When do you call your doctor?

Hi All,

I'm in uncharted territory for me. Usually, when I've needed the doctor, I knew it and had some type of unbearable pain or bleeding, severe cramps etc. This time around, I'm really only dealing with tenesmus and some mild pain in the area I had abscess/fistula surgery about a year ago. I thought I saw a little blood a week ago, but I drank red wine the night before so wasn't sure. I'm thinking the pain is just inflammation messing with some scar tissue and not another abscess formation, at least I'm hoping that's it.

I am taking 4 lialda daily and alternating rowasa at night and canasa during the day. I've also gone back to strict SCD, which I am unsure about but am still experimenting with. I usually go to the bathroom around 3 times in the morning...sometimes up to 5, but that is unusual. Other days its just two, which is my norm. This has been going on for about 2-3 weeks. I am living my life just fine but am uncomfortable for a portion of every day and am having an extra 1-3 trips to the bathroom. A little extra fatigue and fogginess. Should I just hold tight with my current regimen or call my doctor and up my meds? Is this a 'controlled' flare that you all deal with normally or something that demands more attention? When do you call your doctor?

You know your body best but I think there's no harm in calling your doctor especially if you have pain where your fistula is. I sincerely hope it's not another abscess. I'm in a chronic abscess state and it's not fun. If you're worried enough to question things, I'd certainly call.

Btw I responded to your questions about HB. Just unsure you saw it.

only when every thing else fails -

I would call your GI. I was having some rectal symptoms this time last year and when I mentioned it to my doc, he referred to it as a "simmering flare" and offered me a quick taper of prednisone if I wanted it. I've experienced tenesmus and it's seriously no joke. Hope you feel better.

You are new to UC, diagnosed in 2015, so you are still learning what your body is telling you.

You've been given some good advice here which you should write down (as far as RX suggestions) and ask your GI whether to do that. Do not say the word "internet", say a friend with UC suggested it. Doctors HATE internet advice even though this forum is very much different than the usual internet bs.

Start doing your own research so you know what your RX choices are now, names of meds, dosages, etc.
When you talk to your GI write down what he says (he/she will be impressed but it will really help you remember later).

Good luck.

Better to call a Dr a bit too soon than a bit too late. As you've just had surgery it makes sense to let your medical team know about any changes or anything you're unsure about.


Speaking as someone who hasn't just had surgery, I've had UC a long time so generally I speak to my IBD nurses to arrange a faecal calprotectin test if I think I'm flaring (the inflammatory marker blood tests don't work too well for me as an indication of how ill I am).

For me personally 2-3 bms a day wouldn't worry me too much, but I would want that faecal calprotectin test. 5-6 bms a day still wouldn't concern me too much but I'd let my IBD team know I was getting worse. Over 10 bms a day and going in the night, and I'd be more concerned. Roughly 15 bms or more, with a high faecal cal, would mean I'm heading for hospital. During a flare up I'd know if I wasn't coping, and needed more help.

Long term UCers can be pretty stoical about it all, probably because we forget what normal is!

If something doesn't feel right, it's better to ask for help than to soldier on though.