Mucus and healing ( and/or inflammation ) and nearing remission....

So I've been in a flare since mid-February, and am now on a pred taper ( just dropped to 30mg / day - 5mg drop every 7 days started at 40mg ). Symptoms have improved quite a bit ( down to 2 or 3 somewhat formed BM's / day with a lot of urgency only in the morning right after I wake up ), and no visible blood in at least 10 days....

So my question to all of my esteemed, and unfortunately more experienced UC'er's, is regarding mucus in the BM's..... I've noticed quite a bit in some movements, and not very much if any at all in others. In your opinion is the mucus being there a sign of ongoing inflammation and / or possibly a sign of healing?

From my previous flares I've realized that the road to remission ( for me at least ) is a very slow and subtle process. I don't believe I'm just going to wake up one morning and be in full remission. Curious about your experience on the positive progression of symptoms on the way to remission.... Was it fast? Did it take weeks / months? Was there a "milestone" BM ( lol ) that signaled remission for you? Was there a progression from blood with mucus to just mucus to eventually back to "normal". I'd really like to hear from people on their experiences. Thanks in advance!

Hey Songlady -

Thanks for the reply. I started the taper two weeks ago today. Things were not good at the start with 15+ movements per day and flex sig the day prior to taper start showing severe inflammation. So I'm only two weeks in on the pred and so far the side effects have not been nearly as bad as the last time ( fingers crossed although I suspect they will start to show more in the several weeks which for me = severe cystic acne ughhhh ).....

Now that I think about it it's almost like my symptoms occur in reverse order as I head towards remission. The flare started with a few extra loose BM's per day, then heavy mucus, and then of course the bleeding combined with that crazy urgency they only we know so intimately over the course of a month or so. So yes I'm no where near 100% but a thousand times better than just two weeks ago. Hopefully I'm headed in the right direction the path will be as linear as possible. I think the ultimate benchmark for me will be waking up one morning and not having to go within a minute or two. I vaguely remember that from last time. Also would be nice if the near constant pressure in my upper left ab quadrant would take an extended vacation haha.

2-3 mushy/semi-formed bms a day is certainly an improvement but the urgency means you still have rectal inflammation. It's going to take more time until you're in a remission. You're going to see mucus due to that inflammation. Healing was a very slow process for me, I'd say you're on the right path give it more time and you might continue to heal. You should continue seeing improvements, should you plateau or suddenly get worse then contact your gastroenterologist to adjust your medications.

Are you on rectal medications, e.g., rowasa enema? They're quiet good at treating down low, rectal inflammation.

Have you tried immunomodulators (Imuran, 6mp, or azathioprine)? Typically, they are tried before biologics (remicade, humira, simponi, or entyvio).

The mesalamine rectals rowasa enema does include sulfites, important to note if you have an allergy.

@T

I have Crohn's-Colitis which is Crohn's disease isolated to the colon. I am also now in remission. For me, blood was the first to go. Then pain with BM's went away. Then urgency wained and I could finally 'hold' things to a degree, then stools began to become more firm... This part of the process took a few months. Next came a reduction in the number of formed BM's a day to two or three times... then mucus finally went away for good. Over the course of a year and some I now have one or two or two days a week where I have a single formed BM just like the good old days. The rest of the days can vary between 1 & 2.

So basically the process took over a year for me.

Certain foods I ingest now can cause mucus, but it goes away if I remove the food.

Ummm, that a tough question to answer, but the fully known ones; foods that I have ate, had mucus, stopped eating and had the mucus go away and repeated this a few times just to be sure are:

Anything wheat like whole grains. Brown Rice - especially organic. White Rice. Those are my main mucus inducing foods. Raw carrots might fall into this as well but I am not 100% sure. And medium rare steak seems to cause mucus, but well done is fine, that is the weird one. Other foods such as spring mix lettuce, some partially cooked veggies and a few other things lead to diarrhea, IBS like symptoms and sometimes very minor mucus follows.

However there's a big long list of perfectly safe foods that if I eat them I cr@p like dream... Rice flour pasta, salmon, eggs, tuna, pineapple, apples, shrimp, lobster and on and on..

I had to get to the point of solid stools to start to understand exactly what foods cause me issue. Also I am stubborn and tend to cheat from time to time because I hate not being able to eat some things. As always I pay for it for 24 hours and then go back to normal.