I'm 4 years in remission - Am I having a flare?

I've been in remission for approximately 4 years.. no meds.. about a week ago after I ate breakfast I had stomach ache and urgency to go.. The following day severe pain across lower abdomen (break out in a sweat pain) No diarrhea, no blood, fairly formed but small stools.. Day 3 - less intense pain stools are same notice small amount of mucus still no blood.. To me it feels like a flare.. I go to GI doctor and he tells me - You have No diarrhea or blood so it's not a UC flare. Didn't prescribe any medication and he wants me to have a CT scan?. Currently day six with mild to moderate pain prior to bowel movement but feeling better overall..

Doctor asked me why I stopped Lialda.. I told him it seemed like I constantly had to go to restroom and frequent headaches so I stopped.

Why a CT scan? Waste of time and money??
Why do I feel like I need to fire my doctor?
Do I have to be bleeding and Diarrhea to be in a flare? Is this a sign that my doctor has a flawed UC background?

There are some blood tests (sorry I’ve forgotten at the moment what they are called), and also some simple blood smear stool cards that you could do that could help you determine if you are in a flare, at least less invasively than a CT.

Thanks for the responses!

I've had the same GI doc for years and have been fairly happy with him and the staff.. This last visit just didn't sit well with me when he said no blood, no diarrhea means no flare? It worries/frustrates me that a Gastroenterologist treating me for UC has this mind.

I'm thinking to myself..... I'm not having a flare?? What is it then? I didn't know that if there is no blood it means no flare? Sure feels like one!

Now feeling like I made a mistake by stopping my meds for 4 years? Currently not on any meds going on day 7 of flare.

Hey, don't beat yourself up about stopping meds - 4 years is a long time for a drug-free remission and i bet if you asked most people "would you like to have a 4 year remission without meds?" they would probably say yes. It's impossible to tell what would have been if you hadn't stopped them. Maybe you would have flared after 4 years anyway? Maybe it would have been 6 years instead of 4, who knows.....the one thing that's for certain is that UC is unpredictable and nearly everyone will have to deal with multiple flare ups in a lifetime.

Re blood, sometimes it can be very difficult to see it when there is only a small amount - the only definitive test is if you submit a fecal sample for the lab to analyse for trace amounts of blood.

Re having to have diarrhoea, sorry i have been flaring for years (confirmed by endoscopy and fecal calprotectin tests) and most of that time was without diarrhoea because the inflammation was only on the left side.

That all being said...there are other things than colitis that could cause your symptoms and it's wise to perform the relevant tests to be on the safe side. Sometimes the docs will only consider colitis after they ruled everything else out (especially because performing a colonoscopy is expensive and takes some stamina on the part of the patient).

Meanwhile a fecal calprotectin test is an easy and non-invasive test which can give a strong indication if there is active inflammation in the bowel.

I hope you get to the bottom of your symptoms soon (accidental pun). It may or may not be colitis but i strongly disagree with your doctor's criteria for defining a flare-up!

seems to me if you are able to diagnose yourself, there's probably no need for a doc -

Ok, I decided to follow doctors request for CT scan (with IV contrast). Test result shows diverticulitis so I'm on to something new! On a positive note I'm not having a UC flare and I will be talking to doctor about wether I need to start taking meds again..

Thank you for the responses!