In my first flare since getting my UC under control

I was DX with UC in early 2016, and got it fully in remission with mesalamine oral and supps in mid 2016. This year, I've started off with some pretty stressful stuff at work, which has been causing me quite a bit of anxiety, and it seems my colon has decided it can't take much more of it. I'm now flaring.

It's nowhere near as bad as before I was DX, but I'm doing 4-6 BMs per day, with mucus and a small amount of blood at times. It almost seems like it makes no difference whether or not I take a suppository (I had been able to cope with one per week when I was in remission). I'm obviously on oral meds as a rule, and while rectals were infrequent, I'm taking those daily as well.

When I get chronic anxiety, I carry the tension around my gut, and BMs are reasonably common. So I'm of the attitude that this is entirely self-made. But I don't seem to be making headway against this flare.

My plan was to go back onto a low residue diet to rest my bowel for a bit, while also working on relaxation, mindfulness, living in the now etc, to try and stop the rumination and excessive overthought.

I'd be interested to hear people's thoughts about what they would do if they were in my situation.

Thanks

In your situation I would go to the GI doctor ASAP in order to try to get your flare under control before it escalates. I have been in a very similar situation as you and avoided going to the doctor because it was my first flare after diagnosis and I assumed the strong drugs were for "other people" (I tried various yoga, probiotic and diet interventions) and the UC got worse and worse and I needed steroids... wish I had gone earlier. I have given up trying to change my mindset to heal my symptoms because I personally drove myself bonkers with that, but I did do some sessions with a psychologist to help with the anxiety and self-blame, which made a big difference to my mental health (did nothing for the colitis of course).

do you get daily exercise ? what is your life like away from work ?

is a carreer change an option ?

My son is in very similar situation. Went to low residue diet and increased rectal meds to daily (his lialda is already at the max 4 tablets)...took about a week but seems to be pulling out of it. The rectal meds are so key...but once a week might be fine for maintenance but not enough to control a flare.
Good luck.

Thanks for the advice, everyone. I have an appointment with my doctor late this afternoon so will talk it through with them.

Also made an appointment to talk to a therapist about the stuff at work that's causing my anxiety. I know people have differing opinions about this, but for me, UC is primarily a product of stress. 6 months into the most stressful period of my life (after I left my toxic marriage and was dealing with the fallout of that) was when I saw my first ever patch of mucus on my underwear. If I have a particularly stressful day, I can literally feel the inflammation building in my colon. Conversely, last year (particularly when on holiday) I got to the point where I could forget one or two doses of oral maintenance meds and not notice anything untoward for a couple of days.

I've spent most of my working life coming down with mystery illnesses that mimic others, but I've come to realise they are usually my body's way of telling me when to slow down. These days, when I have almost anything go wrong with my body, the first place I look is my mind. Last year I went from one illness every 3-4 weeks to a clear run for several months, all by changing my mindset and staying positive. Hence why I'm inclined to look within for the cause of this current flare-up.

But having meds to stop it escalating will be a good thing, because I can probably deal with the emotional stuff better without having the physical symptoms adding to my worry.

IamCurious said...

In my case diet is crucial for maintaining remission but official diets like 'low residue', paleo, SCD, etc. aren't very effective. I prefer to keep a food diary to isolate food that triggers symptoms. Gluten and dairy are common problems for most people but everyone is different. You can check out my signature for to see my food triggers.

I like this outlook. No two people have the same tolerance for different foods, so it stands to reason there's benefit in tracking your own unique triggers. I'm curious, however, as to how this might work when I get this current flare under control. Eat food, record it in the diary, then observe what exactly? If you're symptom-free (which I have been until now) how did you observe what each food did to you? Or did you do it all while you were flaring?

Food monitoring works while in remission. Start out eating what you know is safe such as chicken broth or whatever. Apparently you ate a lot of safe stuff while you were in remission for over 2 years. Then add something questionable but no more than one food item at a time.

I remember being in remission for a long time but started to eat clam chowder soup at the local salad bar and noticed symptoms. I gradually learned that I cannot tolerate any shellfish at all except wild caught shrimp.

Problem foods change over the years. Before UC I used to have a cast iron stomach and ate whatever I wanted. Some people here have said that food that used to be a problem sometimes can become OK to eat again. But I never experienced that. Over the years I am adding more and more items on my NO-GO list.

My ideal is well formed stools. When they start becoming looser and looser that is when I am doing something wrong and I better change course. It is so much easier preventing a flare in the first place than trying to escape a full-blown flare after it has started.

Gitch said...
Thanks for the advice, everyone. I have an appointment with my doctor late this afternoon so will talk it through with them.

Good luck, let us know how it goes.