • Posted

      Now that is what i call interesting and knowing me as well as i do - "yes" - i may be worrying too much. Fortunately my bowel activities are relatively easy with a regular (very active after the enema) one in the morning and a much simpler one in the evening. A steep learning curve yes and something i will not forget doing too soon. The diagnosis was moderate based on my number of bowel motions which may have been an over estimate since i'm always impatient on the loo at these times.

      Stress yes. Its 22:20 and i'm surfing for information instead of trying to take it easy. esp since 4 weeks can seem like a long time at the outset.

      Good night and thanks for posting again.

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  • Posted

    Dear CJB

    As you can imagine, my consultant and his team gave me a very through briefing before, during and after the procedure. Especially during when I got to ask numerous questions whilst watching the live action. The medication I mentioned is already explained in great detail in the provided literature as we both noticed on the web.

    To answer one question, yes. For nearly two months I have gauged how quickly food is passing through my system. This was very useful to the doctors in A&E. So as hinted in my text I plan my meal times with great care. This is essential so that I am not chained to the loo.

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