No pain plus moody equals flare?

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Regular Member

Date Joined Dec 2007
Total Posts : 29
   Posted 2/2/2009 10:03 AM (GMT -7)   
Hello all. This may sound silly to you, but it confuses me that I don’t have any, or very very rarely have any pains associated with my Crohns. The reason this has been on my mind lately is that I think I am in a flare. But, I have been thinking I would have pain as a symptom and that would help me feel more confident telling my doctor I am in a flare. A few months ago I mentioned to him I was in a minor flare due to increased D, rare blood, and rare mucus. He put me on Entocort, 2x 3mg twice a day. I seemed to be doing better so he is tapering me off and now I only take 1x 3mg twice a day. But I have noticed increased D, blood, and mucus again. The D and mucus are similar in frequency to before I got Entocort, but the blood seems a little more frequent. I would say 20% of the time maybe. The amount is very small, sometimes only a small area in part of the stool.

I’m sure your thoughts are I should tell my GI, but I’m scared to. One, I don’t want to cry wolf to him if it’s not a flare, going back to the no pain issue. Two, I’m scared of the medicine he may put me on. Again this may sound silly to you people with severe Crohns, but I hate Entocort. It definitely effects my mood and mental state and I feel almost like a different person. I consider this a mild medicine and am scared that the doctor will put me on a stronger medicine and the side effects on my mood, etc, will be even greater.

Thanks for listening. If the blood continues I will tell my GI. I just don’t want to.

Veteran Member

Date Joined Feb 2007
Total Posts : 1010
   Posted 2/2/2009 10:44 AM (GMT -7)   
There are many medications that do not affect mood. Steroids, unfortunately are among those that do.

Pain is not always a significant feature with crohn's -- at least not in the beginning. Much more significant to me is the bleeding and increase in diarrhea. It is a sign of disease activity. Only you and your GI can decide where the balance lies between medicating symptoms and tolerating symptoms, but your GI has to know what's going on with you. Why don't you try to approach it that way. Tell your GI that you think he should know what's been happening, and you don't know whether it is clinically significant or not. Explain that you would like to manage with the least amount of medication that will keep the disease from getting out of control and you don't know whether the symptoms you are having should be a source for concern. Then let him guide you. That's what he has been trained to do.

30+ years living with Crohn's.

Regular Member

Date Joined Dec 2007
Total Posts : 29
   Posted 2/2/2009 11:46 AM (GMT -7)   
Thanks for the reply belleenstein. I think I could be pretty comfortable with the doctor talking about it the way you described.

Veteran Member

Date Joined May 2003
Total Posts : 1671
   Posted 2/2/2009 5:35 PM (GMT -7)   
I relate to that feeling of not wanting to say anything because of what they might prescribe. I suppose if I got bad enough I would be willing to try anything but I usually try to manage my flares myself and only go in when I find it's not working and I get scared. Luckily prednisone has always gotten me back in remission but I hate to take it. The last time I was tapering I got severely depressed and now I feel even more reluctant to take it again.

My flares don't always happen the same way. Sometimes I get significant pain, but other times there's no pain just crampy, more frequent trips to the bathroom. The more I go, the more likely I am to see blood so I'm thinking it's not coming from the colon but more likely irritation from wiping/going too much. I'm currently trying to figure out if I'm in a flareup or just happen to be having more digestive symptoms.

Hope things settle down for you soon.
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