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When to go to ER

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Ulcerative Colitis
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Posted 2/5/2017 11:19 AM (GMT 0)
My symptoms have gotten a lot worse. I'm going closer to 20 a day, a lot more blood, and pain. Evert time I go, I run back into the bathroom 3-4x after just to get rid of the blood. Not to mention the blood that comes out during the movement. Most of the time it's just the blood, actually.

I'm not dehydrated and I don't feel weak, so I don't think I need to go to the ER for that, but the blood, pain, etc..

I had my procedure on Thursday my doc said if things got worse to go to the ER. I asked what "worse" meant and he said dehydrated. He said the only thing the ER will do is give me a shot of pred, which we know doesn't work. If that's all they can do, then why do I bother going? But it's gotta be better than this right? I don't wanna give in and go, especially on the weekend.

I'm seeing the surgeon on Tuesday, so I know if I go to the hospital they'll just assign me a doc. Not sure what to do here guys, but feeling pretty horrible.
Posted 2/5/2017 1:17 PM (GMT 0)
In the past I would suffer at home like you. My UC has changed over the last 3 years which also changed how I think about it. While I prefer being at home in my own comfortable bed, I can no longer tolerate the pain and nausea that accompanies my flares so I go to the ER for dilaudid and zofran. If I'm so nauseous that I can't drink fluids, I ask to be admitted. My suggestion is go to the ER if you can't stay hydrated or your pain is unbearable. I don't know your background but it sounds like you're heading down the surgery path? If so, it sounds like you might need to be "tuned up" prior to surgery. If you went to the ER, they could draw labs to check your potassium level and your hemoglobin level.

The ER has never given me prednisone...they always ask me what I need and give me dilaudid, zofran and fluids and check my labs. If I was going 20x/day, I would go to the hospital. I realize others prefer to stay home but I think many have had bad ER experiences.
Posted 2/5/2017 2:31 PM (GMT 0)
I never went to the ER, except when I had sepsis. That was a very different situation with symptoms that were well outside normal UC symptoms, I was having trouble breathing. I think you need to gauge how you feel, but if it's just blood and frequency, there probably isn't too much they can do for you. The flare that drove me to surgery was going for 18 months, and I was going A LOT, with pain, tons of blood, tenesmus, nocturnal BMs, really awful symptoms, & nausea... I didn't go to the ER. Sepsis symptoms where wheezing, low BP, low oxygen, high heart rate, fever. If you have those, definitely go ASAP!
Posted 2/5/2017 2:41 PM (GMT 0)
i always ask myself, what can they do that i can't do at home - my first and only time at the ER for UC was my first flare - and then it was ONLY to expedite seeing a GI - and it worked great for that -

the other thing to consider is whether or not you are on your own or do you have someone that can keep an eye on you -

if you're not dehydrated, that's a good sign and a reason not to go imo - just keep a close watch on things -

hang in there -
Posted 2/5/2017 3:00 PM (GMT 0)
It's a tough call to make. It's easer to go to the ER if you're very dehydrated, in a lot of pain, or very weak.

You're certainly in the fulminant colitis severity at 20+ bms a day, which is the most severe form and nothing to be taken lightly. If they admit you to the hospital as an inpatient then IV steroids or IV cyclosprine (a strong immunomodulator) might help bring things under control and make things more bearable.
Posted 2/5/2017 3:19 PM (GMT 0)
Get Cortenemas,they can stop any rectum or lower area bleeding
Posted 2/5/2017 3:28 PM (GMT 0)
If you think it might speed up the surgery consult, perhaps it is worth going to the er. Just make sure it is a hospital where your go and surgeon work. Sorry you are heading in this direction. Hang in there.
In a side note, one of my colleagues is celebrating their 20th j-pouch anniversary this week and says it was the best decision they ever made.
Posted 2/5/2017 4:57 PM (GMT 0)
Yea I think I've decided to try and stick it out until Tuesday's appt, or at least until tomorrow when my doc is back in the office. I've tried cortofoam, enemas and suppositories already :/

I'm just trying to drink and having really bland stuff if I can tolerate it. Just holding on tight for now. I know I am more comfortable at home and I don't know how much more hey could do for me than I can do for myself here at home.

Post Edited (Doggiedo) : 2/5/2017 10:02:48 AM (GMT-7)

Posted 2/6/2017 1:41 AM (GMT 0)
If you decide to stay home just read up on symptoms of toxic megacolon. My dr suggests going to er if I'm going that often so they can monitor for it. Usually the combined heightened crp above 50 and going more than 10 times a day is reason enough to watched for it. Constant stomach pain, hard belly, fever and vomiting would be the most prominent symptoms.

I'd probably wait it out too and just be very aware of symptoms.
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