Pentasa Enema (mesalamine) is a treatment primarily used for ulcerative colitis in the last portion of the bowel. It may be used to treat other conditions affecting the lower bowel when appropriate.

This medication is an aminosalicylate anti-inflammatory drug, commonly used to treat bowel conditions. When applied the medication reduces inflammation, soothing pain, irritation, and other symptoms. It can be used during flare-ups or over the long term as a maintenance treatment.

Pentasa Enema is administered by enema---fluid inserted into the rectum. This is a fairly normal way to treat lower bowel conditions, and is not painful. Most patients find this administration method---applying the medication directly to the area that needs it---to be superior to other methods, such as tablets.

Pentasa is available in several other formulations, including tablets, sachets, and suppositories. Suppositories are also ideal for treating ulcerative colitis in the lower bowel or similar conditions; other formulations, such as tablets, will provide some benefit but are not as effective. Suppositories are solid while enemas are liquid.

Getting Started with Pentasa Enema

Each Pentasa Enema comes in an individually-wrapped foil container. In the foil is one enema, a plastic bottle with a long tip. The bottle contains fluid medication. To unseal the bottle twist the cap one full turn. More detailed instructions are included with each package.

Pentasa Enemas are ideally administered at bedtime, after the bowels have been emptied. Ideally the patient will go to sleep after administration, staying in bed all night. New users may want to place a protective covering on top of bedclothes in case of leakage. The majority of patients can hold the enema in without issue after several days of use.

Patients who are currently having a flare-up, experiencing discomfort and perhaps frequent diarrhea, may find it very difficult to retain the enema. If needed, small portions may be administered throughout the day. This is better than nothing and will still provide some benefit.

To use Pentasa Enema, most patients:

• Empty the bowels and prepare for bed.
• Lie on the left side with the right leg a little forward for balance. Lying on the left side helps the medication move down the bowel.
• Insert the tip of the enema and steadily squeeze until emptied.
• Relax in the same position for the next 5 or 10 minutes until the urge to pass the enema has gone.
• Sleep through the night if possible.

Some tips to make use easier:

• The enema can be warmed by placing the bottle in warm water prior to administration.
• The tip can be covered with lubrication if needed.
• A garbage can near the bed will make disposing of used enemas easy without getting up.
• If using multiple partial doses, be sure to store the partially-used enema in the foil bag it came in to protect it from light and contamination.

Dosage may vary to some extent; typically 1 gram to 4 grams per day. Benefits may be felt as soon as 3 days after treatment begins, but more often takes about 2 to 4 weeks for significant improvements to be seen.

Treatment duration is also variable, and perhaps best discussed with a doctor who is familiar with a patient's individual variables. Treatment typically lasts at least 6 weeks. Dosage is usually on the lower side when used as a long-term maintenance treatment.

Warnings & Side Effects

Pentasa Enemas should not be used by individuals with severe liver or kidney issues.

Individuals who are allergic to aspirin are more likely than usual to be allergic to Pentasa Enemas; either avoid use or discuss risks with a doctor.

Most side effects are minor and not cause for concern unless severe or persistant, including:

• Abdominal pain
• Nausea
• Diarrhea
• Rectal discomfort
• Rectal itching
• Urge to move bowels, particularly right after administration

Much more rarely serious side effects develop; seek emergency medical attention if experiencing:

• Severe stomach pain
• Bloody diarrhea
• Severe headache
• High fever
• Unexplained bleeding
• Allergic reaction (hives, swelling of limbs or face, difficulty breathing, rapid or erratic heartbeat)

Effects of Pentasa Enema on unborn or nursing infants are unknown; speak with a doctor. Likewise effects on children are unknown; do not give Pentasa Enemas to young patients without explicit doctor approval.