What would you do? A pregnant fellow UC'er with ??

Hi everyone,

I dont post much but I do log on to read all the do's and donts and respond where I can offer advice.  Heres my story:

I have UC (pancolitis) and I am also currently 23 weeks pregnant.  I have been in remission for almost 2 years (after an incredibly horrible flare) on 6mp and colozal.  I have rowasa and canasa that I use occassionally.  I should mention that I also take a probiotic-2 2x daily, and well as a tablespoon of fish oil (although I am not always faithful there!)

Pre-pregnancy you would never guess I had UC- I would have perfect BMs 1-2 times daily.  This pregnancy has my body confused.   I have daily BM's but they are not always perfectly formed like they used to be- I find they are softer and mushier.  And I Find I am going anywhere from 1-3 times daily.  I dont have any cramps/pain and I dont see any blood or mucous nor do I have any urgency, so I dont know if I should call my GI.  I love him, but his office and nurses are terrible- so getting directly to him is difficult to say the least.  I had bloodwork done a few weeks ago and all looked good.  My ESR was slightly elevated but the GI spoke with my high risk OB and they determined that this is something that gets elevated in pregnancy. 

I have started the rowasa enemas at night and the canasa suppositories in the am.  I always have prednisone on hand but of course I hate it as much as everyone else here and I have not been on it since my one and only horrible flare.  SO I guess my question for you "experts" is- does this sound like a flare?  Or maybe just the way my body is reacting to the pregnancy, giving me the opposite of constipation, which I have been lucky enough to avoid.  Is there anything I can add to my daily routine to maybe firm up my BM's and cut back on the frequency?  Lastly, should I be conservative and assume this is UC and start a low dose of predisone (if this is your choice, please mention the lowest dose effective and the fastest taper)

Thanks so much for reading this novel and I appreciate any advice you are able to offer.

I would try to stay away from prednisone at this point.  Although it is considered safe during pregnancy I would use it as an absolute last resort.  I took it while pg with my first daughter 4 years ago.  I ended up on bed rest with high blood pressure.  They are not sure but I think the pred played a part in that. Also I needed a stress dose of steroids while in labor because of how the pred effects the adrenal gland.  If you aren't having blood or urgency right now I probably wouldn't do anything.  If your symptoms escalate make an appt to see your GI.  This may also be a good idea to make a plan for what to do if you flare after delivery (which happens often).  Good luck.