Posted 1/14/2019 8:29 AM (GMT -7)
Ditto the above. Yes signs of rectal inflammation. Your flare sounds like it has gotten worse (unless you suddenly got c diff which is possible).
1.) You could ask for a stool test for infectious-causes as no response from 40mgs of pred makes you wonder if there is an infection (which would get worse with more pred).
2.) If it is an exacerbation of your flare then biologics sooner might be the best plan (although you might ask for endoscopy to prove the need if you are unsure what's going on up there).
3.) Also possible to give the 40mgs of pred more time, it might kick in within another week.
Not always clear and simple answers. Some times you run a bunch of labwork (test stool for infections, and get endoscopy) and see where you are at. Just make sure to keep in contaact with your gasteroenteroligist's office, to check in regularly in regards to your symptoms and progress (or lack thereof). Plans can change dynamically for you based on where you are at, and how you're doing with your doctor's assistance.