Sounds like you're having a flare that's bordering on severe, or is severe.
I would request a second stool test for c-diff, as that test is know for false-negatives, and not responding to to 40mgs of pred for 2-weeks makes it suspicious.
I'd expect a response from 40-mgs of pred within 2-weeks. You can always give it one-more week, depends how much of a hell you're experiencing from this flare and whether you need a quicker relief from it; you know best. You might want to begin thinking of biologic like remicade/humira, as a severe pancolitis might warrant it. You might need IV steroids to pull you back as hospital-inpatient, if you do not respond to the steroids within another week or so. I think you might need to draw up some backup-plans with your doctor.
With really bad rectal inflammation, retaining a mesalamine/rowasa enema is like holding a glowing ember with your bare hands: you can but not for long without great discomfort and difficulty! Often you have to treat with steroids longer before it is possible. Rectal-route steroids are a consideration, but those are often meant for mild to slightly moderate inflammation (with severe inflammation then it might not help).
Moderator Ulcerative Colitis
John, 40, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasaYou never really appreciate what you've got until it's gone. Toilet paper is a good example.
Post Edited (iPoop) : 10/8/2018 8:37:59 AM (GMT-6)