Do you have a condition called Inflammatory Bowel Disease (IBD)? Or are you suffering from symptoms related to it? If so, your doctor may have prescribed you a medicine that you can give rectally. This is what we call a Hydrocortisone Rectal Enema. You may feel a little scared and confused when you hear this name. But don't think anything of it. Let's talk about this medicine, how to use it, and everything you need to know in a very simple way, as if you were talking to a friend.
Simply put, what is this Hydrocortisone Enema?
Hydrocortisone is a steroid . Its main function is to reduce inflammation , which is swelling and inflammation in the body. This medicine helps to control the inflammation and swelling that has occurred in your intestines. Since it is given through the rectum (as an enema), the medicine goes directly to the problem area and works. Therefore, you can get quick relief. In Sri Lanka, this medicine can be seen under brand names like `(Colocort)`.
Things you should definitely tell your doctor before taking medication
Before using this medicine, it is very important to give your doctor a complete picture of your health condition. Because we need to be very careful when using this medicine with some medical conditions. If you have any of the following, don't forget to tell your doctor about it.
| Health conditions that affect you | Why should you inform? |
|---|---|
| Any current infection (bacterial, viral, fungal) | Steroids can reduce immunity and increase infections. |
| Diabetes | This can increase blood sugar levels. |
| Glaucoma or cataracts | It may increase eye pressure or worsen the condition. |
| High Blood Pressure | Blood pressure may increase further. |
| Immune system problems | The functioning of the immune system may further weaken. |
| A previous heart attack | The heart may be affected. |
| Recent bowel surgery (ileocolostomy) | The healing process may be affected. |
| Rectal obstruction, abscess, perforation, or fistula | These situations are likely to escalate. |
| Other diseases of the stomach or intestines | Other symptoms may worsen. |
| Being pregnant or trying to get pregnant, being a breastfeeding mother | Medical advice is essential as it may affect the baby. |
| Allergies to any medicine, food, or dye | To prevent an allergic reaction. |
How to use this medicine correctly?
Since this is a somewhat strange medicine, it is very important to know exactly how to use it. Follow the steps below.
1. Most important: This medicine should only be used rectally . Do not take it orally for any reason.
2. Wash your hands thoroughly with soap before and after use.
3. Lie down comfortably. The best position is to lie on your left side with your right knee tucked into your chest . This position relaxes the rectum and makes it easier to insert the medicine.
4. Slowly and carefully insert the tip of the applicator into the rectum. Then squeeze the bottle to release the medicine.
5. After inserting the medicine, lie down in the same position for at least 30 minutes . This will allow the medicine to stay inside and work properly.
6. Try as much as possible, keep this medicine inside your body for at least an hour, and if possible, the whole night . Then you can get maximum results.
7. Do not use more than the doctor tells you to.
Very important: Do not stop taking this medicine suddenly, even if you feel better. Doing so may cause a serious reaction. If you need to stop taking the medicine, do so gradually, as your doctor tells you.
What if I take too much medicine?
If you think you have taken too much medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
What if I miss a dose of medication?
If you miss a dose, take it as soon as you remember. But if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose or take an extra dose.
Other things that may interact with this medicine
This medicine may interact with other medicines, vitamins, or supplements you are taking. Therefore, it is very important to tell your doctor about everything you are taking. Especially if you are using any of the following:
- Aspirin and other pain relievers (NSAIDs) such as Ibuprofen and Naproxen
- Blood thinners such as Warfarin
- Medications for diabetes
- Antiepileptic drugs such as Phenobarbital, Carbamazepine, Phenytoin
- Antifungals such as ketoconazole
- Antibiotics like Clarithromycin, Erythromycin, Rifampin
- Female hormones, including birth control pills
- Water pills (Diuretics)
- Digoxin
- Cyclosporine
- Some types of vaccines `(Toxoids and vaccines)`
This list is not complete. If you smoke or drink alcohol, tell your doctor about that as well.
Things to be careful about when taking medicine
- Check up regularly: Visit your doctor on scheduled days to check how you are doing.
- If there is no improvement: If you do not feel any improvement after using it for a few days, tell your doctor about it.
- Warning signs: Do not use this medicine if you have blood in your stool. Also, tell your doctor right away if you have rectal bleeding, severe pain, burning, itching, blistering, or anything else unusual.
- Risk of infection: This medicine may weaken your immune system a little. This means you are more likely to get sick. So, stay away from people who have colds or flu. If you have been in contact with someone who has measles or chickenpox, tell your doctor about it.
- Blood sugar: This medication may increase blood sugar levels. If you have diabetes, ask your doctor if you need to make any changes to your diet or medications.
What are the possible side effects?
Like any medicine, this one can cause side effects in some people. Some are serious, some are common. It's important to be aware of these.
| Classification of side effects | |
|---|---|
Serious side effects that should be reported to your doctor immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Cushing syndrome | Fat deposits on the stomach, neck, and upper back, pink/purple streaks on the skin, and thin skin that bruises easily. |
| Increased blood sugar (Hyperglycemia) | Increased thirst, frequent urination, unusual fatigue, blurred vision. |
| Increased blood pressure | Headache, dizziness. |
| Signs of infection | Fever, chills, cough, sore throat, non-healing wounds. |
| Mental and behavioral changes | Anxiety, restlessness, depression, suicidal thoughts. |
| Stomach bleeding | Black stools that look like blood or tar, and vomiting things that look like coffee grounds. |
| Body swelling | Swelling of the ankles, hands, or feet. |
Things to tell your doctor if they persist or are bothersome | |
| General discomfort and fatigue | General discomfort in the body. |
| Burning/itching at the site of application | Minor rectal discomfort. |
| Rectal pain, inflammation, or bleeding | Minor bleeding or pain after using the medicine. |
Take-Home Message
- Hydrocortisone enema is a steroid medication that is given to control intestinal ulcers and inflammation.
- This should only be used rectally. Never take it by mouth.
- Tell your doctor about any other illnesses you have and any other medications you take.
- Use it exactly as your doctor tells you, for the duration of time. Don't stop taking it suddenly, even if you feel better.
- If you experience rectal bleeding, severe pain, swelling, or signs of an allergic reaction, seek medical advice immediately.
- This medicine is for you only. Do not share it with others.
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