New to forums, not new to UC or UP

Greetings all - what prompted me to seek your friendly advice this evening is that I am currently experiencing one of the worst flares in my young adult life. If anyone can weigh-in in any capacity I would be grateful. Just a very quick backstory. My GI confirmed ulcerative proctitis back in 2003 after colonoscopy - typical symptoms of blood and mucus discharge with cramping. This was fairly responsive to mesalamine and hydrocortisone enemas, usually subsiding withing a week or two. Sometimes remission could be achieved spontaneously without treatment.

Fast forward to 2012.

Symptoms returned and my GI advised that a second colonoscopy with long overdue. I agreed. Results revealed severe proctitis, macro and microscopically. Nothing beyond that region though. Still my symptoms seemed to have worsened. The degree of cramping and spasms of the colon during a bowel movement became unbearable. Eventually, with treatment it subsided. Now, here I am in 2015 and the past 4-5 months have been agonizing. Both enemas have had little to no effect on bleeding or frequency of urgency/trips to the bathroom. I've been taken prednisone for the past week (starting and 80 and now on 40mg), but it has yielded no results. When I do have an actual bowel movement it is literally agonizing. The cramping and spasms can have me in tears. Does anybody else experience this kind of thing? Feels like a very slow ramp up to defecation accompanied with cramping, then it subsides, then starts up again like clockwork a minute later culminating in such spasticity and discomfort that you feel like you may vomit or loose control. This goes on for many cycles. Finally when the episode is over, the cramping lingers for hours. I'm at my wits end right now and almost went to the emergency room this evening.

I know most of this probably sounds familiar to you guys, but it's the severe cramping during the bowel movement that has me alarmed.

Steve

Forgot to mention - yes, I was put on oral mesalamine - Asacol back in 2003 for several months (which never had any effect) and pentasa recently for 1 month in conjunction with both hydrocortisone and mes. enemas. It was the failure of that latter combo to induce remission that made my GI want to try prednisone. Currently, the condition is refractory :/

Cramping/pain during bowel movements sounds like spasms. An anti-spasmic medication may help, describe your symptoms to your gastroenterologist and see what he/she thinks...

Thank you all for your replies. It certainly helps to know when you're not alone - wish these weren't the circumstances though. It's just amazing that I can feel somewhat ok for a few days and then out of nowhere a bowel movement knocks me out.

I was a little perplexed by the quick taper on prednisone myself. Essentially decreasing the dose 20mgs every four days. I will definitely have to inquire about that. For those of you who have taken it orally, how long did it take before you felt that it had a noticeable effect, and obviously what dosage?

I suppose I am off to the doctor again tomorrow for additional meds. And with a new job on the horizon - sigh.

I can relate to the pain. I can only describe it as mind numbing and then I can't stop vomiting because my body doesn't know how to cope with it. I had no idea pooping could be debilitating until I got UC. Been ten years with it and I don't know how I lasted some nights!

As for your taper, I never had any success on oral prednisone. I am always admitted for IV steroids for a week and then sent home on oral prednisone. It sucks, but if you are in a lot of pain, then it might help. I'd definitely get on new maintenance medication since yours is doing nothing for your disease. It will most likely spread if it is not treated promptly.

I would guess with your symptoms that oral prednisone will take at least 2 weeks for you to see improvement. My guess is you will need at least 1 month on 40 mg before successfully tapering.