Definition of a flare - urgent

You could ask ten different people what the definition of a flare is and get ten different answers. I came down with UC 3 1/2 years ago and I consider myself to be in a flare for that whole 3 1/2 years. I think you are getting too hung up on a definition. Obviously blood means she is not 100%. Just out of curiousity, why did you demand a switch from Pentasa to Asacol HD? More than likely her symptoms are returning as the pred is tapered to these lower doses. Happens to a huge percentage of UC'rs. In her present condition the Asacol should start working very soon if it is going to work. That's one of the problems with prednisone. You never know if it is the prednisone only that is working or if it is working in conjunction with the maintenance meds (which is what it is supposed to do). This is the point in the taper where you find out if the maintenance meds are working well enough to attain remission and keep it there.

@garylouisville. She was already recovering from a flare. Last time, I had reduced dosage of medicine. But this time, we followed medicine dosage as per instructions.

I understand that Pred tapering may be a reason. But blood stains are increasing in size day by day. Her inflammation is mostly on left sided colon. Based on our experience, I thought Pentasa was not doing enough and the only other medicine which is colon+TI was Asacol. Her GI said Pentasa is same as Asacol. I do not know if I did the right thing. I took a chance. Her Pentasa did not stop her flare last time and this time with Pred tapering it is showing its weakness. Out of desperation, I forced my GI to switch to Asacol. He wanted to move to 6MP if a flare happens.

How do I know if she fissure?They did a MRI and report said nothing about fissure and her colonoscopy + biopsy did not say anything about her fissure. They had done Prometheus crohns prognostic test and the only item that was out of range was "anti I2".

I don't think she has constipation. Her stools seems normal

I actually think you made a wise decision to switch to Asacol. Don't beat yourself up if it doesn't work because you already said Pentasa didn't stop her flare last time anyway. While both have the same medicine inside they have different coatings so they are not exactly the same. This is a tough disease and very few patients or doctors have it figured out. Unfortunately, most all of it is trial and error, which really sucks with a child. You have to learn to take deep breaths and take one day at a time.

Will fissure not cause pain? She is not complaining of pain.She appears very normal and active otherwise.

She does not complain of pain while pooping. Does fissure bleed when Pred dosage is high?

Are you sure it's not a hemmhroid? Generally these will leave blood on TP, but not in the stool. I have a few...a and am in remission. They don't bother me too bad unless I have a large stool or a "drier" one that doesn't slide right out, I do notice some blood on the TP...even had my labs drawn, which were all normal

Thanks a lot for the reply. She did not have these blood stains when she was on higher doses of Pred. These blood stains have started just last few days. I have switched to Asacol HD from Pentasa. Will update how Asacol is working in comparison to Pentasa.

You are too focused on the pred, not on the actual stool.. I posted the bristol chart earlier and asked what was normal and you didnt address that. The stool is way more important then the pred in the case you are describing of a very small amount of red blood only only wiping. her stool needs to be type 2-4. if it is any harder or has been any harder in the last while it is likely a fissure or a hemmi

Her stools are either 4 or 5 as per bristol chart.

She has been tolerating Rowasa pretty well so far. Is this blood stain something that should cause me anxiety?

No, it shouldn't kamakya. You said earlier that she seems fine, has no pain. Trust that.