Flare Up?

hi...i sometimes take an immodium, just to settle my stomach down when it feels active. it works for me...it doesnt bind me up really. the next day i will have a normal bm...stay away from spicey and fried foods. hope this helps...

Whenever I skip Metamucil I have more D.
I take increased Metamucil to combat D and solidify my poops.
So, we're all different.

I would start rectal meds asap if I thought I had flare symptoms starting.....

Could you call your doc soon and ask for rectal meds....I would suggest the mesalamine retention enemas. If you're in the US, it would be Rowasa. Salofalk in Canada.

It's good you're eating...

You might consider to up the Metamucil caps.

You're definitely flaring..it's not the food. Please call the doc for the enemas.

q

Because it's continual with 3 bms daily for a week and has worsened recently with a LOT of diarrhea, and I'll bet that there were gradual symptoms before that not recognised. The term "pretty good" for a new UCer means not enough experience see the variations of symptoms.

Because ll was just off pred in July and is not on any rectal meds, especially for maintenance.

Considering UC flares start at the rectum and continue upward and the symptoms are diarrhea, I'll bet there's mild inflammation involving the entire rectum and probably just above that.

Nausea and bloating can definitely be a symptom of of mild rectal inflammation.

ll is not on any rectal meds nor has been and the asacol oral alone will NOT deal with lower inflammation.

You obviously don't get yet how to use rectal meds to the fullest of their potential....and maintenance is one way. I always tout the 5ASA (mesalamine) over steroid.

What do you mean difficult to get off of them? The point of using them is to keep the inflammation down and prevent flares from being more severe. If one can keep flares limited to the lowest part of the rectum or to just the rectum...that's much better control than having a higher amount of colon involved.

You don't have the experience of them yet...Some are able to get off them, others make the decision to stay on them tapered to maintenance. It may be viewed by some as a failure to be using them as such.


Lactose intolerance more than likely isn't the issue, but while flaring, lactose intolerance can be more exacerbated.

My take on it...

I agree to double the probiotics.

q

All we can do is respond from our own experiences and from whatever school of thought we (with or without our doctors) subscribe to, right, folks?

Q and C_, you both make excellent points. I have recently read that we UCers are much more sensitive to the slightest hint of spoilage in food - and my personal experience does bear that out. (Now the older leftovers in the fridge automatically go to my husband so my UC son and I don't eat them....lol)

In my experience, though it sometimes seems as if one particular meal indiscretion has "started" a flare for me, as the years have gone on I've come to realize I'd been ignoring the tiny symptoms, such as increased gas....

My GI and I discussed once again that I will plan to be on Rowasa twice a week indeterminately - following the research that has pointed to this protocol as helping to prolong remissions and reduce long-term cancer risk...... But we know that there are a lot of folks, UCers and GIs, who just want "off" them.

ll - it takes some time to learn the subtle signs of a flare coming on.... it took me a decade! - and unless you have a food sensitivity, my guess is that your indulgent eating just brought to the fore some increased symptoms of inflammation that was simmering just below the surface of your attention.

Hang in there, and keep us posted!

Ultimately, it's left up to ll to make the decision. I only suggest....and of course, my flares are quickly averted with 5ASA rectal meds when increased to nightly and I taper to maintenance.
I have no intention to stop using them or ever use prednisone, immunosuppressants or biologics.


I don't get why one would use daily enemas instead of nightly ones, and doing twice a week if one is in a flare means they need to be used nightly.

Some are sensitive to 5ASA meds and cannot use them. Some end up with having UC symptoms that cannot be controlled by any meds and require surgery. Not a bad option to me.

I suggest not waiting longer than a few days with continual symptoms and yes, the OP states how long he/she has had diarrhea with worsening of symptoms. The food isn't the issue here.

I would never suggest anyone wait....one tends to wait longer than necessary.  But, you and I have different perspectives...personally, I'd much more depend on mine than yours.

q

ll states "over the past week"...

Regarding your neighbour...colitis..meaning UC or crohn's colitis or microscopic colitis?

Disappearance of symptoms after a week could be IBS..depending on what one's symptoms are.

There are some who have rectal sparing after many years of chronic rectal inflammation...just like it's burned out. or your neighbour has Crohn's colitis with no rectal involvement...

I won't dispute that some have success with oral meds, some have continuing low inflammation of the rectum with NO symptoms. But, I'll bet if you asked further, her remission may have also included periods of constipation, mucus, etc that she never considered a flare.

Regarding your rectal meds...how exactly have you tapered them that you have had no success? Are you taking the 5ASA at night and the cortifoam during the day?

It is possible that the prednisone has made you somewhat resistent to the 5ASA....maybe you using 2 enemas daily (if both are 5ASA) and a larger dosage of Apriso has you taking too much. There is a fine line regarding that.

The rectum can be the hardest part of UC to deal with...which is so frustrating to hear.

It's also been suggested that the Primal Defense isn't really the best for UC...I've never used it.

q

Thank you all for your input. I had my last D yesterday (Sunday) morning and didn't go for the rest of the day. Today I had 2 small BM's (soft but not in D form); however, I feel more gassy than usual and have gurgling down there. I will resume taking metamucil again tomorrow and stay on a low-fiber diet like some of you recommended. I'm scared of taking immodium because when I was flaring in March, every time I took an immodium or something that's supposed to suppress the D, I ended up with major pains on my lower abdomen. Quincy, it's 2 L's for Lara Lar. Quincy and CGK, thank you for the enema discussion. I have been very confused about whether I should be on it. The last appt. I had with my GI about 3 months ago, I asked about it since I noticed many of the members here are on some kind of enema. He said that since the whole colon was affected and not just the lower/rectal portion and since I'm in remission, it is not something he recommends for now but not to say I won't need it later. I'm not so sure about my GI, he seems ok, my GP highly recommended him but I don't have enough experience yet to know how good he is. I don't feel that he really cares... I feel I'm just one of his many, many patients.

Can you explain to me how the enema works (so sorry for being naive). I understand that for a lot of you, it's used 2 to 3x a week, at night and you try to hold it in through the night. Then have a healthy BM in the morning. Is this the only BM you have for the day? or do you have more than that? Before this recent setback, I was having 1 healthy BM daily (a good amount, soft but formed); some days I have 1 or 2 more smaller BMs. From what I gather here, the enemas help bring inflammation down in the rectum. Does it also make you have more BM's? I have a lot of learning to go through still and I really appreciate this forum as you guys are helping speed up the learning process. Again, really appreciate your comments.

ll, there are studies showing the usefulness of mesalamine enemas for people with pancolitis, both to head off flares, and to maintain remission. It is surprising that your doctor is unaware of this.

Retaining an enema overnight is pretty easy for most people, since you put it it in and then fall asleep. You don't even notice it. It would likely make your first BM of the day looser, because the enema is watery.

Are you taking any probiotics? They can help restore the balance of healthy flora in your colon. One called Renew Life-Ultimate Flora Critical Care Probiotic seems popular and well tolerated according to what I have read on this forum.

Hi...You can say to the doc that you've done some research on the 5ASA meds and it does state that using both oral and rectal meds makes sense and you would like to give them a fair try.  Seems harmless to try them and all you have to gain is remission and more control over your symptoms.  You also realise it'll be an ongoing thing, if he's OK with adding his signature to the refills, you're willing to be the guinea pig..etc.  And...you're excited to give them a try.

The Mega foods 50 billion probiotics seem perfect!  They have reuteri in them as well, which I think is a good thing.

http://megafood-vitamins.com/megaflora-plus.html

q