Having some mild symptoms, not sure what to do?

Hello, so I have been tapering off prednisolone for the last 2 months (was on 40 mg for 3 weeks in Jan while waiting to get humira, then once humira started working I began tapering prednisolone 5mg every 5 days). Everything was going great in February, humira got my symptoms under control - formed stools 1-2 times a day no blood and no pain, the only problem was gas/bloating. When I got to 5mg I started having looser stools, I wasn't too concerned to start with as I thought it could be something I ate. But I haven't had a formed stool in about 5 days, I've been off prednisolone for 2 days now and I don't think it's getting worse but it isn't improving. The stool is runny but not watery, I'm going 2-3 times a day, I haven't yet seen blood and I don't have urgency or pain, except for from trapped wind as I still have excessive gas... Also, I've been feeling more fatigued recently and my appetite has decreased a bit.

I know it's not much of a problem at the moment but I am a little bit worried that this could be the early signs of another flare. I am not sure what to do to prevent it developing into a bad flare. I am currently taking azathioprine (100mg) and Humira (40mg every 2 weeks). I really don't want to go on oral steroids again, I would rather try something else maybe a steroid enema? Should I contact my Gastroenterologist or just wait and see if it sorts itself out? Maybe change my diet for a while? Any suggestions?

i agree with mom - get on some butt meds soon -

If you've been off of prednisone 2 days, then I'd wait another 5 or so days and see where you are at. You could have some pred withdrawal temporarily making your bms worse.

Your options at this point are quite a few even without steroids as you're not seeing blood or really bad symptoms. You could increase humira to weekly, up the azathioprine dose as 100mgs is a rather low dose (2.0 to 2.5 mgs per kilogram of body weight is a common dose). You can add back in mesalamine in oral and/or rectal route (like rowasa or pentasa enema).

I'd add rowasa in first, myself. Unless you fall back into a full flare, I'd try to avoid steroids and tinker with other meds.

Would pred be actually masking or tapering too quickly with simmering inflammation? Yes...still the flare, just tapering at a larger drop as it's decreased. An alternating drop would be good to try......go back on 5mg for a few days, then alternate 5, 0, 5, 0,....etc. i would also suggest steroid enemas.

Just fyi that the gas and bloating is indicitive of rectal inflammation....mild and probably limited. Rectal meds should have been added at that time, or alternating your taper and rectals.

q

Good to be cautious. Stinks to go back on pred, but based on your signature it sounds like you've flared a lot during your short time with UC... if you're not stable then all the more reason to.