Need Thoughts on prelim UC/UP diagnosis

Hi everyone,

I have been skimming through the forum, and I noticed a lot of enthusiasm for answering the pleas and inquiries of others. I've kind of just thrown myself into the forum because I have to head off soon, so please excuse any bad forum etiquette on my part. Thank you for your patience!

This past February I noticed bulging tissue in my rectum and thought hemmies immediately. My symptoms were excessive bleeding and bowel obstruction. The realization hit like a brick and I alerted my family doctor via email. He referred me to a general surgeon without an appointment (yeah I'm looking for a new family doctor, since he never has time for his patients) and prescribed some proctosedyl. The consultation with the surgeon was in May, and when he looked he said it wasn't that bad (there was no bleeding at the time), but I felt it had to be. I opted for the colonoscopy in June even when he said it might not be necessary.

In the meantime, I've started noticing large amounts of pus/mucus with bowel movements. And defecation has become harder with apparent bowel obstruction (even when my stool seems good, will explain below). In fact, defecating has become such a trial, that I can't just sit and have a bowel movement, I've resorted to maneuvering my body and "manual encouragement" to help pass a stool. Sometimes all I get is pus and blood without any stool, but I'll have this maddening feeling that I'm not done yet. And that feeling will last ALL night long, making some nights nearly impossible to get to sleep.

After the c-scope, the doctor sent me home with prelim diagnosis of proctitis. In the post-op consultation a week ago (this July), the doctor said it wasn't hemmies, it was proctitis and he showed me ulceration/inflammation (I'm still trying to discern the difference) in pictures from the op; even gave me one (great souvenir). The proctosedyl relieved some of the symptoms (the pain mostly), but its extremely temporary. All he's told me to do was to maintain a healthy diet and wait for my appointment with the specialist (assuming the GI) in JANUARY, *sigh*.

The worst of the symptoms is the constant feeling of having to evacuate. I can't sit still, and it always starts after my first bowel movement of the day. After that I feel like going 10 more times. If I don't, my reaction to the feeling will eventually squeeze out some of the pus/blood. What I'm asking the good public of the forum is for any ideas on how to relieve this feeling. And when I'm making a bowel movement, I'll strain (uncontrollably) and feel really faint. How can I relieve the experience a little? The stool I have is soft but with a nice consistency, like really fresh play-doh (sorry for the comparison!). I never thought lack of fibre was a sincere problem.

Does this definitely sound like IBD and will I have this for the rest of my life? I know not to take answers out of context and will wait for the Jan. appointment (trying to push that to earlier date) for a definitive diagnosis, but I would love perspective on how to approach this problem. Is this a serious or transient problem?

For the record, I'm a 22yo male living in Ontario's GTA.

I greatly appreciate anyone's help and patience for reading this wall of text.

Hi G89, Welcome to Healing Well!

All of your symptoms are very familiar to me because I was initially diagnosed with Procitits. Mine eventually turned into Ulcerative Colitis but this supposably isn't common. My GI wasn't too concerned about it spreading at the time of diagnosis and sent me home with Canasa and like BeachGirl, I did very well with Canasa for quite some time. In the best case scenerio, you may be able to use something for the inflammation and you will go into a long remission and this won't be a huge issue for you. In the worst case, it could progress to the rest of your colon.

Did you get the biopsy results from your colonoscopy? Did they say proctitis? Sometimes biopsy results can reveal information about the source of the inflammation. If it were infectious, it may be possible to treat with antibiotics. It's not a bad idea to get a copy of the report and look through it yourself. It's also not a bad idea to get a stool test to check for bacteria to eliminate that possibility.

I find it very strange that the doctor didn't give you something to treat this as well. Does s/he expect you to suffer for months until you get in to see the specialist? Have you tried calling his office to see if he can call in a prescription? Have you seen about cancellations with the specialist? Maybe you can get in sooner.

The medications do take some trial and error but in the case of procitis, most people respond well to rectal meds. They are fairly easy to use after you get used to them and they are mostly topical and have low incidence of side effects.

I hope you get some treatment soon.

Thank yous to BeachGirl808, notsosicklygirl, and kazbern. Much appreciated for the responses!

Going into this, I was all over the place thinking about was wrong, so I didn't ask many questions beyond "what is it?". I didn't second-guess the fact none of the doctors prescribed me anything besides proctosedyl and more fibre, solid treatements for hemmies I'm sure. As a hydrocortisone, proctosedyl seemed to help a bit with the inflammation, but it didn't last very long.

@notsosicklygirl
There was a biopsy (i remember feeling it), but I've yet to hear anything specific about it. That or he didn't explicitly say "the biopsy indicates...". I liked the surgeon, he was nice and approachable, but hearing what you guys have to say, I can't believe how much necessary information I'm missing out on! All he could tell me was it "seems like proctitis" and "keep a healthy diet". I haven't heard about Canasa until now, do I need a prescription for that or is it over the counter? I might have to call the doctor again... with a firm hand!

I'm going to call this week and see if I can't book against a cancellation. At least this way, I might get it earlier than 6mos away!

I'm really receptive to hearing the facts. I want to look at this and find out what to do. I'm just not good at asking about it, because I don't know what to say and unfortunately, I often downplay my maladies. If the doctor isn't going to tell me what I should know (*sigh*), then how is he going answer questions I don't know how to ask. Thanks to you guys, you guys have really helped! This perspective is exactly what I needed. I'll update, once I'm done with the consult in Jan (hopefully sooner). And thank you for the well wishing.

@notsosicklygirl
Thanks for the info. I'm calling my doctor this week for a prescription. I've seen mesalamine throughout the forums, so I'm going to jump on that right away. I'm also going to adopt a few of the approaches of others in the forum, like tea, less stress, and more sleep. Some things work for some and not for others. I'll have to figure that all out for myself, but it's good to have some guidance.