Help For a New Member Please (drug strategy and other questions)

Hi all,

I'm 33, diagnosed with Proctitis at age 21.
5'10'' 155, very active physically.
Diet is clean and healthy with no dairy at all, and no shellfish. (due to an allergy) Other than that I don't restrict anything.
I do drink a fair bit of wine and beer.
I do not take any probiotics or supplements of any kind. (I eat a ton of fruits and veggies each day)

Initial symptoms at 21 consisted only of a ton of blood, which went away after eliminating dairy and taking and tapering off oral Salofalk.
Completely symptom free from age 24 to 32, with only the odd thin (not pencil thin) stool.

In the spring of 2010 I started bleeding again, and experiencing rectal pain (dull ache) for the first time.
Scope in Aug of 2010 confirmed Proctitis. (I'll get scoped every two years now for the rest of my life on my request - is that enough freq?)
Since then I've been taking Canasa at night and Cortifoam in the morning. (I hold the Cortifoam with np but the Canasa not so much)
I have bleeding most bms but recently went a month with nothing and glorious bms (Sept 11) and as recently as a week ago went 5 days with no blood.
Currently bleeding (just on the tp usually) but bms have really started to have good shape again.
I've never experienced diarrhea except the odd non-proc related incident.

A couple questions: (note that I never had any symptoms except blood prior to 2010)

- I have a TON of gas after around 5pm each day. Pretty annoying with respect to my social life. :) Anything I can do here?
- Should I be getting off the Cortifoam, I read that being on it for long periods of time is bad.
- Should I be adjusting my diet more or taking supplements/probiotics of any kind?
- Does it make any sense that it seems like "sharp" foods like tortilla chips contribute to bleeding?
- Any other suggestions you can give me would be awesome!

Thanks!

Post Edited (Digable) : 12/22/2011 1:16:03 PM (GMT-7)

Hi,

What about adding an oral ASA such as Asacol, Lialda etc... to the mix. A low dose sometimes may help and may help stop any progression (of course no guarentee on that). I know rectal asa's such as the canasa you are using are better for long term use over steroids such as cortifoam, however I hear that people do use them for a long while and are okay. However if you could get off of them or minimize, it is probably better. I think a good bet would be to ask for an enema called Rowasa (they are mesalamine enemas --generic is what I use) It reaches a larger area (although I know you have just proctitis) and I think using them in conjuction w/ the Canasa may be a good experiment to try. I think alot of this is just experimenting w/ different things to work w/ different flares.

I can't comment too much on diet as it doen't seem to make a big difference for me, however alot of people do have luck w/ changing the way they eat.

Finally, most of us benefit from a good quality probiotic and def. fiber such as Metamucil. You may want to give these a try, but start slowly and build up as to avoid any stomach upset.

B

1. Could be dietary rather than UC related. I would try seeing if eliminating certain foods helped. Or take some gas ex.

2. Ideally, you would want to be off the cortifoam eventually. However I don't think they're quite so toxic as systemic pred. I might talk to your doc about sulfasalazine or asacol, though, since you have issues retaining your suppository.

3. Diet is highly personal. If you find something bothers you, don't eat it. But if your issues are not food related, do whatever. As for probiotics, jury is still out (meaning it looks promising for some species, but possibly not all?). I would add some yogurts or fermented foods like miso and see if it helps.

4. A lot of people have trouble with high fiber foods like corn and beans. If they bother you, stop eating them while flaring and stick to cooked root vegetables and lean meats.