HealingWell
Search Close Search
☰

Is start of a flare?

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
12
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 6/8/2019 2:00 PM (GMT 0)
Hi Guys,

Hope you are doing good. My second ever flare started 1.5 yrs ago and was struggling with simmering symptoms until last 1.5 month ago i upped oral dose to max with daily enema. I was having occational bleeding and mucus earlier and i have not seen any of those ever since i started max oral dose. I'm having cold and fever since last 2-3 days and just stopped my daily enema since i'm not having strength and patience because of fever. Today i'm seeing lot of mucus and very tiny streaks of bleeding. I'm wondering whether UC can flare this fast as i just stopped enema for only 2 days and just cant believe myself that i'm having this. Just want to know whether anyone experienced this and shoud i give a call to my GI or just wait for couple days to see if mucus subsides?
Posted 6/8/2019 2:39 PM (GMT 0)
I would recommend you seek treatment immediately, like at a hospital. It’s possible your drugs are no longer strong enough to fight your flare. UC can go from bad to worse in an instant and just gets harder to fight :/

Get well soon!
Posted 6/8/2019 5:47 PM (GMT 0)
You don't need a hospital. Call your doc's office and try to get in soon. Ask for steroid enemas in conjunction with mesalamine enemas to see if that can help get you into a healing mode.

Do you have the suppositories? What strength of enemas?

I hate colds....i feel for you!


q
Posted 6/8/2019 6:12 PM (GMT 0)
Hi Quincy,

Its 4 gm mesalamine enema i'm using. Unfortunately we dont have steroid enemas and next resort is go for oral steroids if my symptoms continuous. I'm having consistent pattern of having 2-3 weeks of no symptoms at all and bleeding and mucous for couple of days and gets back to normal quickly. Last month i've upped my oral dose to max and i'm not seeing any symptoms atleast for last one month. Now i'm back on mucus and tiny spots of blood since yesterday. Not sure whether it is bcz i stopped enema for couple of days or something else? I've very frustrated to go to doctors that i've changed three doctors in last 2 yrs and 2 scopes done all of them said mild inflammation manageable with 5 ASAs. I'm not sure whether i should be happy for having mild symptoms or should i worry about untreated colitis with stronger medication. I did tried with 2 enemas am and pm as well but never acheived full remission.
Posted 6/8/2019 7:01 PM (GMT 0)
Hi...where do reside that steroid enemas arent available? What about budesonide....i believe its7steroid as well? Off to google...

Do you have blood on the tp?

q
Posted 6/9/2019 4:31 AM (GMT 0)
Hi Quincy,

I live in India and we dont have steroid enemas here. I think we don't have uceris as well, ferring is yet to release cortiment(European version) in india. I'm not sure whether i've to continue on current medication or to go for a small taper of pred as thats what my GI mentioned last time. But i'm scared of steroids as i've two colds in last one month. I dont have boood on tp.
Posted 6/9/2019 4:48 AM (GMT 0)
How many times a day are you having bms, are they urgent and whats the consistency? Are you having rectal discomfort?

Is it possible you have hemorrhoids?

q
Posted 6/9/2019 5:40 AM (GMT 0)
Hi Quincy,

I'm having 3-4 semi solid stools a day. Dont have rectal pain or urgency and i dont think i've hemorrhoids. I have mild discomfort in stomach and that relieves after having bms. Today i dont see any mucus or blood but i saw black colour specs in stool. I dont know what it is, may be blood mixed with enema.
Posted 6/9/2019 7:12 AM (GMT 0)
Can you check your inflammation levels before taking new medications?

I was also never offered steroid enemas as a treatment option, I think it's not that they don't have them here but that they prefer to use other things.
Posted 6/9/2019 7:21 AM (GMT 0)

poopydoop said...
Can you check your inflammation levels before taking new medications?


That's exactly what i'm thinking and going to order FCP test myself. It is very expensive in the hospital which i go regularly.
Posted 6/9/2019 10:29 AM (GMT 0)
Ok good luck. For me fcp has been very useful (we tracked it every 3-4 weeks during my last flare into remission so now I've been convinced that it shows what it's supposed to)
Posted 6/9/2019 1:46 PM (GMT 0)
"I would recommend you seek treatment immediately, like at a hospital. It’s possible your drugs are no longer strong enough to fight your flare. UC can go from bad to worse in an instant and just gets harder to fight :/ "


uhhhh, WHAT ?
Posted 6/16/2019 11:29 AM (GMT 0)
Hi Guys,

My FCP Test came back normal at 42 but still i see mild discomfort and mucus occasionally. Does normal FCP means i'm in remission or still there is a possibility of mild inflammation?
Posted 6/17/2019 12:07 PM (GMT 0)
Hi Guys

Anyone has experienced ongoing inflammation with normal calprotectin? Just want to know bcz i need to decide whether i should go for a scope or not. I have my last scope done 10 months ago found moderate inflammation.
Posted 6/17/2019 1:25 PM (GMT 0)
FCP and CRP are great at spotting moderate and severe inflammation, personal experience is that those tests totally suck at finding mild and limited inflammation. When it comes to accuracy, endoscopy always wins in being the most precise.

It is also possible endoscopy will find nothing, and what you are experiencing is more inline with an Irritable Bowel Syndrome type symptoms, as mucus, constipation, looser stools, and various discomforts/pains can be 100% unrelated to intestinal inflammation.

It's up to you, if you want to be absolutely sure, get endoscopy. At least a flexible-sigmoidoscopy, but a colonoscopy would go the full length. Generally speaking, an UC inflammation is always worst at the rectum (first to be inflamed, last to heal, and most severe inflammation), so a flex-sig should suffice in most cases.
Posted 6/17/2019 4:24 PM (GMT 0)

iPoop said...

Generally speaking, an UC inflammation is always worst at the rectum (first to be inflamed, last to heal, and most severe inflammation), so a flex-sig should suffice in most cases.


My last scope showed inflammation from mid sigmoid to mid transverse colon and rectum was absolutely normal. So i think i should go for full length colonoscopy as sig scope might not show any inflammation. Thanks for your suggestion anyway ipoop.
Posted 6/17/2019 4:47 PM (GMT 0)
That might be why your calpro is normal- it's most sensitive to inflammation close to the rectum
Posted 6/17/2019 4:58 PM (GMT 0)
Doesn't sound like you have UC....
q
Posted 6/18/2019 2:22 AM (GMT 0)

quincy said...
Doesn't sound like you have UC....
q


Last time i was on foams & supps instead of enema and that could have been the reason that the rectum was normal. I was on 2.4 gm of oral mesalamine at that time and that didnt do anything for the inflammation in mid sigmoid & above. Now I've increased my oral dose to max and on daily enemas atleast for last 2-3 months so i assume it could have cleared up everything but wondering since i've mucus occasionally is there a possibility for residual inflammation or is just IBS?
Posted 6/18/2019 3:35 AM (GMT 0)
I personally would want a scope with biopsies at this point, or at least a sigmoidoscopy. It's easy to think "Maybe it's IBS", but there's really only one way to figure out the truth. A low FCP is positive, but it's not always accurate. Request a scope, especially if it's been a while since you had one. You can kill two birds with one stone, get your monitoring out of the way, and see what's going on!
Posted 6/18/2019 2:19 PM (GMT 0)
I want to have a scope but i'm bit skeptical as last time i've severe pain after scope with all those random biopsies taken. My GI was mentioning about FCP as a follow up but that was 6 months ago and not sure what he wants to do now. I had my last scope done in August last year.
Posted 6/18/2019 5:37 PM (GMT 0)
UC functions in a fairly programmed manner, from what I understand and experienced. Think thermometer. Unless, you've had it forever and the rectum part is burnt out, so to say...but it wouldn't present with normal biopsies, it would be obviously skewed with architectural changes.

q
Posted 6/18/2019 6:18 PM (GMT 0)
Sometimes people use enemas and that clears the rectum but the involvement is persisting above where the enemas reach.

I have had a normal FCP and been flaring - seen in a sig scope. I wouldn't assume IBS because of a normal FCP personally. Why did you stop the enemas? Most people with UC who respond well to them do them indefinitely. You can use them daily/nightly. If you have symptoms when you stop enemas, they may be what's required to keep you in remission. Can you just restart the enemas and see if you get back to 100%? If that's not the case, and you're on the max dose of meslamine orally, and steroid enemas aren't an option, you will have to explore additional treatment. I think in order to make the determination of whether additional drugs are warranted, a scope is a good step. It sounds mild, can you get steroid enemas from elsewhere, or get something compounded? There is also tacrolimus supps people have had compounded, foam enemas... Steroid supps... Did you have all stool tests to rule out other pathogens?
Posted 6/19/2019 2:38 AM (GMT 0)

quincy said...
so to say...but it wouldn't present with normal biopsies, it would be obviously skewed with architectural changes.
q


Sorry for the confusion Quincy. When i say rectum is normal i just mean they didn't see any inflammation. Still it might have those hystological features but i didnt see the biopsy report properly. I always search for the words dysplasia and malignancy and rest all i just ignore,lol.

Hi notsosicklygirl,
I didnt stop enemas and i'm still on them. But still i see mucus occasionally and thats what i want to check.
Posted 6/24/2019 11:40 PM (GMT 0)
I have to say, I think mine is starting to flare, as well.

I have only gone twice each day the last few days, but something just doesn’t feel right in my stomach area. I’ve been under stress with buying a house in addition to lots of traveling and poor diet/drinking alcohol.

I’m going to increase my medicine to 6x 800MG Asacol H.D. up from 4x and see how my body responds.

Any other tips? sad
✚ New Topic ✚ Reply
12