Annoying flare with D just won't go away

Rookie post here, but I've been lurking for years.

A little background to start. I was diagnosed about 5 years ago just after turning 30 (male, fit, otherwise healthy non-smoker, 0 alcohol, etc).

Got put on Salofalk pills, then later Imuran was tried and failed after ~12 months. I had all the imuran side effects and didn't seem to make a lick of difference to avoid flares. I've done 80mg prednesone cycles three times in 5 years to combat the worst flare (nearly all blood, 50+ times daily, losing 1lb per day). Twice cycled off pred without issue, the last time I got "stuck" at 10mg per day for a few weeks before getting better.

Haven't been on Pred in over 2 years, and I'd like to keep it that way. Last fall I had a bad flare, and Doc introduced me to salofalk enemas (4G) which worked nearly as well as the pred. Cured in 4 weeks! Stayed on one enema every 3 nights for maintenance. I thought that was the new magic fix.

Bad news is I have a flare that came back in March that just won't give me a break. Been on nightly salofalk 4G enema and my usual 2 pills 4 times a day. I'm not getting worse, but not getting better. I'm probably at 8 D episodes per day. Nearly completely liquid. Little/no blood. If I eat anything, I have to go within 15minutes tops. I'm on a nearly all liquid diet (3-4 ensures + chicken/rice + water) to try to rule out food being the issue.

I've learned to see the deterioration of the stool as flares progress. Flares take me from solid stool, to skinny stool, to skinny red striped stool, to little pooplets, finally to D, then worst is D + blood. Coming off a flare is the opposite.

I have no or minor cramps, urgency isn't really that bad at the moment. I can go a work day without having any panic attacks about finding a toilet. I can hold the enema all night without having to do the dash. At night the urgency is worst, going perhaps hourly for the few hours before bedtime.

My dilemma is it almost seems like if I could fix the D, I'd be out of this stupid flare. But everything I read says adding fibre or using Imodium is a bad idea when flaring. It's probably wishful thinking, since the D is probably a symptom of an inflamed colon, not the real problem by itself.

It's just frustrating. The enema every night for 12 weeks hasn't had the same miracle effect it did last fall.

I'm on the usual multivitamins + Cal/Vit D + Fishoil. I think I'll try the oral aloe vera tablets next, I suppose it can't hurt. I started taking probiotic yogurt tonight, it never worked for me in the past but I'm getting desperate for any little bit of help. I've tried resting for 4 days doing virtually nothing. I tried exercising daily. I'm down the the point now where I'm starting to believe that really it doesn't make any difference what I eat or do, the gut doesn't care, it's still pissed off at me. I've never noticed any positive or negative correlation with diet, with the exception of alcohol which seems to cause a flare. No big deal, I was never a drinker so I'm now "dry".

I trust and like my Doc. He doesn't like giving out pred, and neither do I. It works like magic, but I understand it's not a long term solution and has nasty side effects. But Docs next idea if I don't come out of this flare before our next meeting is to go to Remicade which I'm really trying to avoid due to the cost & side effects.

If anyone has any suggestions on getting past this hump, or what I might be doing wrong, I'm all ears

I apologize in advance if you're suffering worse at the moment and my plight seems like complaining over nothing. I've been at the worst end of it, I know how bad it can be. :(

have you ever looked at the ingredients of ensure? the second one is sugar, then corn syrup, then god knows what else. Sugar is an inflammatory agent on the digestive system.  I would cut out the ensure if I were you.  do you have problems with dairy? then the probiotic yogurt  may be  bothering you.  Do a google search for scd diet  chicken soup- eat this soup instead of the ensure. 

I was in a similair situation to you- I had a lingering flare for over a year and a half.  I took asacol and nightly rowasa enemas, the pain went away, and I got slightly better but still going with urgency blood and mucus 6 times a day.     my doc precribed pred to make this lingering flare go away- i was fine on the pred but within 2 weeks of stopping I was back to wher I was before.  

 My d happened from from mid morning to mid afternoon, rarely in the late day and never at night.  well i looked at what i was ingesting in the am (never before believing that my diet was the culprit) I would start my day with a cup of coffee and yogurt for breakfast.  I decided to cut them out- and As soon as I cut this out, I noticed a 75% improvement.

Adding a probiotic, fish oil, and metamucil has me at almost 100%- I am on lialda and rowasa enemas every few nights.

I think now, as far as I was concerned- that the meds did help, but that there were things in my diet that were continuing to inflame my system-  maybe for you you have to stay away from sugar and dairy (ensure and yogurt)  you think you are doing yourself a favor by limiting what you are eating, but the few things you are eating may still be the culprits. 

I take 1000 mg of fish oil (Natures Bounty omega 3).

I was headed for remission when i started the fibre supp.  I had stopped the coffee and yogurt and within 2 days had no more blood, but stools were still soft and 4 times a day, and not quite right, you know?  I added the fish oil and primodophilus reuteri probiotic about a week after stopping coffee and noticed a slight improvement, my stomach didnt seem to have the rumbly nervous jangly feeling as much anymore, then during this time i seemed to almost get contipation, I wouldnt go for a day or so and then i would go alot and it was accompanied by some cramping but the blood was gone.  about 2 weeks after i stopped the coffee and yogurt, and i wasnt quite regular yet but the blood and urgency had mostly gone, i decided to add metamucil (actually, I added generic rite aid brand metamucil, the capsules)  i started with 1 a day, nothing, then 2, still nothing.  then I upped to 5 and within a day or two, i started having nice formed non bloody stools, minimal urgency.  sometimes i go 3-4 times a day but no pain, no blood, sttolls are formed, my system feels like it is getting back to a normal state. 

If I had to say what has helped me the most recently, besides my meds of course(lialda and rowasa enemas) I would say, figuring out the food that was furhtur inflaming me and the fibre supplements.  Do a board search  re: fibrer supps or a google search, to get more information, or ask your doctor. 

princesa which probiotics do you take?

The fibre that people usually is told to avoid is the non-solluble ones (think raw vegetables) due to it can be rough on a inflamed colon.

hi werty
you've gotten some good responses. I will just tell my story as an add-on although everyone with UC seems to be different.
The D and urgency took the longest for me to overcome. I have had UC for 10 years, progressively worse every year with no remission.
I am one of the Specific Carbohydrate Diet's success stories although I had to eliminate a few "legal" foods because my colon was in such distress. Crazy with inflammation I think.

I really recommend NOT eating yogurt until your D is much more under control, Get your probiotic through pills, it may take trying a couple different formulations before you find the right one for you.

I also would suggest not using fish oil at this point. I am a believer in it but it could contribute to D in early healing. Just my opinion, feel free to disregard.

I would eliminate Ensure and any pre-packaged shake. You really do not know what is in them. Sticking to whole foods is best.

The one food my colon never minded was meat and protein (not soy). Chicken, turkey and beef. I've decided to buy anti-biotic free as much as possible even though it's more expensive. Cheaper than than bad health.

Fiber is a bit tricky. Soluble fiber is best but even that can be difficult for a wounded gut. Well cooked low fibre veggies are fine but don't go heavy on the fiber. When constipation gets to be an issue you can go there (after celebrating the end of D).
Having said that my colon never minded well cooked carrots in butter and cauliflour, not in large amounts though.

Again, the urgency and D took some time to overcome for me. Perhaps you will get better faster but take it one day at a time.

Last idea: Keep a food journal. Really really (really) helps.

Good luck