Newbie, advice please!!

Hi Everyone
I'm new to the forum and looking for some advice. I'll give you guys as much history as I can.
I was diagnosed UC (proctitis, severe) in Feb 2015 after a year of symptoms (pain, bloating, gas, mucus/pus, blood in stool) which started after some questionable food on a trip to Costa Rica. Obviously the underlying condition was there but whatever made me ill triggered my first flare. I was prescribed mesalazine suppositories (1g). The same week I also found out I was pregnant! I wasn't very good at remembering to take the suppositories initially so on my next appointment I was started on Asacol tablets (1.2g daily) too. These worked brilliantly (im also better at remembering the suppositories) and I had an uneventful, healthy pregnancy and my son was born a hefty 8lb 13! Postpartem I was doing really well with no symptoms - yay!. Then it all changed - boo! lol. I have been flaring for 2 months and have a theory that it is related to the contraceptive pill. I breastfed my son for 3 months and was taking the progesterone only pill. Once I stopped bf I decided to switch back to the combined as I don't get on with progesterone only period-wise. I switched about 6 weeks after. It has been since then that my flare symptoms kicked back in. Now I guess it could be related to stopping breastfeeding but its too close to call. I haven't yet had a decent amount of time not being pregnant/bf to find out how my body is going to react to everything, darn hormones! But looking back, I remember being relatively symptom free for a month or two when I initially came off the pill to give my body a break. This current flare, I have doubled my asacol tablets (now 2.4g daily) and had two 5 day courses of 40mg pred. My GP doesn't really know what to do so I had to contact my consultant for advice. He has advised to up the Asacol more to 2.4g twice daily and if no improvement to contact him again in two weeks. I feel at a bit of a loss now. I don't want to change too much at once as I won't know what has worked and what hasn't. Have any other ladies noticed a correlation with birth control or am I clutching at straws for an answer? I initially kept a symptom diary and didn't really notice any specific triggers so I have never tried going gluten/dairy free or anything. Any advice would be appreciated :)

Hi! I must admit, the first couple of days going back on the pill each month I have looser stools (when not flaring!) than normal, so it is quite possible that the contraception can cause issues (not enough of a problem for me to come off, and it's never been commented on by my GI). Are you able to have something like the Depo injection rather than take the pill? I would go back on that in a heartbeat if they would allow it!

Yes mesalazine=mesalamine. We just spell things funny on this side of the pond.

Ulcerative colitis always starts at and is most severe within the rectum. The oral pills aren't very good at treating the rectum but do well higher up. Therefore suppositories or enemas are a great way to "treat from both ends" and heal the fastest. Not all gastroenterologists mention rectal medications due to the ick factor and poor patient compliance. Results are what we're after, and they work. I'd ask for some.

For a proctitis patient, such as yourself, taking daily 1 gram suppository and 4,800 milligrams of asacol should be good. Enemas are best for those whose uc goes much further than yours. I'd change all at once, no sense in prolonging your worsening of symptoms.