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Blood in stool

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Ulcerative Colitis
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RyanC
Regular Member
Joined : Jul 2017
Posts : 100
Posted 2/21/2021 2:07 PM (GMT -6)
So I stayed off my meds for 6-8 months thinking UC would go away, which it did for a while. Of course it came back, now I’ve done 2 Entyvio infusions but I’m constantly seeing blood in my stool, sometimes it looks like streaks in the actual stool but recently it’s turned it to just chunks of blood. Probably best described as blood clots. I’m was going 1-2 times a day now it’s 4-5 but with blood. We tried 20mg prednisone taper but it didn’t help. I have Entyvio infusion Monday morning. What’s going on?
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quincy
Elite Member
Joined : May 2003
Posts : 32633
Posted 2/21/2021 10:36 PM (GMT -6)
Get on rectal meds?
Are mesalamine OK?...if not, try steroid.
q
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RyanC
Regular Member
Joined : Jul 2017
Posts : 100
Posted 2/21/2021 11:49 PM (GMT -6)
I’m allergic to mesalamine. Pred didn’t help. Maybe try endocort? My doctor and I have discussed that but haven’t tried it yet.
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 1592
Posted 2/22/2021 5:16 AM (GMT -6)
When you were on Pred did you start at 20mg and then taper? If so, I have never heard of anyone getting relief when starting at that low of a dose. The usual pred dosage for a UC flare is 40 mg for 2 weeks and then taper 5 mg/week. My last flare I had to go up to 60mg to get relief.

Entyvio can take a while to work so you have to be patient. Also, your sig says you started Entyvio in April. You should have had a lot more than 2 infusions if that was when you started. When did you actually start Entyvio? There are 3 loading doses so if you only have had 2 you still have another loading dose.
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CCinPA
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Joined : Dec 2014
Posts : 1592
Posted 2/22/2021 5:18 AM (GMT -6)
P.S. Blood was always the last thing to go away when I am in a flare.
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quincy
Elite Member
Joined : May 2003
Posts : 32633
Posted 2/22/2021 9:01 AM (GMT -6)
I disagree about the blood....the inflammation doesn't spontaneously disappear at that point.
q
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CCinPA
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Joined : Dec 2014
Posts : 1592
Posted 2/23/2021 11:58 AM (GMT -6)
I guess I should have said that blood was always the last symptom to go away for me when in a flare. While there may still be inflammation, without having any actual symptoms my life returns to normal.

You can agree or disagree, but I know what my body does.
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quincy
Elite Member
Joined : May 2003
Posts : 32633
Posted 2/23/2021 12:28 PM (GMT -6)
But you are still flaring...maybe visual symptom, but I would assume you still have some symptoms of flaring and know treatment should continue?

My point...that statement would be confusing in its meaning, and the repeated adage just ads to an untruth of facts regarding the process of a flare.

q
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poopydoop
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Joined : Dec 2018
Posts : 998
Posted 2/23/2021 12:33 PM (GMT -6)
But having symptoms and being in a flare are not necessarily coincident - hence the importance of fcp tests - so I can fully believe some people will have blood as their last symptom.
One doctor once told me 90% of people "in remission" will still show microscopic inflammation on a biopsy, even if the colon looks healed visually.
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quincy
Elite Member
Joined : May 2003
Posts : 32633
Posted 2/23/2021 12:52 PM (GMT -6)
OK...I've never had a FCP test, and from what I read and as per my GI, mild rectal inflammation isnt really registered on that test.
Ive not bled in at least 15 years with a flare, but I do have symptoms that register that I am starting to flaring, albeit probably passed off by others as not. The clincher for me is the rectal spasming during a bm, and the process is pretty much the same.

So...my point is that if you need to wait for the bleeding to indicate it is for sure a flare, the process to get there is still inflammation. It will heal the opposite process. Cessation of bleeding does not indicate the flare is over.

I, personally, have learned to not wait. In saying all of the above, there are some who do not have symptoms that match the amount of inflammation on both sides of the coin. Maybe those are who need to be more dependent on the FCP.

q
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 1592
Posted 2/23/2021 1:10 PM (GMT -6)
When I say that blood is the last symptom to go away I mean just that.... it's the last "symptom". BMs are fully formed with normal frequency, no urgency etc. The blood lingers for a while and then is finally gone.

We're all different and our flares are different.
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 998
Posted 2/23/2021 2:07 PM (GMT -6)
I've found FCP really sensitive to my flares- well because I'm a nerd i made a chart of fcp through time versus number of BMs and they tracked each other. That being said, it took me years to figure out that my first/last symptom is abdominal pain, mostly because it took 4 years to have my first full remission; before that I assumed that daily pain was just part of having colitis....
Mind you, I also don't go sticking my head down the toilet after every BM so it's possible that there was blood and i didn't see it...
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RyanC
Regular Member
Joined : Jul 2017
Posts : 100
Posted 2/25/2021 8:38 AM (GMT -6)
Had my GI appointment yesterday. Doctor wants to do Full labs, also another colonoscopy to make sure my UC has not progressed any further. Also, wrote a prescription for Flagyl just in case there’s is some bacterial infection he wanted to rule out. I honestly think 40mg of pred will solve the issues because it always does. Also, he wants to do Entyvio every 6 weeks instead of 8 but insurance sometimes will not approve that. Currently still have blood every time and just sensation to go but not a lot actually going. Mainly just small amounts of blood. Not cramping or in pain just very annoying mainly.
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TroubledTurds
Veteran Member
Joined : Jan 2004
Posts : 8607
Posted 2/25/2021 11:55 AM (GMT -6)
not sure i'd go along with 'just in case' flagyl - but that's just me -

maybe try a cortenema or 2 ?



TT
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RyanC
Regular Member
Joined : Jul 2017
Posts : 100
Posted 3/4/2021 8:03 AM (GMT -6)
Had colonoscopy done yesterday. They found 25cm of inflammation in my colon. Which is causing all the blood and clots. Doctor insisted on flagy and mesalamine enema. If it progresses start high dose of prednisone. Do the mesalamine enemas work better or suppository’s?
My problem is I’m trying to work and I’m using the bathroom 8-10 times a day and I don’t have an office job. I work physical work outside and the frequent bathroom breaks are taking a toll on me. I feel very fatigued. This has been going on for weeks. Feel like pred is my best option for quick results. ??
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quincy
Elite Member
Joined : May 2003
Posts : 32633
Posted 3/4/2021 12:44 PM (GMT -6)
How are you on mesalamine if you're allergic to it?

What dosage of enemas?

q
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RyanC
Regular Member
Joined : Jul 2017
Posts : 100
Posted 3/4/2021 1:58 PM (GMT -6)
Oral mesalamine only, it’s weird.
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momto2boys
Veteran Member
Joined : Jun 2013
Posts : 2380
Posted 3/4/2021 5:35 PM (GMT -6)
I would use the enemas for sure, they will reach all of your inflammation if it is up to 25 cm. Pred will work, and likely quickly, but the side effects are brutal. You could do both or try something like cortenema, which is a steroid and works much faster than rowasa and skip the pred. The side effects are much less systemic than prednisone.
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quincy
Elite Member
Joined : May 2003
Posts : 32633
Posted 3/4/2021 11:53 PM (GMT -6)
Ryan...you mentioned mesalamine enema with flagyl.

q
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