Ending flares without moving up the med ladder?

I know there are people here who get flares and treat them without moving up the med ladder. And others who seem to move up with every flare. With this disease everyone gets flares. How do you get out of them without moving up the ladder? What determines when you need to move up the ladder?

Always have wondered about this.

Even moving up the ladder didn't work for me. I would think diet would be the best chance based on what i've seen here. Perhaps some alternative meds (LDN) or probiotics, FMT.

I am in remission from pancolitis - my last flare was at this time last year. It was my 2nd major flare - came on pretty quick and escalated fast. I had been on Apriso and Canasa for maintenance at the time.

They put me on pred, just like the first time, but while it really toned things down quickly the first time I didn't respond as well. I was going about 15 times a day, mostly just blood and mucus, with lots of body aches, pain, and fevers. The frequency reduced to about 10 times a day, and I called my doctor to come in - his assistant told me on the phone that since I wasn't responding that next appointment the following week would be to take next steps on Remicade. I had heard a bunch of things about Isatis Cooling here and had ordered a bottle, but didn't really feel like starting anything new until I felt like I was backed into a corner....haha.

Isatis cleared things up quickly for me and by the time I went in the next week, things were well under control - within a few days I had stopped bleeding completely. I had heard that I would know quickly if my situation was responsive to Isatis and I'm so happy that was the case. I am also really militant about watching my diet, which is helpful as well. I may have to go up the med ladder later on but I am grateful to hold off as long as I can. I hope that you find some relief no matter what the solution proves to be! Feel better soon.

CCinPA said...
I know there are people here who get flares and treat them without moving up the med ladder. And others who seem to move up with every flare. With this disease everyone gets flares. How do you get out of them without moving up the ladder? What determines when you need to move up the ladder?

Always have wondered about this.

This is a very interesting question. Somebody posted an article a few weeks back about using dna analysis to choose the correct treatments for patients and I'm really hoping that's where ulcerative colitis treatment goes in the near future. It's all highly theoretical and nothing currently available today. But that they might someday know whose going to be a difficult case from the getgo and start him/her on strong medications (or even surgery, imagine if there wasn't years of suffering before it...) from day 1 and he/she therefore has stability, certainly and a clear path forward.

I'm willing to bet there's an immune deficiency with genetic markers/indicators underlying uc. Some of us have the perfect combination of genetic mutations to make uc a bloody nightmare, some of us get an easy pass and can remain on the mildest medications for decades with a few easy flares than are treated with prednisone and we continue on the same maintenance medications again. Roll of the dice I guess, not everyone gets a good score.

Right now, generally, everyone starts with mesalamine, then immunomodulators, biologics, and finally surgery. They do assign risk based assessments based on initial diagnosis and assign meds and doses accordingly, for example a pancolitis patient might be aggressively treated early on compared to a proctitis patient (which makes sense). However, some proctitis patients become pancolitis and are difficult to treat. There's some mystery and guesswork now, we're all left guessing if our uc will ultimately progress to stronger medications or even surgery (our doctors and us).

Someday perhaps, I'm a hopeless optimist.