# The Upside Down Enema and the Rest of the Story



## Sonoma1 (Dec 17, 2011)

Crohn's for 29 years - I'm currently doing very well with mild left side symptoms (a little intermittent blood off and on sometimes days or weeks apart...and othewise good health; knock on wood).

Before I give my background, here's something simple that seems to work for me when I'm starting to get more blood and urgency.  It's the upside down enema.  *The idea is to insert the enemas and then go inverted so that gravity gets the medication further up into the colon*.  Sounds crazy, but it seems to work and my doc says he can clearly see from my colonoscopies a healthy line of demarcation where the medicine reaches and it's much higher than the normal "lay on your side" technique.  He's now recommending it to some of his patients with left side disease.

The necessary ingredients are 1-2 enemas of your choice (Rowasa seems to work best for me)  and an inversion table that can be purchased at most sporting goods or back stores.  I insert the enemas while laying on the floor, and let things get settled for 3-5 minutes.  I then get up and make a quick move onto the inversion table.  I then hang upside down for 1-2 minutes, come back to level, and repeat the process 1 or 2 more times.

After this treatment, I find I can walk around the rest of the day and retention of the enemas is not a problem.  When I start to have increased symptoms, this method has worked extremely well at calming things back down.

Now the Background:

Diagnosed in 1982
A couple of severe flares in the 80s.  These were shut down with 70-80mg of prednisone over 7-8 weeks.  I'm lucky since these seemed to give me remissions of 2-3 years.

The 90's were good.  I was in remission for about 10 years and only took Asacol.  In terms of diet, I don't go crazy but I definitely limit bread, cereals, grains and sugars and try to keep carbs under 100 grams per day.

Then I had a severe flare in 1999 that put me in the hospital.  Looking back, I was working too hard over several months and let a minor flare turn into a major flare - my left colon was "hamburger", severe pain with bowel movements caused me to vomit...when the fever and chills kicked in, I got checked into the hospital.   We should have caved in and gone to the prednisone earlier.  I was in the hosptial for 7 days, and mainlining 135mg prednisone a day.  Went home and had 30 days of bowel rest on TPN to allow things to heal up.  It was a very depressing return home, wondering what was next and whether I'd recover and be able to work again.  I'm fortunate that I did recover, and other than a very scarred colon, I've been doing pretty well since then.

My flares seem to come every couple of years, are treated with predinisone and I've been fortunate that nothing major has developed.  

Right now I'd say my symptoms are a 1-2 on a scale of 10.  I'm healthy, active and thankful.  I haven't taken prednisone in 2 years, and am trying to stay off it. The next major flare my doc wants me to go on Humira, but I'm trying to avoid it if I can.  My doc tells me it's amazing I'm not on a TNF inhibitor given what happened 10 years ago.

Here's my approach:
4 Lialda per day (4.8 grams)
4.5 mg Low dose Naltrexone (started July this year and I think it helps, keep you posted on this new treatment)
4 oz. Rowasa enema nightly, even if I don't have symptoms
200% RDA Folic Acid
Very low grain, and no sugar diet, easy on the alcohol (not more than 1-2 drinks)
5 Fish Oil tablets daily, I'm currently experimenting with between 5-10
Exercise - Crossfit (intense) workouts 3-4 days per week
If I see increased blood or urgency, I start doing the upside down enemas

I hope this is helpful.  I know everyone's disease and experience's are different.  I've been fortunate that my rough times have been limited, and all in all I've been able to successfully manage for almost 30 years...and hopefully many more.


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## Mountaingem (Dec 17, 2011)

HI Sonoma and welcome! Wow awesome story-I really appreciate the hints you shared. I also have disease on the left side and I've been hitting a brick wall with my treatment. I  will definitely give the Rowasa suggestion a try! Also about your Lialda prescription-I take Pentasa which is the same drug but smaller dose-I'm on 4 grams right now. I didn't know I could go up from here, gonna call the GI and see what he thinks...thanks for sharing, I hope I have results as good as yours 

One more thing, which inversion table (?) do you use and for how long?


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## Angrybird (Dec 17, 2011)

Hi Sonoma, this info will be interesting and very helpful info for many - thank you.  I have not yet been given this type of treatment but it is something to keep in mind in case it does get introduced in the future.  I am pleased that things are going well and hope they continue to do so


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## Sonoma1 (Dec 17, 2011)

The inversion table is made by Stamina.  It can be any of the basic tables.  They currently sell online for between $100-200.  I hope it helps, certainly worth a try.  If you're in having a flare, it may take at least a few days of treatments to notice if it's helping.

The normal Lialda dose is 3 tablets or 3.6 grams.  My GI doctor upped it to 4 tablets (4.8 grams) when I had a mild flare a couple of years ago.  We've just stayed at that level and I've tolerated it well.


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## David (Dec 18, 2011)

Hi Sonoma and welcome!  I love the inversion table idea!  Thank you for sharing that.

I notice you take folic acid supplements.  Do you have your vitmain B12 levels checked regularly?  I ask because vitamin B12 deficiency is very common in people with Crohn's Disease (especially with ileal involvement) and studies have shown that folic acid supplementation alone will mask the symptoms of B12 deficiency which is bad news.  

Again, welcome!  I am so glad you joined and hope you become a regular part of our community.


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## Jessi (Dec 18, 2011)

Welcome Sonoma!  Thanks for sharing your story. 

It looks like you've got a great plan in place for your CD. We have a sub-forum for LDN where you can chat with others who are trying it out. We even have people who have been on it for a long time who have found great success in it. I hope it works as well for you. Here's a link to the LDN forum. http://www.crohnsforum.com/forumdisplay.php?f=32


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## Gwen pippy (Dec 18, 2011)

Hi Sonoma and welcome to our mad family.
I thought I was the only one who did the upside down enema trick, I haven't used the usual meds in enema form in many years but I did have flare that put me in hospital in May of this year and so I started a short course of pred-sol enema's, I thought back to the late 80's when in hospital one lovely nurse would tilt the bed as much as she could because she thought it would give the best possible return. 
I don't have an inversion table but I give the enema on the floor like yourself and then hang backwards off the bed, it looks really funny to anyone watching but IT WORKS and I can hold some enema's for hours even into the following day. Once back on my feet with pred I normally take 4.8grams of Asacolon and folic acid, oh and calcium with D3. 
Thank you for sharing your story and advice.
Gwen xxx


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## Sonoma1 (Dec 18, 2011)

Jessi - thanks for the link to the LDN forum.  I've been on it since July (4.5 mg per night).  The results seem to be positive.  I was having increased symptoms in June so gave it a try.  Since then the combination of LDN, Lialda and a nightly Rowasa have kept me almost asymptomatic.  No side affects from LDN other than I sleep a little better and have more vivid dreams.

Cheers


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## Jessi (Dec 19, 2011)

Nice. Those are some sweet side affects.


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