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How do you know you're flaring

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Ulcerative Colitis
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Posted 1/10/2009 12:04 AM (GMT 0)
Hi all,

I am new to this whole UC issue (diagnosed 12/08) and have thus far been on Asacol (2x3) and Pred (started on 30 mgs and tapered--currently off).  Before starting the Pred I felt really bad...I would have a BM at least 4-5 times a day (lose stools).  While taking the Pred, I never felt as normal as I did (1 BM a day which was a solid stool).  I recently just got off of the Pred and am starting to feel the "urge" to go a bit more (not as much as before I took the Pred however).  I am currently haveing 2-3 loos BM's a day.  Is this considered a flare? I spoke to my GI and he recommended I get back on Pred at 25 MG's. 

Can anyone help...am I flaring or is 2-3 lose stools normal...how am I flaring so soon after the Pred?

Should I still be on the Pred or should I be switching my meds from Asacol to something else???

I have no idea about this stuff yet?!??!!?

Posted 1/10/2009 12:37 AM (GMT 0)
I consider remission 1-3 solid stools a day with no blood or mucus. The BM urge can be held for a period of time without accident. Gas can be passed easily and discretely.

Loose stools, putrid gas and cramping, frequent urges or BM's lasting more than 2-3 days is mini-flare that can go away or go into full flare. Little mucus but no blood. Gas is "iffy" to pass and usually done in the safety of a restroom.

Full flare is urgent BM's often, blood mixed with mucus and undigested foodstuffs in very loose stools or D. BM's can range from 5-30 per day. Any BM urge or gas must almost immediately be performed in a hasty manner... bathroom or not.

That's just my take on flares. Also, I would listen to your GI doc if you trust him.
Posted 1/10/2009 1:51 AM (GMT 0)
Your situation sounds like mine and I consider myself to be flaring. I've been flaring for SO Long and this is the most minor it's been in a while so I am thankful for that but I am not "normal" imo. I have urgency and loose stools. Sometimes I wake up in the middle of the night and have to go... I don't take pred, just Asacol and Canasa. I sometimes get frustrated and think I need to be on stronger meds but I don't want to put that stuff into my body if I can avoid it so I deal with the flare. At least I am able to live normally at the moment. It is funny how you become so appreciative of the littlest things when you're dealing with such an unpredictible illness.
Posted 1/10/2009 1:58 AM (GMT 0)
Shadam,
Please get the book "Patient Heal Thyself" ...the meds are a vicious cycle. They are only treating the symtoms!
It will be worth your time.
Good Luck!
Posted 1/10/2009 2:12 AM (GMT 0)
For me blood is the big indicator I am flaring, as well as cramping, urgency and D. Thankfully I am not like some who cant hold it if I need to - I can but it causes pain. As for the blood, if I am in a bad flare I can often sit down to go and just pass pure blood. It is rather scary at times. jo
Posted 1/10/2009 3:40 AM (GMT 0)
Please take any recommendations to stop your medications with caution. Others on the board are posting as peers, and are no health professionals. Stopping medications can be dangerous in some cases.

And the only cure for UC at this time is surgical removal of the colon.

Just making sure people have the full picture.
Posted 1/10/2009 5:42 AM (GMT 0)
Shadam,

I am about 2 weeks behind your timeline (tapering off the 40mg I was originally taking) and was wondering this same question. I was wondering if there was a "gray area" between a flare and remission. I am worried that the more a tpaer off, the more I might slip back into a full flare. I am 2-3 semi-solid BMs/day with occassional blood (very little). Currently at 20mg of Pred and two Lialda per day.

I am keeping a very detailed journal/diary online so I can update it from any computer I am near. Complete with food/BMs/pains/meds/times etc. Hopefully this will help me keep up with it all.
Posted 1/10/2009 6:41 AM (GMT 0)
Hi Shadam,

I can definitely relate to your situation. When I first got diagnosed, they said I had a severe case and were always talking about surgery, which scared the hell out of me. Luckily I responded well to the IV steroids, and even better to the pred, so they released me on 40mg of pred. But as soon as I tapered off that the symptoms came back almost straight away.

I guess in terms of 'what constitutes a flare' it is different for everyone. some people get severe diarrhoea and dehydration others get constipation. For some people the whole colon is diseased for others only parts are. Mine is left sided.

for me it is when I don't feel confident going a long stretch of time without going to the bathroom, meaning music festivals, bbq's in the park and sport (to name a few things) are all out of the question during a flare.

I think I'm in remission when I feel confident going out and about, usually only going to the toilet 1 - 2 times a day with formed stools (but don't think they will ever be like they used to be, cause I've found that just doesn't happen anymore) - but the biggest sign that things are on the up is when I can break wind with no problems and it doesn't make people run as fast as they can in the opposite direction due to the smell.

The things that I have found to help me stay in remission are: Chamomile tea (I cannot recommend this highly enough - I swear by it, probiotics - I use one called inner health plus, not sure if it is available outside Oz though, and multivitamin tablets - to help keep vitamin levels up when everything you eat is pouring out your other end)

Just try some different things to help supplement the meds. I believe Colitis has some sort of neurological triggers as well , as I only ever seem to flare when stressed (usually from work). given time you will begin to understand how you might be able control your UC and you will definitely better understand when a flare is coming on. Just don't get down, stay positive cause at the end of the day there are worse things out there than UC..

hope that helps

Dan.
Posted 1/10/2009 7:38 AM (GMT 0)
Your GI may be concerned that you might flare again and is taking precautions by prescribing prednisone.

Please remember:

1) Prednisone harms the body. It can cause more complications than it solves.

2) The other medications for Colitis aren't without side effects either. Many of them are not recommended to be taken more than several weeks at a time and may damage the kidneys over the long term.

3) Do not taper off prednisone too quickly. Prednisone is similar to cortisol--a steroid the body produces in the adrenal gland that reduces inflammation. The body will produce less cortisol when you are taking prednisone and needs time to start increasing its production of cortisol again when you are tapering off the medication. In fact, it is this lag in cortisol production that may cause your symptoms to return during the tapering stage.

Please do your homework and research all drugs you take for Colitis so that you can make an informed decision.

As for me, I have no plans to save my colon only to have to get hip replacements or be put on a kidney dialysis machine.

I consider myself in remission when my poo is normal and I'm not bleeding. I'm in remission now. I still have issues with urgency, which is no surprise considering what my colon has been through.
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