" I'm flaring to the point where I don't want to leave my house without taking immodium, and there seems to be a lot of blood in the toilet every time I go, which is about
6 x per day. Do you think I need to ty to get in to see my GI tomorrow"
Yes.
Do you need prednisone? It depends. Standard flare protocol is:
- Call your gastroenterologist when your symptoms are persistently worse. He/she will likely schedule an in office consultation and perhaps a colonoscopy or flexible-sigmoidoscopy to assess: How severe is your inflammation? and How far does that inflammation extend? As that assessment will help guide which medications are needed to exit your flare the quickest and most effective way possible.
- Get a stool test to make sure you don't have a pathogenic cause to your worsened uc symptoms. Bugs like c diff mirror the symptoms of a flare, but respond to entirely different treatments.
- Often your current medication doses are increased. A flare dose of lialda is 4 pills a day. Often you'll want to add rectal route medication like canasa suppository or Rowasa enema.
- Prednisone is sometimes needed based on how severe and how far your inflammation extends. Some jump on prednisone earlier to stop their flare early before it worsens. Others try to deal with their flare initially without prednisone and save it only as a last resort. We dred + love the pred, totally a love/hate relationship. As you're having accidents and afraid to leave your house, I'd bet a steroid is likely essential for you. Sounds like a bad flare.
- Alternatives to prednisone with less side effects are rectal route steroid suppositories, foams, and enemas. The delayed-release coated Uceris pill is equivalent to the rectal route steroids. Advantageous as these options are 90 percent topical and 10 percent systematic. Prednisone is 100 percent systematic which results in the side effects we all know and loath.