Stable with issues, some advice?

Hey all,

I posted a while back about ending up in the hospital after not being able to get a flare under control (after upping the 5ASAs, trying Entocort and a short course of Pred). I was having one or two BMs daily with blood and D. Outwardly it didn't seem the worst (though I did feel fairly unwell) but once I went into the ER and they scoped me they found despite the higher doses of anti-inflammatories my sigmoid colon was severely inflamed (I underline severely). All the doctors are suggesting I go on some sort of immune suppression long term (e.g. Imuran).

Anyway, once in the hospital, IV steroids for three days (80mg) then out of the hospital and down to 50mg per day orally of Pred and now tapering 5mg a week. After a few days on the steroids things had returned to normal, 1 well formed BM every couple of days (my normal), no pain, no urgrency. It's been a couple of weeks since I started the Pred. Seemed promising.

The last 3 or 4 days, however, I have an incomplete (but well formed) poop : the volume is about half what it needs to be. Its like my rectum just tightens up and then I need to get up and walk around for 30 mins. I may eventually have another, longer complete poop shortly after or another half poop later in the day. I also have started to have some longer lasting rectal pain. No bleeding though. And again, poops are normal in shape if not volume.

Pre flare, this was not abnormal for me, and it would resolve within a week. I do get hemmies more regularly now than I did (I don't feel one yet though). But with the biggest flare I have ever had and the progression of my disease out of the rectum I am concerned and gun-shy. My thinking is I am on high doses of Pred AND 5ASAs, I shouldn't be having these issues.

Thoughts?

Should I ride it out for a week?
Should I talk to my GI right away?
Is this 'normal' and I should just be patient?

I would see how you are Monday since I know not much happens if you try to call a doctor on the weekend. The incomplete evacuation feeling is part of the inflammation. If your already starting to have pain this is concerning also. If things are still the same I would call.

No you shouldn't be having issues and since things are looking very severe I would seriously consider going up the med ladder. Remember you could have almost normal things going on and still have bad inflammation. These things don't always match. Your GI would want to up the med treatment then too because staying inflamed increases your risk of colon cancer.