flare up questions & frustrations, med advice, food..

Hey,

I'm so frustrated with being in & out of a flare for the past 6months-1year. These last 2 months in particular have been awful. I'm getting so depressed (not clinically, but you know what I mean) with having to deal with this. I have been spending a whole lot more time at home, inn my bedroom and bathroom than ever before.

Current treatment for this flare has been enemas and suppositories. I used to take prednisone to get out of flare, but have been on it a lot so dr wanted to try something else. My ongoing/maintenance treatment is remicade every six weeks, and methotrexate once a week (which kept me in remission for approx 3 years). Just had remicade a week ago. First few days after I felt hopeful, because things were improving. Less frequency, consistency lil better everyday, BUT still a significant amount of blood. First question I have is: What meds do you do/take to get out of flare?  

Next, I wanted to hear what you tend to stick with diet wise during a flare. I have currently been sticking to applesauce, ritz crackers, plain noodles (gluten free), Chex cereal (gluten free) with water, grilled chicken, turkey,.. Based on my list, do you see any problems, things I should stop eating? Or what other foods do you think could be added?

In regards to dietary things: I've seen that some of you take fiber supplements, such as metamucil. Do you take fiber supplements when in remission, or during flare? I thought that when you are in a flare you stay away from fibrous foods...

Lastly, my flare up troubles. If my frequency improves with rectal meds, and consistency a little, but still have a lot of blood, what are the chances it could be a hemorrhoid, or fistula, anal fissure or something else?

As always, I appreciate everyones advice and suggestions. I wish I had a doctor that I trusted and could ask, but right now I am between doctors. Trying a new GI dr soon. Hoping he can help me out of this flare.

Fistulas don't bleed. They develop after and abscess doesn't heal correctly. Although in Crohn's, I *think* they might just form due to all of the inflammation, but I might be wrong. I have one right now that developed from an abscess, but the colorectal surgeon I am seeing about it does not think it had anything to do with my UC. I also have a pretty strong family history of perianal abscess/fistula. A fistula is a tube, so to speak, from the rectal wall to the skin. It would not cause blood like what you are seeing.

I've never had a fissure, but it would hurt like an SOB when you have a BM.

You may have some internal hemmies that are bleeding. However, I really think that it's just because you're flaring.

How long have you been on the enemas/suppositories *without* missing a day? It may just take some patience of using them every day, for a few months, to get this under control. Or, maybe you could try pred enemas. But, that would take a prescription.

As for food, I kept it low fiber when I was flaring. I tried fiber supplements, but all that did was make more poop.

Glutamine, glutamine, glutamine! Please look into it. It has cured me.

You do realize that ritz crackers are not gluten free??? What's the point of making all the other gluten-free choices if ritz crackers are on your menu?

If you would consider it, a complete bowel rest might induce remission. You can take your meals via total parenteral nutrition. I think this has to be a prescription (search TPN here for others who've done it), but you might be able to make due with OTC solutions like Ensure (although I hear that one is particularly hard to digest for some people).