HealingWell
Search Close Search
☰

Help! First ever flare. Now I get it.

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 3/11/2019 2:02 PM (GMT 0)
2 and a half years into being diagnosed with Ulcerative Colitis the only meds I am on are Mezvant and Salofalk suppositories. Two colonoscopy’s since and both times in remission. However now I believe I am in a flare. This would be my first one so I am unsure but I am having loose and sometimes blood in my stool. My joint pain which I had previous to being diagnosed is back, I am exhausted been napping the last two days and I am having the worse stomach pains I have had since being diagnosed.

Here are my questions. I this a flare? What do I do to get out of it? When is it appropriate to go to the hospital? Yesterday morning when I was on the toilet the pain was so bad I thought I was going to pass out but it got better with time.
Posted 3/11/2019 2:41 PM (GMT 0)
Flares can present differently for everyone, but it definitely sounds like you are in one. You should call your doctor (GI) as soon as possible and let them know what symptoms you are having. They'll probably order blood and stool tests. Based on your results, your doc will probably recommend modifications to your meds. You may need a course of prednisone to get the flare under control and possibly changes to your maintenance meds. Other users here can probably give you more details.

I've read from others that unless you're losing a ton of blood or are really dehydrated, the hospital (assuming you mean ER) won't do very much.

I'm sorry you're in so much pain. I hope you feel better soon. In the meantime, try to stay hydrated and eat flare friendly foods as you can.

P.S. it's very common for symptoms to be the worst in the mornings.
Posted 3/11/2019 2:53 PM (GMT 0)
Contact your gasteroenterolgist whenever your UC symptoms have a pattern of getting consistently worse. I'd ask for a stool test to ruleout possible infectious causes to your symptoms (like c diff). I'd get a stool test to measure your intestinal inflammation: a fecal calprotectin stool test.

What's your Mezvant dose? A maintenance dosage is 2,400mgs and a flare dosage is 4,800mgs. Ask about going on the flare dosage, if not already on it.

You can ask about steroid suppositories, rectal foams, or enemas.

You can ask about mesalamine enemas, often 4.0grams, which are much stronger than canasa. Rowasa/salofalk/pentasa enemas are available in most countries.
Posted 3/11/2019 3:02 PM (GMT 0)
Thanks team. Honestly I have never been on pred despite my doctor prescribing it when I was first diagnosed. I know that's the route he would probably want to go but I just don't want to go down that path. Ugh this morning the mucus is back and but I feel constipated which was a symptom prior to my dx. I am taking 3.6mgs maybe I will bump it up to 4.8. I am feeling a bit better today but I am exhausted despite getting lot's of sleep.
Posted 3/11/2019 3:30 PM (GMT 0)
Exhaustion despite getting ample sleep is a common flare symptom, as causing and healing inflammation eats up lots of energy!

Pred is kind of like the a-bomb, or nuclear weapon of the UC arsenal. It has a purpose, when we're beyond agony it takes care of that quickly. Pred means lots of side effects, and those should be of no concern when debating taking pred (as when you truly need pred, your UC symptoms are far worse than anything pred could ever pitch at you). Pred should only be prescribed when we truly need it, not for mild flare symptoms.

Your, as described, symptoms do not warrant pred usage. I'd consider Entocort EC (delayed-release), Uceris (delayed-release), steroid suppositories, foams, or enemas; all of which are 10% systematic and 90% topical. Pred is 100% systematic which results in the nasty side effects. The other options mentioned are unlikely to give you side effects, or if they do they'd be mild.

Sometimes a boosted dosage of oral mezavant, and/or adding mesalamine enemas are enough to skip all steroids. When not, start with the lesser of the steroid evils, as described.
Posted 3/11/2019 3:36 PM (GMT 0)
Ipoop thank you so much great info!
Posted 3/11/2019 5:54 PM (GMT 0)
Have you contacted your gastro doc? Get a stool sample kit asap.
When is your next c-scope due? Maybe now is the time to ask for one after the results of your stool samples are back.

What is the original diagnosis extent location of your UC?
What is the schedule of using the supps?

q
Posted 3/11/2019 7:16 PM (GMT 0)

quincy said...
Have you contacted your gastro doc? Get a stool sample kit asap.
When is your next c-scope due? Maybe now is the time to ask for one after the results of your stool samples are back.

What is the original diagnosis extent location of your UC?
What is the schedule of using the supps?

q

None scheduled at the moment did one lasy May was in remission. The original diagnosis was moderate colitis throughout. My supps are every other night but I am doing daily now since I started flaring.
Posted 3/12/2019 4:41 AM (GMT 0)
Really, you should be using the enemas....when are you seeing the doc again?
q
Posted 3/12/2019 12:50 PM (GMT 0)
Get in touch with your gasteroenteroligist asap to let him/her know what's going on, and get some tests ordered. We can only help so much, it's the doctors job to get you in-office, assess the situation, order tests and adjust your meds according to those results, etc etc.
Posted 3/12/2019 5:34 PM (GMT 0)

quincy said...
Really, you should be using the enemas....when are you seeing the doc again?
q

What's the difference between enemas and suppository's?
Posted 3/12/2019 5:44 PM (GMT 0)
Aside from the obvious... they cover rectum, sigmoid and into the descending. They come in liquid and foam (depending on where country).
I suggest 4g mesalamine. More bang for the insertion effort. Suppositories (my opinion) are helpful for supplemental during the day, tapering and maintenance. Treatment....not usually enough at 1g dosagemor deal with the sigmoid (which is usually the iffy area).

Steroid comes in supps and enemas as well....see... a whole new experience of options for you 😁
q
Posted 3/12/2019 7:41 PM (GMT 0)
Thanks Team. Still learning a lot about UC and since this is the first time I experienced since my dx any big issues I took for granted that is was no big deal.
Posted 3/12/2019 8:45 PM (GMT 0)
Hi Quincy and Ipoop one more question. I will have an intense feeling like I have to go and all that comes out is small mucus like fleshy stools. Like tiny ones. Is this concerning?
Posted 3/13/2019 5:29 AM (GMT 0)
It's flaring.....inflammation causes the spasming, frequency, mucus, smaller stools because they're rushed out asap.

q
.
Posted 3/13/2019 12:06 PM (GMT 0)

YoungSuffererCanada said...
Hi Quincy and Ipoop one more question. I will have an intense feeling like I have to go and all that comes out is small mucus like fleshy stools. Like tiny ones. Is this concerning?

Ah, tenesmus the most awful symptom we experience. It is the strong and frequent urgency to evacuate your bowels, and you either pass nothing at all, or only small bits of mucus or stool. It's a sign of moderate to severe rectal inflammation. For relief, hit it your rectum hard with enemas: mesalamine enemas (rowasa/salofalk/pentasa) and/or steroid enemas/foams.
Posted 3/15/2019 7:08 PM (GMT 0)
Hi Team just got back from my GI. Over the last couple of days I have felt way better. I had blood work done yesterday standard stuff and CRP. My GI told me my CRP was slightly elevated indicating a flare. He said if it gets any worse I am to take some cortiment he gave me orally. Yesterday I finally had pretty solid normally looking stool, I am hoping I am getting out of this. Thank you for the help.
Posted 3/15/2019 7:16 PM (GMT 0)
Glad you're feeling better! Cheers to more healing to come.
✚ New Topic ✚ Reply