Colitis Meds and the Colon

Colitis Meds

Descriptions below refer to how Colitis meds can be administered in order to reach particular areas of inflammation more efficiently - not specific brands of med. Choosing a brand of medication is specific to each case and depends on the severity of the Ulcerative Colitis.

Colitis Meds and the Colon

I often see UCers (actually, all IBDers) discussing which meds are working for them, or asking why their meds aren't working. I've learnt that meds can be administered in various ways and some will reach the inflammation more efficiently than others - something I wasn't aware of when I first started taking my meds.

Once you know where the large colon is and get an idea of its shape and the various colon sections, you should get a clearer understanding of why it's important to choose how your brand of med is administered.

Just to clarify - I'm talking about reaching the inflammation, not which specific brand of meds will work best. Doctors try to follow a certain procedure when prescribing meds (starting with those that should have less side effects), but unfortunately, just like finding a Colitis diet, discovering a brand of meds that work is generally a case of trial and error carried out by a specialist based on feedback from the UCer.

Note: some meds work by absorption into the blood stream and not by going to the area of inflammation, in these cases, types of administration below are irrelevant.

Oral

The most common way Ulcerative Colitis meds are taken is by mouth. The further along the large colon the inflammation is, the longer the oral meds take to reach it and therefore, the longer they take to start working.

As an example, I often have inflammation in the sigmoid colon and the oral meds (in my case mesalazine) can take 3 weeks to begin working. It can take over 4 weeks to start working in the rectum (for proctitis).

You may find that oral meds aren't completely successful in dealing with inflammation at the end of the colon e.g. proctitis in the rectum, which is where suppositories can be more successful.

Most oral meds used for Colitis are enteric (relating to the intestine) and are designed to release (dissolve) as they reach the large colon. Unfortunately, some UCers have found oral capsules undissolved in the toilet which means the med isn't working in the colon at all - one possible reason could be pH levels.

Most efficient for:

Ascending colon, transverse colon, descending colon

Oral Colitis Meds

Enema

Enema meds are designed to work in the lower bowel. They come in various forms e.g. liquid or foam because some UCers find it difficult to retain them for any length of time (they need to stay in the colon for a while to work properly).

After the enema is administered, the correct method is to lay on the left side to allow it to move as far along the colon as possible.

Some instructions state that for best results the enema should be retained for up to 8 hours. The suggestion is that it be administered before bedtime so the UCer can sleep overnight whilst it works.

Comments by some UCers suggests that it's difficult to retain an enema for this long, let alone trying to sleep! However, some Colitis sufferers found that it was easier to retain after the first 10 minutes or so, and it also became easier over a few days as they administered more enemas.

Personally, I've tried both foam and liquid enema and had no problem retaining them overnight. Laying and remaining on your left side is important, particularly for liquid enemas. Also, try to administer after a bowel movement for best results (to ensure a clearer colon).

Note: a liquid enema will reach further along the colon (possibly somewhere along the descending colon) than a foam enema.

Most efficient for:

Rectum, Sigmoid colon and some of the descending colon

Enema Colitis Meds

Suppository

A suppository is for the rectum and is prescribed where the UCer is suffering from proctitis.

Instructions are fairly similar to an enema, where the suppository should be retained for as long as possible, the advice being to insert it before bedtime in order for it to work overnight.

It's worth noting that an Ulcerative Colitis flare-up often begins from the rectum and spreads further along the colon. Suppositories might be a way to stop this happening if taken early enough in the flare.

Tip: It's easier to insert a suppository after soaking in a bath for 20 minutes.

Most efficient for:

Rectum

Suppository Colitis Meds