Hydrocortisone for cuffitis - got the wrong kind

I have no idea what he prescribed, but the appropriate thing for cuffitis is rectal hydrocortisone, as either an enema or a suppository.  This is *not* available over the counter. OTC hemorrhoid ointment is hydrocortisone but won’t get up to the rectal cuff, and OTC hemorrhoid suppositories aren’t hydrocortisone at all. You need the right medicine to deal with cuffitis. What did he prescribe?

He prescribed hydrocortisone cream 1% to put up there with my finger. 

That’s not what I would use. Does this guy know what he’s doing? Did you press him to come up with a low-cost treatment?

If I had cuffitis I’d try Canasa first. Canasa is expensive but has a much better side effect profile than hydrocortisone.

He is a great doctor from my precious experience so Im surprised he hasn’t prescribed suppositories. I was going to call the pharmacy tonight and fill the script for the real cream he prescribed, but now I think I may call on Monday and see if I should get suppositories? What do you suggest I say? The cream isn’t working? Or based on my research?

I mean I did look online and it does say the typical treatment is mesamaline sups. I’ve never really questioned a doctor before. I suppose I could just say the cream isn’t working. 

Neither hydrocortisone nor mesalamine work immediately. I suppose you could say that you’re not confident that you can get your finger all the way to the rectal cuff’s circumference, and wondered if mesalamine suppositories might be worth a try, or perhaps Uceris (budesonide) foam if he feels strongly about starting with a steroid.

I eventually used both in suppository form. It's not an either or situation. They started me on hydrocortisone first and then canassa, mesalamine, and when it didn't went to expensive canassa to using both. One at night and the other in the morning. 

They both as samples that I tried first. I don't remember the exact cost but the hydrocortisone was pretty inexpensive.

It is possible to get your finger all the way up to the cuff but it is not easy. My question about that is wouldn't you loose mist of it before reaching your cuff. It will do you no good unless it gets to the cuff.

I hope you are feeling better soon. 

Thanks. Yea I don’t want to be sticking my finger up there daily. I have found relief just doing topical once at night and with the Cipro - not sure if that’s just wishful thinking? I did put in a request to fill the script the called in for the hydrocortisone that’s the expensive kind but it’s on order bc they don’t carry it. 

i ended up pulling a muscle today so I was worried about that, didn’t get to call the gastro. Now the day is almost over and haven’t gotten the sups. Maybe call I’ll tomorrow...

could it be the Cipro is helping the cuffitis? I actually went the entire night last night without having to go to the bathroom! That’s unheard  of! Itching is way better too. 

I couldn't take Cipro but took other antibiotics for pouchitis. I was a patient at Mayo's and they just did the 2 suppositories for cuffitis. You have to stick your finger up there pretty far to get them in but not as far as I'd think for the cream. Maybe it's something new that comes with an applicator. That would be nice. I suggest talking to the pharmacist before paying out so much. 

Glad your night went better.