Blood again and Uceris

After two months of no blood, reduced abdominal pain, formed stools and feeling like I was almost out of this flare, I started getting bright red blood again the end of last week, as well as increased abdominal discomfort. So disheartening! I'm really down about it.

I'm having a lot of pain/raw feeling right at the anal sphincter, so I wonder if I have a fissure or internal hemorrhoid. It hurts to push. Nothing was spotted there when I had a colonoscopy on May 19; at that point, all that was seen was mild inflammation in the sigmoid. If it is a fissure or hemorrhoid, any tips to help it heal?

I talked to my doctor yesterday, and we decided that I would try Uceris for a month. I've been scared to take it thus far, because I'm scared of systemic effects on my immune system and how that could affect me in regards to Covid. I had a terrible time when I took prednisone a few years ago for an allergic reaction -- horrible headache and sleeplessness the whole two weeks I was on it. I know Uceris is supposed to be less systemic than prednisone, but I'm still concerned.

You can get an order for an inflammation test from your gasteroenterologist to see if it's s flare (Calprotectin stool test or C-Reactive Protein blood test). You can try an over the counter hemorrhoid treatment for a few weeks and see if it clears up.

Uceris is only 10-15% systemic. I wouldn't be worried about being on Uceris short-term.

Sorry, I thought it was implied that I meant it does not affect the immune system in the way OP describes (systemically rather than locally). The capsule of Uceris is designed to work differently than other budesonide medications in that it does not open in the stomach or small bowel (where it would be more readily absorbed into the bloodstream). From the Uceris website:

What makes UCERIS tablets different?
UCERIS tablets are a different kind of treatment for ulcerative colitis because they provide extended release of medication in the colon. Because of the way UCERIS is released, and processed in the body, most of the drug does not stay in the blood for very long.

Think of it this way: hydrocortisone (for example) is a potent immunosuppressant when taken intravenously. But if you apply a hydrocortisone cream to your elbow for a few weeks, it is not going to cause you to become immunosuppressed or have any systemic effects.