Nicotine dose - patch or gum - for ex smoker

Hello everyone
I was diagnosed with uc in July '17. Symptoms appeared in June, 3 months after quitting smoking. I am currently on 3g mesalazine/day. My flares are moderate but really stubborn in duration. Except for the blood in my stool I don't have any major physical symptoms. No pain, no cramping, no diarrhea. But I am experiencing bouts of depressed mood and anxiety. For 6 months I was stupid enough to quit my medication, and gradually these mental issues progressed and I was left wondering what on earth was going on. Since my physical symptoms were not debilitating, my depressed mood was not originating from thoughts about having the illness, and my quality of life was at the best it had ever been. But still my whole way of thinking was turning negative, I was feeling anhedonic and getting rushes of anxiety even when I was not thinking about anything in particular.
There is ongoing research that suggests that chronic inflammation might cause mental problems like depression and anxiety. For me it really feels like that is the case, because while in remission I had never suffered from mental health problems.
Taking up smoking is not an option for me since the potential hazards of smoking by far outweigh the benefit of keeping me in remission, but I have started with 3 pieces of 4mg gum a day. From what I read approx. half is absorbed into the bloodstream. It has been 2 weeks and I haven't seen any results. I think the dose is small and I should probably increase it a bit. I have not tried the nicotine patch but I will consider it if I see no progress with the gum. I don't like the idea of vaping because I am afraid I will relapse into smoking.
Any insights from ex smokers who have tried the patch or / and gum would be much appreciated. Did any of these nicotine sources work for you and at what dose?

I started smoking again after 9 years quit and it threw me into a huge flare. I know I am not the norm though because I got UC as a smoker and my symptoms got better each time I quit. Are you seeing a gastroenterologist? Have you been scoped recently to see if you even have inflammation?

Other possible causes of blood are anal fissures or hemmorhoids. I would assume the same as you if I saw blood, but you have no other symptoms (well, other than anxiety and depression which I have never heard of being linked to IBD inflammation with no symptoms). I personally would want to make sure it was my UC before making myself addicted to nicotine again. You could request a calprotectin stool test to see if you have inflammation. Good luck with whatever you decide to do.

What I've heard over the years is this: If you were a former smoker who quit and then got a UC diagnosis, then there is a chance reintroducing nicotine in some form might help a little bit with your symptoms. Of course, you gotta weigh the downsides of nicotine an addictive substance, and other risks when smoked that are well known and I will not say more about those here. Over the years, people have tried patches, gums, vaping, and cigs with varied results. The majority reintroduced cigs.

In my opinion, you are better off using UC meds, even stronger ones like remicade if needed.

Former smoker (quit at 24), diagnosed with UC after battling GI problems for years in my early 30s.

Had a GI doc that wasn't worth anything for a couple of years and finally went into a major flare that he couldn't or wouldn't touch. Got a new GI guy. In the week before that appointment, my UC went hyper crazy and I started bleeding so hard I couldn't leave the house. By that point I knew about the reintroduction of nicotine theory and was desperate so I went out and bought a pack. And it worked. The bleeding stopped. By no means did it stop the flare but it allowed me to manage the symptoms. Which I did for the next five years.

I am not advocating smoking, but I am telling you it worked for me. During the five years I quit smoking many times when my symptoms were better, and also tried all of the nicotine replacement systems. Patches, gum, lozenges. None of them seemed to do anything for me. I tried vaping a couple of years ago and actually believe it made things worse. Didn't really study it as hard but I ended up with some funky symptoms that went away when I quit vaping.

But smoking always helped me. Pure, simple cigarettes. Nothing else.

Now that I've said that, I will strongly agree with iPoop. The stronger UC meds are a better choice. I quit smoking for the last time at my colectomy surgery and do not miss it a single bit. Smoking sucks.

But there is something there and I honestly wish the medical establishment would get over their aversion to all things smoking to figure out that there might be a key to understanding this disease in those nasty, publicly unpopular little boxes. I challenged my doctor on it one time. In my career, if something offered a clue on how to figure something out I would rip the walls down until I understood it. They seem totally disinterested in it because... cigarettes.