Kenalog for cuffitis

Kenalog (Triamcinolone Topical)

Triamcinolone is used to treat the itching, redness, dryness, crusting, scaling, inflammation, and discomfort of various skin conditions. It is also used to relieve the discomfort of mouth sores. This medication is sometimes prescribed for other uses;

I just saw Dr. Shen for my chronic cuffitis and wonder why he did not prescribe this for me. I would try it. It sure beats canasa and steriod suppositories if it works. Why was he against a BCIC for cuffitis? If they remove your entire rectum and sew the anal opening shut, I cannot imagine you would have cuffitis any more? He was also opposed to pouch advancement surgery, which I have been recommended.

Have you tried antibiotics, suppositories or have you been recommended for pouch advancement surgery? How long have you had cuffitis and how bad are your symptoms? They did find an ulcer in my ATZ at my last scope in October and I have been treating it for months with suppositories and antibiotics.

yes, i was on flaggly and other suppositories.
no, i have not been recommended pouch advancement surgery.

My cuffitis is quite bad, I have been house bound for more than 2 months. It is the burning around the anal area during the BM and constant pain. Let alone more than 10 times a day of BMs.

The idea of the steroid injection is to get long term treatment exactly where you need it, but it is for when the topicals or oral meds don't work. I would wonder if you also have a stricture, because the steroid injections are most often used for that.

Also, I would imagine that the discouragement regarding continent ileostomy for cuffitis is about his belief that more conservative treatment will ultimately be successful and you would be happier with a functioning j-pouch than a continent ileostomy, which has its own set of problems and complications. Plus, it is a big, big surgery, not to be considered lightly.

Jan

Guy,

You can try other antibiotics, if you have not already. I was on augmentin and until I went off this and on cipro, my symptoms did not improve. While I am on cipro, my cuffitis is very quiet.

You may very well have a stricture as Jan has mentioned as I do also. When my cuffitis flares, the stricture also acts up causing much anal pain and burning like you describe. I do not at this time have increased frequency.

Dr. Shen did mention steriod injections to me at my last visit. I guess you have nothing to lose going this way. Have you seen a colorectal surgeon as they may recommend pouch advancement surgery as well? One last thought...have you tried 6 mp?

If going for surgery,I want to have a total solution, which in my mind, it would be BCIR.

I have not used 6MP yet. Is it cuffitis medicine or pouchitis medicine?

6MP is IBD medicine, same as Imuran. So it does not matter if it is pouchitis or cuffitis, but I guess it is more for cuffitis because it is considered to be a return of UC.

Jan

Are you doing any better? I have chronic cuffitis and have it somewhat under control with canasa. It took me 9 months to do so. Along the way I also had a wicked case of a C-diff infection. You are going to Dr. Shen so I'm sure he's checked you for this. I just want you to know I still have days where I go more than 10 times a day.

My Mayo doctor put me back on canasa, I was on anucort at the time I saw him, and told me to take it until it worked and gave me a 6 month prescription for it.

I hope Dr. Shen helps you get this under control -- soon.

TE Marie,

Glad to her you are doing better. This chronic cuffitis is so incredibly annoying and irritating!!! It's annoying when your pouch seems to work fine but you have constant anal pain and now I am dealing with fissures also from it (uuugh).

Canasa does not seem to do much for me so I am alternating this with anucort at the time. I spoke with my GI yesterday who read my operative report from my scope at CC and it appears it is pretty evident I need some type of reconstructive surgery down the road as I do have a stricture at the anasotmosis that is very stubborn. We are going to try and continue to medically treat and possibly add dilations to the mix, but how long can you really do this? My GI trained at Cleveland and shares the mind set of most GI's, where they would rather treat you medically than have you undergo more surgery. I am totally with him on this one. I hope you continue to have success, but I think those of us with chronic cuffitis need to accept that we will be on life long medication if we want to retain our jpouches.

jeanne,
I'm sorry you are having so many problems but glad you are being so proactive about them. Keep on turning over those stones and sharing with us all.

So has anyone tried or had any relief from these Kenalog injections for cuffitis. My cuff is terribly inflamed, and I was wondering if this was even worth a shot.

Nomoremeds, I've had Kenalog injections for migraines and pain before but not specifically for cuffitis pain. I have chronic cuffitis and my GI at the Mayo Clinic has never recommended or talked about using Kenalog before. Would the Kenalog injection be for pain? If that's the case you would get relief for a day.

My surgeon has indicated injections are not a good long term solution, but temeber this is coming from a surgeon not a GI. I believe Dr Shen at CC does this. I too suffer chronically from cuffitis and most days it is a real annoyance I have learned to tolerate and try and calm w Canasa and antibiotics when I am really uncomfortable. The other option is pouch advancement surgery.

I too was just recommended to use
Kenalog, but it's the paste used for oral sores not an injection. Is there an injection they use for an ulcer just inside anus? I am having trouble applying this paste as the tube us soooo small that I use small amount and not sure it getting where it's needed. Have cuffitis since August, now extended down throughout anus and also have this suspicious ulcer. Waiting to get started on Entyvio.

What is entyvio? Is that entocort? I too have a non relenting ulcer in my anal zone. I thought it was due to my fissures. I'm going to get it checked out in full at next scope.
I have had ongoing anal issues since my surgery over three years ago that I never had with UC. It's very frustrating. Most if the issues are due to a recurring stricture at the anastomosis resulting in lack of blood flow to the anal area. The only real fix is to advance the pouch.

Entyvio is Vedolizumab- new infusion drug approved July 2014. Works better for UC than Chrohns but not really optimistic that it will help. Also, takes 8-12 weeks to kick in. Waiting for insurance approval- thrn I believe I'd do a couple starter doses, and every 8 weeks thereafter. Hopeful, but ...
Laurie

I am still waiting approval for my infusion of Entyvio. Still struggling with cuffitis, though pouch is great. Have suspicious "ulcer" just inside anus for which I'm trying topical dental paste supposedly Kenalog. Has anyone had any success treating cuffitis or Anusitis or to rid if ulcer in that area using an injection of Kenalog, or anything else? If you've had Kenalog injection, what strength was it? I read where people are using/ rotating antibiotics for Cuffitis. My doctors prescribed antibiotics when they thought I might have Pouchitis but don't think it will eleviate Cuffitis. I don't want to give up my pouch and welcome any all suggestions of what else might work. I am putting my hope into the Entyvio infusions but know that is only a 50/50% of working! and that's if I just have UC. Worse odds if I have Chrohns. Would love to hear from anyone who has had Cuffitis successfully treated. Thanks much for taking time to respond! Hope for strength and good health for all in the coming year! Laurie