It could be that his bowel is so inflamed he can't retain it, in this case he may be better with suppositories or foam enemas. The bowel needs to be able to absorb the medication and if the wall of the bowel is inflamed it won't stay put. Does he have an IBD nurse to talk to? Is he currently in a flair or us it maintenance?

Is he taking it last thing when he is in bed and ready to go to sleep? Is he lying on his left side with his right knee bent up?

I used several different enemas including Salofalk. It is true that if your husband is in a bad flare his lower colon may be so inflamed it isn't able to retain it. It does feel a bit uncomfortable and I have had to really concentrate on listening to an audiobook or similar until it settles in.

It is not fun to have to use an enema but they can really work well. It is worth trying for a bit longer maybe. Make sure the applicator is high enough up.

I hope he feels better soon.

Agree with the other posters, if his flare is bad then it can take some time before he is able to retain the enema. Is it the foam enema he is using? Might also be worth getting a prescription for suppositories to try as well?

Does he have an ibd nurse to contact?

Join the crohns and colitis page on Facebook, will get lots of good advice on there too :)

If you are keen to try the suppositories, your pharmacist might be able to help - if no luck elsewhere.


It was a few years ago that I had a repeat prescription for the foam, but one time the pharmacist couldn't get it and asked if I wanted to try suppositories instead. I did, so they spoke to gp surgery to arrange a new prescription. I've been on the salofalk suppositories ever since, and eventually stopped taking the tablets as the suppositories work so effectively for me.

@itscomplicatedlife is this his first flare since diagnosis? It can be very overwhelming at the start and what works well for one person won't for another. It is best to try and use the enema when he is 'empty' otherwise the enema will very likely result in a trip (or 3!) to the bathroom. That's not to say he still might not retain if he's very inflammed. I do think trying to get him the salofalk supps will be a good call. It also might be worth trying another med instead of pentasa. If I recall correctly, I was on pentasa for about 6 months before I changed to something else.

how frequently is your husband going to the bathroom? Is he bleeding?

I hope your DH is feeling rested this morning. Do you know if your hospital has an IBD nurse? They are worth there weight in gold. Try to speak to the GP about starting steroids, after a week or two he will likely tolerate the enemas. GP can also change prescription and request suppositories. How long has he been diagnosed for? My DH was diagnosed nearly 10 years ago. I read up about the different medications available, I constantly phoned the hospital to speak to the consultant secretary who arranged a steroid prescription. I phoned the GP to request medication as I understood where his colitis was and what medication works in that area. My DH was to unwell to do this he lost 2 stone and was passing blood. The steroids worked quickly. My DH is now on anti TNF injections.

If he can get your DH to take some diorylite to replace what he is loosing that will really help, squash even is better than water. If he can eat make it bland and easy to digest so his bowel does not have extra work (chicken, white bread rice).
Is your DH passing blood? Contact consultant secretary and ask about IBD nurse they will know, ask for a steroid prescription if not phone and ask GP. NHS is awful at the moment no harm in asking for what you want.

Fwiw I am an NHS nurse specialising in bowel conditions and it is awful seeing DH in a flare. I also didn't realise how little I knew about IBD. IBD is still something most GP know little about that's what I made myself an expert. Let us know how he gets on.

I'd recommend a low residue diet for now, which I like to call the white/biege diet. I'm veggie so scrambled eggs on toast, mash, white rice with a bit of soy sauce and fried egg, banana's etc. Nothing with skins/seeds which can aggravate the colon especially when you are trying to promote healing.

I've had UC coming up to 11yrs now and I know what I need to do re meds/food etc at the start of a flare and also when I require steroids. I am lucky to have a great consultant who trusts my judgement and listens to what I need. My condition is very much self-managed with the support of my consultant/nurse.

Just to let you know the suppositories only work on inflammation very low down as they don't get medication any higher. I used them years ago when my disease was not as advanced.

I know a flare is awful after almost 40 years of this stinkin' disease. But I have been in remission for two years on Entyvio (vedolimumab) infusions. I just had one today. The world has really improved for IBD people with the new treatments. And they are using them earlier in the disease to spare steroids which is good.

Take care.

I forgot. Yes, "white" diet. No kale salads to say the least. Easily digested, low residue foods like eggs, white bread, potatoes, rice, chicken.

My DH has Crohns. I wonder if his thumb being inflamed could be gout - my DH also suffers from this and I believe the two could be linked. He also has rashes/ spots/ itchy skin. He finds using duublebase cream helps.

It is interesting to read about food and the beige diet. Two things my DH can eat only in moderation are bananas and rice.

As IBD is an inflammatory disease it can cause arthritis, skin and joint problems too. As someone up thread has said treatment has moved along now for IBD. With what used to be considered last resort drugs now being offered if symptoms don't settle. My DH is doing well and the more you learn the easier it gets to treat.

His swollen thumb could indeed be related. I have UC and also get bouts of inflammatory arthritis. (usually in my hip, which makes it very hard to get on and off a toilet - oh, the irony!)

How soon is his consultant appointment? If he's going more than say 5/6 times a day he really needs to talk to someone now. Ideally not the GP, but a specialist. IBD nurse would be perfect if your hospital has any.

I would call the hospital and either ask the switchboard if they have ibd nurses, or if they don't know or they don't have them, ask to be transferred to the gastro dept.

As it's BH weekend, if he's very poorly and struggling, I'd ask to speak to the gastro ward. They will be able to judge severity of symptoms and if an urgent intervention is required.

Ans please, please make it clear to DH that he must not downplay his symptoms. I am often guilty of this and then it all gets too much and I email the nurse begging for help. At which point the remedies are often much more complicated than they would have been if I'd given them a heads up earlier! (like having to be admitted for iv steroids)

I hope DH is feeling a bit better.

When I started Entyvio I was in a flare that just would not quit. I was taking prednisone. After a couple of months the Entyvio started working and I have not taken steroids since.

I am lucky to have an excellent GI specialist who is an expert on IBD. It makes a huge difference. When I first met him he joked I have two diseases, UC and prednisone.

For anyone in BC it is Dr. Brian Bressler at the IBD Center of BC in Vancouver. I worship him. He just totally gets it.

Entyvio is fairly new as in maybe 8 years or so. In Canada it is paid for by our healthcare system, which is good as it is scary expensive. There are other "biologics" such as inflixamab and some have generic versions now.

I don't have stats but I know they are going to biologics earlier now. I had way too much prednisone over my life. It works but has bad side effects.

I have been on pretty much all the older treatments, including Asacol. Salofalk, azathioprine etc etc.

Colitis is no fun. It has ruined many things for me and I struggled with work at times. I am retired now but had a high demand profession and running to the bathroom was to say the least difficult.

I still have some joint pain as Entyvio mostly treats the gut but I can live with it.

I really hope your husband gets better quickly.

I too tend to downplay symptoms and it has got me in trouble. The flare gets worse and it takes more to calm it.

I tend to tell myself it's just something I ate and many other theories but end up begging for prednisone so I can live my life.

I found that Salofalk wouldn’t “stay in” during a flare. Oral steroids all the way!