Ask a doctor on the topic of Internal medicine

Problems treating acute pouchitis with Entocort Rectal

February 21, 2012 | 20,00 EUR | answered by Dr. med. Kathrin Hamann

I have had a pouch (colon removal due to ulcerative colitis) for 10 years and have also had chronic pouchitis since then, which I usually treat with antibiotics. Since I recently took antibiotics again, but my pouchitis is active again and my cuff is also slightly inflamed, I am currently treating with Entocort rectal enemas for a week. The symptoms have improved significantly (pouch is calmer, reduction in bowel movements, less intestinal movement/noises), but for the past few days I have had a stronger burning sensation in my pouch mainly at night (after administering the enema), which I did not have before starting the therapy. Normally, I do not experience burning in my pouch during active pouchitis. Is it possible that the burning is related to taking Entocort? If so, should I continue the therapy further (I plan on one more week) or stop it to prevent the burning and symptoms from worsening?

Dr. med. Kathrin Hamann

Good evening,

It is quite possible that this burning sensation is related to the Entocort. However, I consider this treatment to be very effective for pouchitis. If you prepare the enema exactly as directed, the burning sensation should disappear in the next few days.
Using it for three to four weeks is advisable, so you can indeed extend the treatment.

If your symptoms do not improve in the next 7 days or even worsen, then a doctor should examine the findings and determine the levels of inflammation through a blood test, possibly also conduct a stool sample for germ detection.

All the best