Hi Supernurse....one thing you need to understand..you don't have to go on pred.
Not all of us bleed with flares...eventually, you can treat them earlier and earlier to avoid the bleeding. Remember, inflammation is a process, the only reason you'll bleed is if the tissues are in a state of severe fragility. Hormones would definitely affect that as would steroid enemas.
It's a fine line of distinction.
I don't understand why you're on both steroid and 5ASA enemas....
Definitely hormone fluctuations will have a huge influence on UC. It did before I had a hysterectomy in '93. I did stop bleeding with flares prior to that because of treating flares earlier and earlier with symptoms....but, this year when I decided to go off the estrogen patch, it was interesting that the bleeding returned with a flare. Shocked the heck out of me...but it did take a few months for my body to be depleated of estrogen. I must admit that the hot flashes/shivers/anxiety was extremely stressful and it took a while for me to figure out it was the lack of estrogen. Then the flare hit and the blood....interesting and humbling.
I have a question regarding what your expectations are for treating your flare.....the rectal meds should help get you back to feeling better if the 5ASA meds work well for you. It could take weeks of nightly use before you notice improvement...I suggest you let them do their thing. Remember that they must be tapered....down to every two nights for at least 2 weeks, then every 3 nights..etc. It's a continuing process, but that way, you'll be able to find a maintenance dosage.
I would suggest you not taper just before period time...
Try to get the threat of having to go on prednisone out of your thinking process. I think it may make you feel desperate to get rid of your symptoms quickly....but the consequences of being on pred can be worse than if you just stuck out using the 5ASA enemas (plus oral) and found a good schedule that can work for you.
It took me years to figure out how to use them effectively. 19 years later...I till use them plus Asacol...I've never had to be on pred.
UC isn't caused by stress....but it definitely has a hand in flares. I don't believe food is a cause. IBS symptoms are difficult to differentiate from UC...but mostly UC symptoms will continue and eventually get worse. Starting the rectal meds early such as when we recognise it's more than just food related or stress related IBS is a good way to prevent flares from getting worse.
Do make sure you eat well-balanced meals. You need proteins to help heal the body and keep blood sugars balanced. Not all foods need to be digested quickly, and you do need to remember to help get the rhythm of peristalsis back to more normal rather than in an irratic spasming fashion. Meds such as antispasmodics will help. I use dicyclomine. With IBS and IBD....gut spasming is the norm for many of us....and stress and some foods will exacerbate that.
Try to find what works for you. Don't be threatened by meds if you haven't yet worked on the basic meds. There is a scheduling process of tapering and increasing that will give you the freedom to deal with flares early and help keep things in check.
Do use antispasmodics....they do help.
Probiotics are great...although not all agree with everyone. I don't use any yogurt sources...waaaay too much discomfort, although, I'll have it on occasion.
Eat to keep your digestive tract exercised.....liquid diets and very low residue foods make the colon lazy. A day or two is OK, but in general, it's a work in progress to find what you can tolerate. Make sure you get enough proteins and the right fats...your body needs them.
OK...enough for now.....I hope you feel better soon.
*Heather*Status: mini flare Dec 28... increased enemas to nightly
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....bromelain 1 - 2x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg; Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!