Is there anything else I could try to control this flare?

Hi everyone, I am now at the start of week 6 of a flare and I am scheduled to have a sigmoidoscopy on Thursday (can't wait!).

My symptoms are mild and it is the mildest of three flares so far. However, apart from some good days after taking glutamine powder, I am generally going to the toilet with two trips of diarrhoea first thing in the morning and then 2/3 trips over the next couple of hours when it is more formed or formed but with some bleeding and it is quite painful to go although not anywhere near as bad as previous flares when I would be clutching the towel rail or anything nearby to cope with the pain!

I have done all the stool tests which are clear for gastro issues. The inflammation test came back "equivocal" which the encouraged the doctors to test for bugs etc in case it wasn't colitis.

The most strange but welcome thing is that I am having no problems holding on to enemas and suppositories whereas normally it was a nightmare in a flare.

I am taking the maximum mesalazine tablets (asacol HD) and using 2 g salofalk enema at night and 1g suppository in the day.

I don't want to be on steroids as it is the easiest flare so far but I only came out of the other flares by increasing my mesalazine tablets and swapping from Pentasa to Asacol last summer in that flare. I can't do that now….

i am under a lot of stress because my employer is making my life hell after the absences last summer during that flare and I anticipate I am about to lose my job so that isn't helping.

I would be grateful for any suggestions on anything else I could try…….

In the steroid front, you have options that have a lot less side effects than oral prednisone. Most of us will take steroid enemas, foams or suppositories over prednisone any day (a lot less side effects). Uceris or it's European equivalent called Clipper are all delayed release steroids with greatly reduced side effects.

You're close to the maximum of mesalamine. The 4gram enemas are more effective than the 2gram ones. Maybe try a delayed-release or rectal-route steroid, plus a stronger mesalamine enema? You can nix the mesalamine suppository with a stronger enema.

If that doesn't work than immunomodulators like Imuran, 6mp, or azathioprine might soon be on your horizon. So, I'd start thinking about them and learning about them.

Looks like you're covered from a meds point of view ...

In terms of stress I recommend mindfulness meditation ... Don't know where you are but here in the UK there's a book available called "Mindfulness - a practical guide to finding peace in a frantic world" by Prof Mark Williams & Danny Penman ... it comes with a CD of meditations ... I find it very no-nonsense and compassionately written, there's also a book called "Mindfulness for health" by Vidyamala Burch and Danny Penman, that seems to be published by the same company. I strongly recommend checking them out. Obviously the more you relax and are happy, the more good health is encouraged ... and vice versa.

Hi chickenwings1, I am in the UK as well. I have bought a mindfulness book that I will read. I am terrible at reading as my mind often drifts onto something else but I will give it a try. Do you know by any chance if we can get 4g enemas in the UK? I asked for one last summer and the consultant just said no but he didn't say we don't have them. I am seeing a different consultant next week and so will ask him for the 4g enema and see what he says.

DBwithUC, he said that if I was put on azathioprine that I would need to have very regular checks at the hospital and if any consultant suggests this that I must say no. I will ask more next week now that they might be putting a question mark over mesalazine. Thank you for the good luck message, I really hope it subsides. Hope you are all well.

It sounds like you have reason for optimism in subduing this flare with steady medication (mesalamine meds are slow-acting, alas, but can get one to remission eventually). The job-related stress is likely a major impediment to your healing process; maybe you could find a local IBD support group or take up Iyengar yoga to help relax the tension you feel. If you have an unsympathetic supervisor at work, it can really raise your anxiety level. Unfortunately, that happens to many of us during our UC "careers"! You could also try venting here in a thread about about specifics, for example, any unpleasant comments made to you on the job-- because it might be something one or another of us forum members has already experienced and could therefore comfort or advise you on how best to deal with the situation. Sending best wishes your way! / Old Hat (35 yrs with left-sided UC; presently in remission taking brandname Colazal)

Hi Jessa

I'm also based in the uk. I had a serious flare at xmas but my employer has been really understanding. My uc is classed as a disability - it might be worth checking this out and letting your employer know. Stress is undoubtedly a major trigger and I have found mindfulness invaluable. I use the UCLA free guided meditations on the train to work, which keeps me sane on Southern railway. If your mind tends to drift easily, then you need it even more! Azathioprine has really kicked me into remission and I feel better than I have in years. Remember that going 5 or 6 times a day is just not normal and living with the disease at this level means constant flaring.

Good luck
Cath from Brighton