Reducing medication due to remission, when should I worry?

Hi All,

I was diagnosed with Ulcerative Proctitis in late 2015. My inflammation levels were very high and I was receiving stomach pains and a lot of bleeding. The colonoscopy showed many sores, etc. Since this diagnosis I have been taking Pentasa orally as well as via a suppository daily.

My last colonoscopy and blood tests have all come back great with levels of inflammation below average. The doctor has instructed me to stop taking the Pentasa pills orally each day and just stick to the suppository for now. In a few months I will have some more blood tests and if everything is still OK I will be taken off the oral pills as well. He instructed me to contact him and resume taking the oral pills if I experience another flare up.

My question is this, since Wednesday I have stopped taking the oral pills. I feel fine but this morning I did see some blood on the toilet paper when I wiped after a bowel movement. I found when on the pentasa my stools were often very soft however now they are not nearly as soft. Not sure how to describe it but feels like my bowel movements are almost too big and causes this bleeding. What would constitute a flare up? Should a little blood right now be cause for concern? Just wondering what others have experienced when reducing medications.

Thanks for the reply. We stopped taking the Oral pills but I still take the suppository each night. Think I will maybe see how today goes and call tomorrow.

Thanks. I had never had issues prior to 2 years ago (aged 29) so this is now my first go-around reducing meds since. Does Pentasa soften stools at all? I'm just not sure if this related to UC or if its because I had a bit of a cheat weekend where I didn't consume the most nutritious of foods so my last couple of bowel movements have been a bit rough (too wide/hard). I don't remember having too many like this on the pills, but might just be a coincidence.

Our bms vary a lot in consistency even when we're in a remission. Mesalamine enemas can make stools a little looser. The oral mesalamine doesn't make stools looser.

OP said...
Reducing medication due to remission, when should I worry?

I did see some blood on the toilet paper when I wiped after a bowel movement. I found when on the pentasa my stools were often very soft however now they are not nearly as soft. Not sure how to describe it but feels like my bowel movements are almost too big and causes this bleeding

Instead of worrying maybe it is possible you can celebrate your remission. Hard stools are sometimes associated with minor bleeding because they can cause hemorrhoids. Hopefully that is all you have. OTOH if the problem persists or gets worse then it sounds like you were given good advice to go back to your oral meds.