Next course of action?

I've been dealing with an on and off flare for a few months now.

I'm currently on 125mg imuran, pentasa and colifoam both once nightly and meteospasmyl for cramping.

These days, I have 3-5 BMs, the first few BMs are usually decent with formed stools and no blood. However, it seems that after that, my rectum gets irritated by the frequency of me going to poop and the next 1-2 times tends to have abit of blood and mucus. I also deal with some cramping which is what really irritates me.

I've been trying to stay off steroids due to its undesirable side effects but I feel a little worn out by the battle with this on going flare and am unsure if I'm doing more damage to my own body by not going on steroids.

What do you guys think?

Hi Dude -

Not knowing your history / did you already try ASA's etc.? My thoughts: 13 years in, did great on asacol and lialda, huge flare out of the blue in August (so almost a year now). Had moderate to good success with prednisone, used rowasa enemas, but flared back up again just EIGHT DAYS from the end of a taper. Starting Humira next week.

If you're already on Imuran, you've probably already gone the ASA route. My doc is just not a fan of Imuran and we're going straight to Humira. Ditto on the rectals, definitely try them. I think this flare just went ballistic so nothing was going to help, but they are a valuable tool. Get past the idea of it and just do them.

Yes, prednisone is the devil but if you've never had to do a cycle, you should consider. (I think my flare went way too long BEFORE doc put me on pred, we tried rectals and a few short medrol pack blasts.) It is the drug we love to hate, but you MUST be compliant, do the prescribed amount, and taper exactly as doc tells. Nothing worse than months on pred and you try to rush off and you're right back at square one.

Also interesting that you "get worse" after your initial bathroom visit. Even this far in the flare, I have a tough 1-2 hours in the morning and then I get better and am totally fine all day. Can eat lunch / dinner/ don't wake up during night for bathroom. Lots of people have "morning clustering" like that. Good luck!!!

P -