Flare Advice - Lots of blood, mesalamine not helping much

I'm on nightly enemas too for the last 45 days but still bleeding a bit. But my GI wouldn't agree to put me on oral steroids until the scope done. Not sure why he wants to have another one within 6 months? One more thing is it necessary to have biopsy done with every scope?

Colonoscopy is essential for initial diagnosis of an UC, and necessary for colorectal cancer screening after you've had UC 10 years. During flares and when a treatment isn't working, your gasteroenteroligist may request another colonoscopy or flexible-sigmoidoscopy to assess: how severe and how far in extent? It's a good tool to measure where you stand and your progress.

The benefits of endoscopy are both visual and also in the biopsy. Do biopsies have to be done every time? No not necessarily for flexible-sigmoidoscopies, as I've had some with and others without biopsies.

Endoscopy is the most accurate means of determining how we're doing, so preferred by many doctors. However, for us, scopes are a pain in the arse to prep for and also literally lol. Often a flexible-sigmoidoscopy is sufficient, the prep is easier, and you do not need to be under anesthesia for it, so waaaay better. I always prefer a flex-sig over a colonoscopy any day.

Often a Fecal Calprotectin (FCP) stool test or a C-Reactive Protein (CRP) blood test is sufficient to measure our inflammation levels. And you can dodge a scope at times by insisting on one of those as an alternative.