Need some advice for a loved one

Hello,

A lot of background here--feel free to just skip past the first several paragraphs to where I ask my actual question. ;)

My name's Chris. I don't suffer from Ulcerative Colitis myself (though I have my share of digestive troubles and UC isn't 100% off the table as a source; I just haven't been tested and don't have acute troubles at the moment). My girlfriend, however, was hospitalized two years ago with an acute attack (her first sign of bowel trouble ever and they almost had to remove her large intestine, it was so inflamed).

She is presently 20 years old. She went into remission after being given cortisone/prednisone, with the dosage tapered off and messalamine (mezavant) used to maintain remission. She stayed in remission until 2.5 months ago, when she had another flare-up. She went on prednisone and started a messalamine rectal suspension therapy, which she was not using as much as she should (it's hard at her age, though we do understand its importance).

Two weeks ago she came off of her prednisone again, and she has begun to show syptoms again. So it may be that she's not in remission. So far, it has just been loose stool (not full diarrhea) 2-4 times a day, accompanied by some abdominal pain/discomfort (which is unusual for her).

We have her on a low-residue, low-fibre, low-chemical diet, which we're following closely. We have switched to using the rectal suspension every night for the past week (and she's still on mezavant) but she seems to be slowly worsening. The thing is, she still is not having diarrhea, just loose stool--it's mainly the abdominal pain which has worsened in the past few days. Before then, she hadn't really had much abdominal pain at all since she started the prednisone.

We've contacted her doctor's office, but by the 'normal' appointment schedule it could be weeks before we get in to see him. We have the option of going to the emergency room and most likely seeing him that day, but if it's not an actual emergency it will definitely negatively impact the doctor-patient relationship for her to show up in his office that way. Unfortunately, doctors in Quebec are difficult to get in touch with.

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My main question is just whether or not, in your understanding/experience, it's important to act medically on a failed attempt at attaining remission right away, or if managing the symptoms (which are quite mild relative to how they could be, but which are definitely not normal for her) for a few weeks until we can see the doctor properly is fine (assuming things don't get significantly worse).

My concern is that waiting may make it more difficult to get her into remission, while acting quickly might give us a better shot, but I don't know enough about how it works to say whether or not it's important to treat a flare-up early. I do know that her options at this point are a little less pleasant, but for all I know it might even be the case that a few weeks will give her body time to adjust to the lack of prednisone and let the messalamine and diet do their thing.

Thanks, and sorry for the lengthy post. :)

-- Chris

Is switching GI's an option? It is a shame she has to suffer like that waiting for her appt.  My GI always tells me not to suffer waiting for an appointment, that if I am doing badly just call and she will prescribe whatever is needed.

When I am not in a flare, I can eat anything.   when I am in a flare, certain foods bother me.   I discovered that coffee, black tea and dairy are huge no-no's during a flare.  Best thing I ever did besides meds was keep a food and symptom diary to figure out  what was worsening my already inflamed system. 

I know the rectal suspension enemas are hard to get used to when you are young, but i have found that they are indispensible during a flare.

good luck!

Good luck, she is so lucky to have a caring boyfriend like you. How beautiful.

It looks like there is a waiting time to get to the doctor.

Has she tried probiotics and eating very small, liquid meals?

It helped me, so it might help you. It maybe won't but maybe yes.

It could help stave it off.

Breakfast: small bowl of porridge (with water not milk)

lunch and dinner: soup and bread.

No cheese - cut out dairy

nothing spiky or sharp - no raw carrots, corn chips, popcorn. No coffee.

give that colon a rest.

And also dose it up with probiotics - they can help you digest.

I took as many types as I could lay my hands on, all at once.

4 brands of the refrigerated type you get at the chemist.

1 capsule morning and night - 8 capsules.

most brands had 8 or 9 organisms.

I took:
Nourishing flora
ultrabiotic 45
IBS support
Polybac 8

You might have different brands - whatever brands it doesn't matter just make sure they have lots of different strains of organisms.

Cost about $140 and worth it. Took them for 2 months.

That plus plenty of rest maybe you can help stave off the attack or last until the doctor.

I also took a tablet that nuked the candida in my gut, this might have helped too I don't know. It is an over the counter thrush tablet you get from the chemist. Took this before my probiotics.

Definitely stick with the enemas. It's not so bad. I don't know if you have to cut back to liquids but yeah, go ahead and watch the diet. Probiotics... it's possible in the future she may need a different med. Has she tired Asacol? I've seen her current med here a few times but I still don't know what it is.