Remission Since December

I've been in remission since December, while taking 3x Asacol 400mgs per day, and suddenly I've starting noticing large amounts of mucus without blood. Consistency has been, and still is, normal, and I've been able to eat a pretty regular diet without anything bothering me. I'm a little concerned, and the last thing I want is another flare. My flares have pretty much followed a set schedule, starting with noticing mucus(thus my concern) for a few weeks, and then gradually blood and increased bowel movements, I fear this is the start of a flare and would like to do anything and everything possible to keep from flaring.

Could anyone offer any suggestions as to causes for this, and tips on what I can do to get this back under control? As the doctor suggested, I have been trying to get more fiber (at least 4 servings of fruit and veggies per day), Metamucil everyday, and Asacol 3 times daily. I've been following this regiment pretty strictly. I do eat a ton of fruit, and try to get my veggie servings every day. There really hasn't been any change in diet that I can recall, with stress, depression, and anxiety levels at an all time low.

I agree that rectal meds can help you get this under control.

hello....rectal meds. Try to not worry about the season as much as how to deal with the flare you're obviously in.

Considering each has suggested rectal meds...what are your thoughts on the suggestion? and are you going to consult with your doctor and ask for them?

q

uh, what else are you eating besides fruit and veggies ? my newest "miracle" diet is paleo - search on here for other posts - for me i think this may be the one -

also, what blood type are you - it might help to know -

hope you're enjoying the sun like i have today - nothing makes me feel better - seriously, it's been a long, dreary winter !

High fiber cereal...Arby's Roast beef or cheeseburger... I do eat sandwiches on occasion - bread, etc...Snacks during the day are usually fruit

With the caveat that everyone is different and what causes flares for me may be perfectly fine for you, let me say that the menu listed above would send me directly to flarestown. The irony of it is that until very recently these were perfectly fine foods for me to eat. Change happens and it can come awfully fast.

I eat lots of fruit but it was only last year that I discovered that plums in particular are bad for me. So have you introduced any new fruit into your diet recently? High fiber cereal can sometimes mean high gluten cereal and that can also be problematic. Same is true with the roast beef sandwich or cheeseburger, not the meat itself but the bread and roll that comes with it.

it's the two advils.

Avoid NSAIDs at all cost.

Try rectals as the others suggested.

Conquer UC said...
it's the two advils.

Avoid NSAIDs at all cost.

Try rectals as the others suggested.

I've discussed this with others and they seem to believe that such a small dose wouldn't have much affect on me. I tend to believe what you are saying. Have you had experiences where NSAIDs have triggered a flare?

I think one difficult thing about UC is that you'll just flare for no identifiable reason. It just happens. I personally don't that that just two Advil would trigger a flare, as it's such a small dose.

That said, I think the best way to get out of this flare would be to add in meslamaine enemas (they make a HUGE difference), and then to stay on them twice/week, even after you're in remission, as they'll help keep you in remission. I'd also add a good probiotic supplement.

I'm really not too sure about my Doctor, nor am I really sure how to evaluate his treatments. After seeing everyone on this board saying that they were prescribed rectal meds and mine hasn't even mentioned any other treatment options besides Asacol and diet adjustments, I'm really starting to wonder how good a Doctor he his. I've had my doubts from the start.

He diagnosed(Colonoscopy), prescribed Asacol 800mg/3 times a day, and Flagyl (Which about killed me). I stopped the flagyl a little short of the 2 weeks he prescribed, and returned to see him still in full flare. He told me to continue the Asacol and come back in one month. After the one month, things were slightly better - better formation, less frequent, less blood and mucus; still urgency. No additional treatments were offered after this appointment, and he scheduled for 3 months with blood tests (This is when I began to doubt his treatment ability). By the 3 month appointment I was out of the flare and feeling 100%. Diet suggestions - Metamucil, 4 servings fruits and veggies a day, try to stay away from trigger foods (fried, lots of bread, pasta, etc), and stay on the Asacol. This has been my treatment schedule thus far.

This is my first time REALLY being sick, so I really have no idea how to conduct myself with the Doctor, other than to take what he says and try it. I'm not the most patient person in the world and I want to do all possible to work this out as quickly as possible (No one wants to be sick).

I'd tell your doc that you've read some good things about using mesalamine enemas in conjunction with oral meds like Asacol, and that you really want to try them, so will he please write you a prescription.  I'm including a link to an article from Gut journal that outlines the effectiveness of using the oral + rectal approach with extensive UC (pancolits).  I found it the other day b/c there's been a lot of discussion on the board lately about docs who say rectal meds "won't work" for pancolitis.  My personal experience told me otherwise, so I went looking for proof.  I don't think you've said where your inflammation is, but even if its not pancolitis, this article at least discusses their effectiveness in limited UC.  I'd at least skim it if I were you, and you could perhaps take it with you to your doctor's appointment.

As for other discussion with your doc, be completely honest about the symptoms you're experiencing. 

Journal article in PDF form:

http://gut.bmj.com/content/54/7/960.full.pdf+html

Tommy, welcome to the forum.
IMO you have do reduce the overall inflammation.
There are a few ways to do that: diet modification, certain supplements, probiotics.

I have a whole list of specifics for you, if you want to email me, I'll be glad to forward it onto you:  [email protected]  (edited to add this sentence today, 4/25/12).

Peter Waite,

If you look at this new member's post, he asks specifically:

Could anyone offer any suggestions as to causes for this, and tips on what I can do to get this back under control?

The only reason I post what I do is to help those people with new postings or new people to the forum who are seeking help. The advice I post has helped me greatly and I know from emails and comments from so many others, that it has helped others too.

I'm sorry, I'm only trying to help people get better.

I know their suffering all too well.

And I hope you understand now why it is that I post it to those who ask for advice and help.

It would be a shame for me to have this information available to help others and not be able to share it.

Please advise.

Thank you very much.

Hi Tommy,

I can't do fiber at all, metamucil is a no no for me! I would just do a very bland diet for a couple of days to see if that helps.

Have you been on probiotics at all during your remission period?