After a long wait, I had an appointment with the gastro specialist last week to discuss my treatment and progress to date. Since being diagnosed with UC in early feb (the gastro said on a scale of 1 to 10, he thinks I'm about
a 2.5) I was initially prescribed a light dosage of mesalazine (800mg, twice a day). This did alleviate my symptoms somewhat, but to be fair, I think the biggest relief I saw was within the first week, most probably a result of my colon responding well to the break it got during the bowel prep. It began to revert more to normal some time after that. There was definitely an improvement though - urgency was less, less BMs, less blood etc etc. But on the whole, still a long way off what I would consider to be anything like remission.
After the visit last week, he has increased my dosage to 2400mg per day, by adding a third dose of 800mg. We talked about
enemas, which he said he could prescribe but only in the absence of oral meds, but recommended I continue with the oral meds.
Within four days of increasing the dosage, I noticed an increase in the severity of my symptoms. The first sign I had was a bloody BM at an uncharacteristic time, after having had an evening of watery D (hasn't happened for weeks). I put it down to the fact I had eaten too many grapes in the days leading up to it (yes, it's the end of summer here, and my vine has gone nuts this year). I made this call after seeing seeds in the D, and reading some on here who have found the skins and/or seeds don't agree with them during a flare. I laid off the grapes, and things did seem to settle down, but I'm still finding a bit more blood (especially in my morning BM, which is always the roughest anyway), and what I colloquially refer to in my head as 'curry colon' (that feeling in your lower colon the morning after you've had a very spicy curry). Interestingly, however, I've found the D has considerably subsided, as has the need to pass gas. So in some respects, it's like I'm more settled but not in others.
At this point I have three options:
1) Keep taking the 2.4g per day and observe over the next week to see whether things get worse, stay the same, or improve
2) Drop my dosage back to 1.6g per day and observe for any changes
3) Call the hospital and get the advice of the specialist I saw.
Logically, #3 might seem the obvious choice, but the way our health system works here, it will probably take several days before I even get a response. One of the things that has begun to sink in for me over the past week is that this is going to be a disease I have to manage myself. Not on my own, by any stretch, but going straight back to the gastro when the flare up may have a perfectly rational explanation that only I know about
could lead to an incorrect path being taken. I'm going to have to read my own body and gauge for changes in symptoms, and record these. Nobody else is going to do it, and nobody else will know my body the way I do. Given Mesalazine is slow to take effect, it might well be that it's too soon for the increase in dosage to have caused the increase in symptoms. I was doing really well on mesalazine, with no side effects and a clear improvement. It just seems odd that by adding another dose every day can have the reverse effect, particularly after I've not long been on the medication.
I'd be interested to hear the thoughts of others who may have been through something similar.
Post Edited (Gitch) : 3/28/2016 8:26:26 PM (GMT-6)