At Wits End - Next Steps??

Glad to have found this forum. I have had UC since 1998. I am 56 years old and otherwise in very good health. It is my only real health issue. It has been in remission most of the time and I get flares every 5 years or so easily controlled with medication increase (Delzicol) and/or prednisone and Canasa suppositories. I had a very bad flare in mid-November - came out of the blue. I was on vac in New York City. They called in a script for prednisone. Started with 40 mg for a week and then tapered off. It helped control it and at the end of the taper I was probably 90% better. Still having looser stools than usual once a day but I could live with that. Since Christmas Eve, I started flaring again and the last few days have been the worst in terms of a flare up in my life. I have had accident after accident, extreme urgency and incontinence and have even gone while sleeping once. I am at my wits end and could not get into see my doctor until Jan 13. I'm going to call again Monday, but I needed to reach out to see what suggestions/thoughts anyone here had. My questions are:
1) Could this be something other than UC? Everything i eat unless extremely bland goes right through me. Stomach rumbles like a volcano and then it's like lava coming out uncontrollably. Sorry to be so graphic but I'm sure it isn't totally foreign to people on this site. I wondered if I had an allergy, some type of infection?
2) Canasa and Delzicol are not touching this. Are there better meds to take? What about steroid suppositories.
3) Should I be eating more fiber or taking fiber supplements to bulk up the stool?
4) what foods should I absolutely stay away from?
I am looking for some relief before I can talk to the doctor. If anyone has had a flare like this, please tell me what you did for it and what helped you. I feel very alone and scared. Hard to discuss with others. It's embarrassing and disabling at the same time. I am wondering how I will make it to work after being off for almost 2 weeks for holiday time, which wasn't so good with this going on. Thanks for your time - I appreciate it.

Maybe cdiff?

Hi MLP2050

Sorry you/re having such a bad time. I have been in an acute flare for 2 months and am a similar age. I have to say that my uc has been far worse in my 50s (I'm 53). The disease is progressive and I believe that menopause has really had an impact on my flare ups which are longer and more severe than previously. As the others say, you need to rule out CDiff first. Other things to consider:
Are you feeling any unusual stress factors other than having u/c? My flare started with heavier workload than normal and then was exacerbated by a broken shoulder and 1 tablet of NSAID. I have just got out of hospital and have been treated with steroid iv and remicade. I had no idea quite how sick I had become and am still struggling to get back on track. Don't suffer in silence because every flare makes uc worse. You may need to step up the medication ladder and consider immunosuppressants? I was advised to two years ago, but thought I could manage without. 2 years on and I nearly lost my colon. A good GI will give advice on best drug protocol. I am currently carb, gluten, dairy free so eating lots of fish, avocado, chicken and steamed carrots. Seems to be helping somewhat as the colon heals. Don't overload the system.

To say it's a pain in the arse…..!

Hope you feel much better soon.

Catherine UK

We are all a little scared to go on immunomodulators (Imuran, 6mp, or aza), myself included. It helped me to weigh the risks versus the benefits. The odds of immunomodulators helping your uc symptoms are 60+ percent. The odds of side effects are less than 1 percent. Few get side effects, but they are serious when they occur. I've been on 6mp over two years, and have yet to experience a side effect.

If you want to read up on it more, here's some good risk verses benefit information from the Crohn's and Colitis Foundation of America:
Webcast: programs.rmei.com/CCFA139VL/presentation/player.html
Transcript: www.ccfa.org/assets/pdfs/risk-and-benefits-transcript.pdf

Thanks to everyone here sharing tips and information, I have alot of questions for my GI next week. A couple of you here mentioned c-diff? I wonder why. I thought of that or some type of infection on top of the UC flare. this is the worst smelling stool I've ever had in my life. I feel like there is something else in there that needs to be taken care of. My GI had said that sometimes it's caused by the stool passing so quickly, malabsorption, etc, but this is unreal. Is that a sign of c-diff or possible infection?

Thank you - that's good to know (I guess) This board is a God Send for me!

Hi MLP
Just picked up your question. I am now tapering on 35mg Prednisolone and have had 1 infusion of remicade. I am having my second remicade tomorrow and then starting azathioprine as maintenance. I have felt terrible for the first week out of hospital with fatigue, bloating and D but heard my first magical 'plop' over 24 hours ago. Now getting formed stools amidst the usual D carnage which I take to be encouraging!!! Remicade is probably working but diet is essential! Grain free, dairy free and only natural fruit sugars with lots of avocado, cucumber, salmon, chicken, carrots, olives and tons of camomile tea. I really think the diet is helping! Also lots of homemade stewed apple with coconut milk yoghurt *Coyo). Are you based in the UK? It seems as if stress has definitely contributed to your flare.
Let me know how things are going?

Best wishes Catherine