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first flare in years

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Ulcerative Colitis
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Posted 8/3/2018 2:57 PM (GMT 0)
Hello, I'm new here and would appreciate some reassurance if possible please.

For the last month I've been having what I assume to be a flare of ulcerative proctitis. It started with frequent diarrhoea (not unusual for me), then passing brown slime, then windy mucus with some blood. Huge urgency - I only had minutes to get to the loo. I wasn't able to get medication for the first 3 weeks as I was on holiday. Unfortunately I also took a dose of Immodium (loperamide) on 2 consecutive travel days, which I'm sure made it worse.

My GP didn't examine me, but based on my history prescribed Pentasa Mesalazine suppositories 1 gram per night (this was last Monday). After the first couple of nights I've had no blood, rare show of mucus and less diarrhoea. I was being careful what I ate and resting as I was exhausted.

The last couple of nights has seen a return to explosive diarrhoea with a smudge of blood, and uncomfortable bloating. I suppose I'm just seeking reassurance that I am recovering, but am feeling very low as I haven't dared to leave the house much at all because of the urgency.

I was initially diagnosed with UC in 1988, but had long periods of remissions. In 2000 I was diagnosed with proctitis, but again have been very lucky not to have had many flares and haven't needed any medication. I had a sigmoidscope examination about 3.5 years ago which was clear. My last flare was when my father died 4 years ago, but it didn't last longer than a week. Please can anyone advise?
Posted 8/3/2018 3:42 PM (GMT 0)
1g suppostories is a very small dose. A lot of us use 4g enemas. You should inquire about those. If things still do not improve, you could consider oral meds, or steroid rectal medication. Some of us use supps 2x a day too, that can also be helpful...

I am sorry you're going through this. In reality, you've had UC for quite a long time, and you should be getting regular scopes. A sigmoidposcopy is okay, but you really need to look at the whole colon at this point. You should be getting scoped every year to every other year after 10 years with UC. It sounds like things are still very mild, which is great, but it is smart to monitor.

I doubt the imodium made things too much worse. No reason to beat yourself up feeling like you've caused this. In fact, a lot of UCers take imodium to help calm symptoms.
Posted 8/3/2018 4:24 PM (GMT 0)
Hi...welcome.

If you have diarrhea, you need much much more coverage, and hopeful prevention of spreading, of meducation. Both ends! Oral mesalamine and retention enrmas.

Please call the doc and REQUEST them.

The imodium didn't make it worse.

q
Posted 8/3/2018 5:05 PM (GMT 0)
Thank you both. I will go see the doc next week.
Posted 8/3/2018 5:50 PM (GMT 0)
Please keep us updated. Make a list of questions....hopefully the doc will address them.

q
Posted 8/3/2018 6:09 PM (GMT 0)
Sorry to hear your UC symptoms are acting up again. Standard flare protocol is to get a stool test for possible infectious causes to your symptoms (things like c diff). You've only been on medications since last Monday, healing internally is a very slow process and that is not enough time to notice a sustained difference. Give it 3-4 weeks time for the biggest improvement. For now, expect good days and bad days, with some randomness to it all (frustrating but part of what's normal for us).

If you do not improve then you can ask for multiple suppositories a day, or a mesalamine retention-enema (rowasa/pentasa/salofalk/mesalamine enemas) which are more potent (often 4.0 grams per day). Oral mesalamine/Mesalazine might help as well.
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