Crohn's Disease Forum » General IBD Discussion » Anucort Question and advice needed


12-28-2018, 10:36 PM   #1
crohnsinct
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Anucort Question and advice needed

Hi all! Thought I would start with the adult forum as the sed GI's don't typically prescribe rectal suppositories.

My 19 year olds had Crohn's for 7 years. About 3 years ago she started passing a lot of mucus, having extreme urgency (some accidents), and her frequency was way up. Initially the GI said "IBS". Then she started off and on bleeding. Fecal cal in the thousands. Scope showed inflammation. Increased Remicade and it helps most of the inflammation but she still has tenesmus with about 20 bathroom trips a day. Sometimes diarrhea, sometimes fine, sometimes nothing. No blood.

New GI wants her to try Budesonide and Anucort suppositories. I just picked up the script and directions are for twice daily. I figure at night right before bed would be our best shot at her keeping the med in but am at a loss for when else she could do it? How do you keep the med in if you are going to the bathroom 12-20 times a day. Is there a minimal amount of time that is needed to keep the med in and after that you should be fine?

P.S. they are still thinking that this might be an IBS overlay to her Crohn's. If the suppositories work I am thinking that means all these symptoms were her rebellious rectum. Does anyone know if hydrocortisone suppositories help IBS?

Also, Budesonide was denied by insurance. GI is out of the office until the new year. Do you know if the suppositories will work without a systemic med also? I guess she isn't totally without systemic given she is on Remicade but wondering what the shot is for it to work without Budesonide. How fast do you guys typically get relief. She is pretty miserable right now.
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Daughter O dx 2/1/12 at age 12
Crohns & Remicade induced Psoriasis
Remicade
Vit d 2000IU
Multi vitamin plus iron
Calcium

Previously used - Prednisone, Prevacid, Enteral Nutrition, Methotrexate oral and injections, Folic Acid, Probiotics, Cortofoam

Daughter T dx 1/2/15 at age 11
Vitaligo, Precoscious puberty & Crohn's
Remicade
Vit D 2000IU

Previously used, Exclusive Enteral Nutrition, Methotrexate (injections and oral), Folic Acid, Entocort,IBD-AID Diet
12-28-2018, 11:21 PM   #2
my little penguin
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Ds did rectal suppositories at age 8 and on and off since
They melt/leak and are messy/stain clothes
They also make them feel like they “have to go “
Just sayin
We were told to try to keep it in as long as they can
Every 12 hours
So night and morning
Night was slightly easier not by much

Just like regular meds 15 minutes was what we aimed for
Mucus membranes absorb the meds quickly similar to the nose

Since buesonide is a steriod
You probably need both at once

Topical steroids alone .....
Don’t remember how long anucort took to work
Or if it was something else we changed honestly
Good luck my kiddo hates them now
Willing to do pretty much anything else but those
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12-29-2018, 01:22 AM   #3
Maya142
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Just like regular meds 15 minutes was what we aimed for
Mucus membranes absorb the meds quickly similar to the nose
I'm confused MLP - what did you mean by 15 minutes?

My daughter was put on hydrocortisone suppositories for a fissure. She hated them and found them painful and uncomfortable. Like MLP said, she always had the urge to go, probably because there was something in her colon/rectum!

But anyway, M's fissure cleared up VERY quickly once we started hydrocortisone suppositories. Within days I think - or maybe a week at most. It healed well after that but it does reopen every now and then.

We tried to make them more comfortable by using a lot of Vaseline. She also did one dose before bed and the other sometime in the afternoon. For the second one, she tried to find an hour to lie on her bed in her dorm - she promptly decided that she would use that hour for TV time and wouldn't move so she could keep the suppository in.

M found it easier after some time - she did get better at it and once her fissure healed a bit, it became much less painful. She still hates Anucort but admits that they really do work for her rectal issues.

Incidentally, she does have rectal involvement with her Crohn's - first scope showed ulcers and inflammation in her rectum - but Anucort did work. For a different issue, but hopefully it will work as well for O!

She is a real trooper to do this in school.
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Mom of M (20)
diagnosed with Crohn's Disease at 16
Juvenile Idiopathic Arthritis at 12
Juvenile Ankylosing Spondylitis at 16

Mom of S (23)
dx with JIA at 14
Ankylosing Spondylitis at 18
12-29-2018, 01:50 AM   #4
crohnsinct
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Thanks MLP and Maya - I don't know how on earth she is going to find an hour to lay still. She is taking 18 credits next semester, commuting from her apartment, has swim team practice and, and, and. She doesn't go back till 1/8 so hopefully by then we will have an idea of whether or not they are working and maybe ca cut back to one a day.

Do either of you know if the suppositories in any way, shape or form help with IBS? I am just hoping that this little rectal med experiment may help us sort out which thing is causing her issues...of course a scope would answer the question but we all know her GI isn't quick to scope.
12-30-2018, 03:26 PM   #5
my little penguin
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Not going to help ibs
Anucort is a steroid and helps inflammation
Ibs does not cause inflammation or damage

Maya142
Ds was only 7 or 8 at the time
So the GI told him to hold it as long it in as long as he could
Aiming for 15 minutes without trying to go to the bathroom
When he used when he was older he did aim for laying still on his side for an hour
But that was too much to ask of a 7 /8 year old to “try to hold it “
At the time

Sorta like ideally humira shots are rotated spots etc...
But the Rheumo said for little kids the goal is just to get the shot in
So if the kiddo needs the same spot so be it

Last edited by my little penguin; 12-30-2018 at 04:27 PM.
12-30-2018, 08:09 PM   #6
Maya142
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Oh, I understand what you mean now. Poor little guy - 15 minutes feels very long at age 7.

Yes, lying still for an hour really helps - and it is MUCH easier with teenagers/young adults because they understand why they have to lie still!

crohnsinct, I would guess a steroid would only help IBD, right? It would make no difference in IBS because it's not driven by inflammation.

That said, I wouldn't be surprised if your GI somehow manages to find a way to call it IBS anyway .
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