Dealing with Rectal Stump Inflammation and Mesalamine Treatment

The adventure continues.

As I posted previously, retaining a rectal stump long term causes trouble.

A recap: Last December, about 2 years post-op, my rectal stump became inflamed and began bleeding. This, of course, freaked me out a little. Blood discharging... where it should not. I consulted with my most excellent gastroenterologist. He didn't share the concern I had. He examined my stump with a scope. Diagnosis: Inflammation. He prescribed 30, 1000 mg Mesalamine suppositories. After the first one, bleeding stopped. I was overjoyed. I completed the 30 and continued on with my regularly scheduled life.

About 3 weeks later... bleeding began anew. Like before, it started out small, and soon I was pooping out a small stream of blood, 3 to 5 times a day. I had to wear a pad at night. Unamused.

Last week, my pharmacy sent me a text asking if I wanted them to refill my Mesalamine medicine. Since I didn't have any refills from the first prescription, I replied, "please do."

And a day later, I received notice my Mesalamine was ready for pick up. Yaaaa.

I went to pick it up. Price: $190!! I was somewhat stunned. The first prescription was around $40 for 30 suppositories. The pharmacist said that was the cost based on my Medicare Part D insurance. Then I remembered... I had signed up for a free GoodRX card. I whipped it out and asked if the card made a difference. The pharmacist punched away at her computer for a few minutes. And yes! The cost was now $63. She asked if I wanted to buy it that way. Hello... YES! I noticed this box came with 10 refills. But if I had checked the GoodRX website, they had a coupon to get the medication for $52.00. And a coupon for $42.00 if you were a member of their pharmacy program. So... live and learn. Look up all this stuff before I go to the pharmacy.

I performed quite a bit of research about the long-term use of Mesalamine suppositories. It can be used for long periods of time without trouble.

I deduced: My most excellent gastroenterologist is, of course, familiar with long-term rectal stump inflammation. And he knew Mesalamine was successful for me for 30 days. Then the effect wore off. And now I needed a long-term prescription. He arranged this without me having to contact his office.

So, I've taken 2 suppositories. Bleeding stopped. I'm getting a little watery mucus discharge. I'm gonna take one more suppository... then skip a day. See what happens. Hopefully, I can take one suppository every other day or every 3 days. One thing is for sure... I'm happy bleeding has ceased.

Everyone is different. I have no underlying intestinal disease. My colostomy was due to the physical puncture of my sigmoid colon. If you develop rectal bleeding, visit your doctor as soon as possible. Do not visit an urgent care facility. Most are not equipped to treat ostomies.

Thank you for sharing. My rectal stump is newer, but I may end up going down the same path.

Having had rectal cancer, I'll be running, not walking, to my surgeon's office if I have any bleeding. No one should ever ignore bleeding. And don't settle for a suppository treatment unless there has been a physical examination, as there was in BB's case.

I had a short bout of bleeding about 8 months before my cancer diagnosis. We assumed it was an internal hemorrhoid. It was seen in a screening colonoscopy 6 years earlier and seemed a likely culprit. The bleeding stopped with the suppositories, and we thought all was good. It turned out not to be true.

Sounds like a really big ordeal. I am glad you worked out the RX problem. Sorry you are having trouble, though.

Hi Beachboy,

Your story is ringing in my ears.

Without getting into the story, speak to your GI specialist about mucus plugs. After months of pain, mucus leakage, and blood, I was at a point where I could not sit on my bum, only lay on my side in pain. He did a stump examination with his finger, found a large mucus plug, and pulled it out...what a relief. It took a few days of rest before I could actually sit on my bum. What a big relief in my physical life.

I now have an ileostomy, and my large bowel has been removed. I now monitor my plugs and remove them with a child-sized anal irrigator with warm water...

I hope you can find the help you need. If this works for you, I would love to know.

You can contact me—however you do that—if you would like.

Take care,

Linda/Stillmovin

Take care

Hello,

My most excellent gastroenterologist performed the "finger" probe. I didn't have any plugs or blockage. Then he used a scope that had an attached air pump. That... was uncomfortable. Verdict: Inflammation. Since stool is diverted through my colostomy, the rectal stump area becomes "malnourished," and inflammation/bleeding is the response.

In my case, it is an inconvenience. Unless I undergo reversal or have the damn thing removed, I must learn to "play nice" with it.

Cue the Mesalamine suppositories. After using just one, bleeding stops. But the effect is temporary, and soon bleeding resumes. So I'm now experimenting. How few suppositories do I need to stop or reduce bleeding? Last week I took 3 (1 each night).

Bleeding stopped. So last night I skipped the medication. This morning and today... no bleeding. Tonight I'll use a suppository. Then wait a day to see what happens. It would be nice to go 2 days (or longer) between each suppository. Saves money... and my anus will thank me.

Stay tuned for further updates of.... Beachboy vs Rectum.

My Ostomy Journey: Keyla | Hollister

Good luck to you.

We are all so different and need to adapt to our own circumstances.

Keep plugging along...

Linda/ Stillmovin

I have a rectal stump, or at least until July of this year when they will remove it and the anus. I'm still passing blood and mucus, and they have given me Mesalamine rectal foam enema (not nice at all), but it's only a stopgap until my next procedure. Has your doctor not suggested having yours removed? Mine has suggested that if left in situ, the rectal tissue can die, and there is an increased chance of cancer forming in the stump.

Not sure if I could continue indefinitely with these enemas or even the suppositories.

In my case, inflammation is due to a lack of stool passing through and keeping the area healthy. I didn't suffer any underlying intestinal disease. I'm 67 in a couple of weeks. I've had more surgeries than I can remember. I don't want one more that would be very memorable. I'll take my chances with just using medication.

Hopefully, the medications work for you, BB. Have your bike rides been uncomfortable or tolerable? I know even small things like that help us through our days.

My rectal stump inflammation causes me no pain or discomfort. Just the occasional release of blood. Riding the bike does not make it worse. But... I have a huge padded seat. People comment on it all the time. Got it on Amazon. Real comfy.

I have had similar issues but never blood only large amounts of mucus. I have a nonrelaxing muscle in the mix that caused the stool and now causes the mucus not to pass. Needed Botox injections to get the muscle to relax. And WOW! I filled the bowel with what looked like ABC gum.  Was prescribed the Mesalamine suppositories for a while and the cost was minimal but then came the custom "Short Chain Fatty Acid" enemas not covered by insurance 1 weeks supply was $190.00  I hope you get you issue resolved soon. 

Whoa... $190 a week.  That's just way too steep.  Did you get your non-relaxing muscle fixed?

Unless I have reversal or Barbie Butt surgery, I'm gonna have rectal stump inflammation.  As long as I get regular check ups from my Gastro, using Mesalamine will be good.

The Mesalamine suppositories are easy to use.. vs.. an enema.  Clears up bleeding right away.  And for me, very effective.  Right now I'm taking 1, every other day.  Soon I'll try 1, every 2 days.