Ulcervative Colitis Flare - Question

I was diagnosed with UC in Feb. 2011 went on prednisone and Lialda and within days my problems associated with my flare subsided.
But then came the long drawn out prednisone use taper from 40mg to 0, tapering 5mg per week. During this taper period I gained
25 pounds, my face grew round, my hand joints ached, became very tired all the time, etc.

I've finally started to get back to normal weight and energy levels from the prednisone use when wouldn't you know it I started flaring again
about 7 weeks ago. I've been trying to just rough it out and deal with it by increasing my Lialda and taking probiotics, SCD diet, Immodium,
mega vitamin C doses, L-Glutamine and Quercetin and anti-gas pills but it does not seem to be helping. The bleeding comes and goes but it
is a constant diarrhea with small volume of stool material that is very hard to pass, now up to about 8 times a day.

Am I kidding myself in thinking that the flare will run its course if I hack it out long enough, or is the only way I'm going to get this flare to go
away is by taking the prednisone and let the chips fall where they may? Also if I do take the prednisone and my flare goes away, when my next
flare happens would you recommend that I start the prednisone as soon as I establish that I'm flaring and nip it in the bud, is that the best way to
deal with it rather then letting it fester like I have now for 7 weeks? Does the damage to my colon just keep getting worse when I could have taken
prednisone and spared my colon from the damage it is receiving now due to my not wanting to take the prednisone?

You do have options, and prednisone isn't the only one.

At the very least, you should push for the mesalamine retention enemas in conjunction with the Lialda.

I plan on never going on pred to treat my UC and have successfully used the oral/rectal 5ASA (mesalamine) for almost 23 years.

q

Yes the enemas have to be prescribed. I also think you should give them a try before going the pred route. I have left sided as well and the second time I was put on pred when I would taper down the symptoms would come back. The enemas done nightly is what made my flare go bye bye and now I do them once or twice a week for maintenace. If I felt like I was seeing signs of a flare I would increase them immediately along with upping my Lialda back up.

I'm taking 4000mg Vit C per day.

So it is possible to beat a flare without taking the prednisone.

Is it just a matter of time or will the enemas make all the difference? So far nothing has helped just getting worse slowly but surely.

How expensive are the rowasa enemas without insurance?

Also not sure taking anti gas pills like simethicone is good check with doctor or research it.

JHarvey, I too have had success with the retension enemas, although they are the hydrocortisone ones, not Rowasa for stopping a flare, maybe for maintenance I would try that.  You should really go that route to get your flare under control esp. since you don't want to remain on the oral pred.  The side effects on the hydrocorts are not anywhere near the oral prednisone! 

Just to be clear, I took prednisone 40mg with a 5mg taper per week when I was initally diagnosed with UC back in Feb of this year. I was also taking 3 Lialda tablets a day as well and have been all along.
The prednisone knocked out my very first UC flare back in Feb but at a cost of some kinda bad side effects, joint pain, weight gain that has taken forever to lose, swollen face, tired all the time etc.

So I have been UC flare free from basically last March until October when I started to flare again, since then I've upped my Lialda to 4 pills per day and have been on the SCD diet for about 2 months now,
also taking L-glutimine and Vit C (which I have recently stopped) and Quercetin and a 20 billion probiotic. I've been doing these things now for about 2 months and the bleeding is usually everyday except some
movements there is none or very little and others there is alot, my movements are almost all watery with a small hand full of semi solids, and a lot of tummy rumbles kinda like hunger pains along with a fair amount
of gas and urgency to go that comes from out of nowhere.

I so not wanting to have to deal with the side effects of the prednisone that I trying to do anything I can to get this flare to go away without taking it, but like I said its been 2 months and it just doesn't seem to
want to go away it's just kinda the same thing day after day.

I have not tried the enemas yet I'll have to go see my gastro to get a prescription but I know he will want me on the prednisone, but it sounds like at this point the only option I have left aside from upping my Lialda
to 5 pills a day is to try the enemas. I'm just worried that by trying to beat this flare without taking the prednisone that I my have allowed the colitis to grow into a worse condition then it would have been had I nipped it
in the bud with prednisone. I have not seen my gastro during this flare mainly because I currently have no health coverage, so I've been trying to fight it the best I know how with what I've got.

I'll have to decide to either take my prednisone from my previous flare, or break down and see my gastro for a prescription for the enemas. UC really bites!

Thanks everyone for your help!

Hi, I wouldn't recommend treating your UC flares with prednisone unless things spiral out of control. Take your oral mesalamine and add the enemas, a few a week while not flaring and nightly when flaring.

Relying on prednisone to treat a flare is a bargain with the devil.

If you can manage your UC topically with mesalamine, you're at the level of least toxicity.