How to gauge symptoms - What to expect from healing process

Hi, I'm posting a lot these days, sorry if it's too frequent. It's just that I've been very ignorant about my disease and I'm trying make up for it.

Quick recap: Long Time Pred user. Was in process of tapering, tried going gluten-free, didn't seem to do much. Went in a sudden flare two weeks ago after using a nicotine patch, lots of blood, diarrhea, abdominal cramps. Was on 10 mg prednisolone, upped the dosage to 30, then 40 and stayed there for a while. Last week I started getting better, dropped to 35 then 30 mg couple days ago.

Other meds; Salofalk pills 8x500 mg, Salofalk Enema before sleep, Imuran 100 mg(started around ten days ago), Prozac Anti-Depressant(also started a week ago), taking Iron Supplements and Folic Acid. Also taking L-Glutamine Pills in the morning.

Current symptoms: Pulsating pain on the left side from time to time. 3 to 4 times Bowel Movements. Stool seems to be mushy, number 6 on Bristol Chart I'd say. Chart says it means there is still inflammation. There doesn't seem to be any blood but it's very dark. Can't see any mucus either. It's been like this for the last 4 or 5 days I think.

Too much gas, making noises, not smelly AFAIK. I'm burping and farting all the time and it just doesn't end. Considering how depressed I am at the moment, I can say I might actually be doing good but yesterday, all I ate was a bit of ice cream and a small chocolate cake. I was able to tolerate these well in the past, why is it that everything is giving me gas at the moment? Is that normal?

My doctor told me to start tapering 2.5 mg every week. Question is, should I expect any lessening of symptoms in the process? If so, how long would it take for my gut to heal, if I don't go below sufficient pred dose? Should gas go away? I know these things vary from person to person but I wanna be able to evaluate my condition on some basic level.

What to expect from healing process

Expect the healing process to be inconsistent, slower than you like, and laden with daily ups and downs. Uc is a tricky disease to initially get under control, there's no one size fits all solution. Rather, there's a fair amount of trial-and-error to find your solution. It's extremely frustrating but the reality of the situation, and many of us have been through the same process and emotions. It took me 2 years to reach a solid remission (absence of uc symptoms). Healing can be very slow, look for week-to-week improvements, rather than daily.

You're 10 days into Imuran, give it 2 months minimum.

Ah the gas, yes, I remember that well. It's actually a good sign. My gas increased considerably as I was healing. That gas settled down considerably as I continued to heal. It's sure annoying though.

It's normal to see enema in your first poop. Sometimes I'd pass white liquid, sometimes the first vm would be slightly looser and a light tan.

If your maintenance medications are sufficient then you shouldn't get worse as you have taper down prednisone. If you get worse, stop reducing and contact your gastroenterologist.

@ipoop what I'm confused about is tapering. Because I didn't put any thought in how drugs work until now. Doc told me to start tapering, albeit very slowly but should I wait till I see a fully formed stool or my BMs decrease even further? I don't if pred just stops the symptoms or actually doing any healing. I haven't been careful up until now and I wanna do it right this time. Wanna be off pred but I don't know whether mesalazines work on me or not.

One thing I can say about my last taper is that, I did go a bit fast and results were weird, I don't know what to think about them. Was using suppositories instead of enemas at the time. I had eliminated all gluten in my diet. Wasn't eating any fresh vegs or fruits other than bananas. No legumes either. An occasional salad or a peeled carrot but nothing more. Was basically eating just chicken & bananas and exercising. Was sometimes drinking protein shakes(Optimum Nutrition Whey Gold Standard, I know it can disturb my stomach but it didn't give me half the gas I have now). I went as low as 5 mg on pred and I was quite pleased with myself, I had 4-6 BMs a day, it's was all liquid but blood was very rare urgency was not heavy. I wasn't complaning since all I cared about at the time was getting rid of pred and side effects were subsiding. Then I used a nicotine patch and bam, blood everywhere.

(I'm still tempted to try the nicotine again, though I will have to find something with a lower dose. I tried at patch with weird dosage info that states both 14 and 35 mgs. I'll try lozenges if I can find any. Since I'm on high dose of pred, maybe I can safely(?) learn whether it caused my last flare or not.)

(I also want to try LDN therapy but it seems companies stopped selling Naltrexone in my country. Don't know if customs would let it pass if I were buy online.)

@DBwithUC one thing I never tried is probiotics. I tried eating Active yoghurts but they seemed to disturb my bowel. Guy at my local pharmacy recommended NBL Probiotic Gold but I've seen a lot of different names around here so I don't know what I should try.

@iPoop you're right but for my luck, I didn't experience any withdrawal symptoms at all under 10 mg, eventhough I tapered fast and have been using it for a long time. On the contrary; when I'm on high doses I somehow become intolerably lazy, like I am now. During my last taper I was feeling better and better physically and mentally other than UC symptoms. For some reason I yawned all the time but that was it. Other than that, only thing that was still present was brain fog, which seemed less intense and I was hoping to get rid of it completely when I'm done with the pred since it was interfering with my work so I rushed a bit. At least while going from 20 to 10. Sadly it didn't work out. Hope Imuran takes effect.