questions for veteran UCers!!!

Hi Damo,

Here's waht I think:

1) i think so. that has been my experience and I've had varying degrees of uc - from proctitis to pancolitis. with pancolitis it was completely liquid.

2) could be. there's a thing called tenesmus which is the feeling you constantly need to poo which comes from irritation in the rectum. often, you'll feel like you have to go but nothing much will happen when you sit down, or you'll just pass gas and/or mucus.

3) i have found that the more extensive my uc is (length of colon affected), the more pain I have. The pain I had with pancolitis was mindblowing. The pain I've had with proctitis has been minimal.

Stay well,
Jane

My answers are based on experience, research and info from my doc.

1) The higher up your inflammation is on the colon, the more looser your stools will be?

Yes, many with UP have constipation as a symptoms.  Constipation is a many times a first sign of the start of inflammation in the rectum .

It does depend on how high one's UC is to start, and if one has been diagnosed with UP initially and then has diarrhea, I will bet "dollars to doughnuts" that the inflammation is spreading higher.

2) If you are producing solid stools but still have to go to bathroom 4+ times a day, does that mean your inflammation is probably just localised in your rectum area i.e. you can't 'store' the stool.

Solid stool while flaring would mean the inflammation is getting controlled even if it extends beyond.  It could also mean you're eating enough foods that encourage stool formation and are absorbing enough of the water, especially if going 4 times a day.  I would deduce if it were me...that inflammation would be limited to the rectum and that I was still flaring, especially if I was eating normally.   If I had urgency, however, it would mean I still have inflammation.  There's urgency that can be held in for a short while and urgency that will be out asap.

3) What's the significance, if any, of never having pain from your UC? Is the lack of pain a positive sign relative to the condition.

It would depend on where the pain is....in the rectum, in the sigmoid, on the right side..etc...during a bm, after a bm, between bms.

Pain can be caused from inflammation or from foods that create too much gas.  Some foods will increase peristalsis.  Sometimes when the colon is inflamed there's spasming.  Add food, not a good combo.  Sometimes those with UC have IBS...both can create unbearable cramping and pain. 

I think the lack of pain is a positive.  I have different pains/cramps when flaring and when not flaring.   A lot depends on what I eat...and there's interesting consistency.  It ends once it's out..so to say.

I have more discomfort during flares when I have just rectal inflammation than when it's been higher.  Two reasons....1)with lower inflammation I have more stomach discomfort. 

2) With higher inflammation I have looser stool, which goes through the inflamed rectum with a bit less discomfort and pain than with formed stool.

 

oh, I read in the ccfc newsletter (many years ago)  than UC isn't painful.  interesting reading while on the toilet and white-knuckling it through a pencil thin poo that feels the size of a watermelon.  Nah, no pain at all.

 

quincy

My thoughts on question 3 - I think the lack of pain (at least if flares are associated with pain for you usually) in my experience is a positive. The site of pain I don't believe is consistant with the site of inflammation. I've been getting pain in all areas of my abdomen - probably most to the centre and right despite a recent scope only showing a proctitis - my gastroenterologist says this is common and is due to a proximal constipation.

Questions 1 - this is very variable - a lot of people with a pan-colitis will have more diarrhoea than those without - however, this is not always the case and sometimes it is not until you have a colonoscopy that you realise that the extent of inflammation is worse than you think - or vice-versa

Question 2 - I agree with you

 

Hi Damo....I don't know if there's a specific medical reason for stomach discomfort and lower rectal inflammation.    The two went together and seemed to fit a pattern that I noticed eventually and when I brought it up to my doctor, he said lower (in the colon/rectum) inflammation brings on different symptoms.  I had less severe discomfort with higher inflammation because diarrhea was easier to deal with than formed stool in an inflamed rectum. 

It's like it all goes backwards....starts at the rectum and continues upward.  Healing seems to work the opposite way.  Most of us don't recognise consistent stomach discomfort and gas with rectal inflammation.  It depends on where they came from initially during flare symptoms.  Constipation or solid stool with cramping and stomach discomfort could just be a blip...but if it's consistent, then it's more than just what one ate or didn't eat the day or so before.

I don't use steroid enemas....I would always suggest and have only used (except once) the 5ASA enemas.  I'm sure they are available in the UK under the name of pentasa or asacol...check your pharmacy or another pharmacy in the area.   Some pharmacies are limited to what their suppliers bring in. 

The 5ASA suppositories aren't really a treatment from my perspective...but do well to supplement enemas, for tapering and maintenance. 

Are you not on any enemas at all?

quincy