Flare coming on

Hi

Since my last post in May about occasional poops when the doc did a look see with a sigmodoscope and found all well . Post that was doing well but noticed a streak of blood and went to my gi . Asked for a full colonoscope where he found just mild erythematous mucosa without granularity , loss of vascularity or friability in the mid sigmoid colon and two small diverticuli in the caecum and descending colon . Rest colon was completely normal and He said my colon looked very healthy and if he didn't know I had ulcerative colitis he would just say i had a mild infection. Multiple biopsies were taken where he saw the erythematous mucosa , reports of which are awaited . But two days post the scope I again noticed some streaks of blood . Is this a flare coming on or effects of the colonoscopy / biopsies . I am on 3.6 gm of Lialda and a 4gm enema at night . I had dealt with a streak of blood in Jan by upping the enemas to twice a day for ten days and nipped that in the bud . I am doing the same again . Just looking for some ideas . I called him today but he said nothing to worry . Complicated part is he doesn't approve of the enemas so He does t know I do them . He's my local gi , I can't fly down to meet my gi in another city who makes me do the enemas nightly . What should I do . How can I ensure this doesn't become a flare

Best
Ritu

You're two days post colonoscopy so that could be the cause of your slightly worse symptoms. A scope's pretty invasive. It should settle in a day or so, I'd wait.

A single change, like a streak of blood isn't of big concern. Especially if it's a once, sporadic, and inconsistent thing. We're most concerned with consistent/persistent worsening of a symptom ( or better symptoms) when we're taking about flares.

Hi
Thanks for the prompt responses . The blood was like a streak along the stool . Am gonna continue with my enemas and hope it is nothing . Bit anxious about my biopsy reports , fingers crossed .

I go about 3 times a day , it's mostly semi formed , bit mushy . Except the morning one which is formed . I take vsl 3 as probiotics and psyllium husk powder at night . Tried to add to my noon meal but made me very gassy and poop more .

The local gi I have is for the times I can't travel to meet my gi in another city who I had mentioned earlier is a pioneer in fmts and wants to enroll me in a trial for the same , still on the fence regarding that . He's the one who insists I do rectal meds every day But I can't fly down to meet him for every small thing hence have a local gi as well .he doesn't approve of rectal meds but I do them anyways coz I feel I need them

Will keep you all posted on how things Pan out

Best
Ritu

Hi

So the biopsy report came , mid sigmoid colon mild activity of ulcerative colitis , no dysplasia or malignancy , quiescent ulcerative colitis. Doc told me to watch out for any symptoms and see him in 6 weeks . Will continue the enemas and hope for the best . To add to the fun it's that time of the month so no way to check for blood in stools 😜

Best
Ritu

That sounds like a pretty good report. I am happy for you. Perhaps you should see about getting a different local GI who is on board with using the rectal meds. Flying seems like a hassle to me, though it sounds like the GI who you travel to see is much more on-top of treatment options. Stay well!

The enemas reach the sigmoid colon , right ? Should I up my oral to 4.8 gm for some time to also reap additional benefits or stick at 3.6 gm . The doc doesn't give any solutions , he doesn't even want me doing the enemas , I do them on my own

Thanks for the prompt responses everyone

Best
Ritu

Yes, 4.0g/60 ml enemas consistently reach the sigmoid colon and beyond.

Ps ..... No other symptoms like diarrhoea or urgency or mucus are present , even the no of poops is the same as earlier which was 3-4 times a day . It's just minuscule streak of blood which is also decreasing but persisting

Hi

An update to my last post . So it's been nearly 3 and a half months and the blood just won't go . I have tried the steroid foam in the morning and mesalmine generic enemas at night but the only symptom is the lingering blood that just won't go . A scope was done again a week back and only showed a small patch at 35 CMs in mid sigmoid Colon small ulcers with everything else normal . How long will this flare last as don't know what else to do . Doc wants me to hold off on oral steroids as he feels the patch is too small to warrant oral pred at the moment . There are no other symptoms , no diarrhoea and the blood also goes away for few days then reappears . It's so frustrating . I am already on the max dose of 4.8 grams of oral mesalmine . Am I just being impatient because have asked two docs and they all want me to do nothing but this is really frustrating me
Thanks in advance

Best
Ritu

Hi Quincy

Good to hear from you

Yes it was biopsied in Sep scope and said consistent with active ulcerative colitis and the usual jargon of crypt and neutrophils etc etc , no dysplasia
Sometimes I worry since its patchy (just a 4-5 cm patch )and rectum is clear could it be crohns but the doc says biopsy is consistent with Uc and even earlier biopsies said Uc

What do you suggest should be the next step . Trying a short course of flagyl as it seems to help a lot

Ritu

Yes...hope the flagyl helps. Did you just start it?
Do you have copies of your results?

Any more info regarding the doc that will do the fecal transplant?

q

On day 3 of flagyl

Will be on the flagyl for 10 days but thinking if I should be on a longer course . What is the general time period one is prescribed flagyl for in your part of the world . Yes I think I should think about the fmts soon now .

Best
Ritu