4M2K....The rectum will be the worst place for inflammation...regardless how high it extends to. Remember...UC starts at the rectum...it will always be inflamed during a flare.
So...rectal meds will help get the inflammation down. The'yre a MUST for UCers.
You're also on a very low dosage of Asacol...it should be upped at least to 6 or 8 daily. They can be taken twice daily..so if you can't fit in more than that, it's helpful to take them times when you won't have a tendency to forget (such as mid day).
You could have the above mentioned of hemorrhoids or a fissure....but with what you're describing..it's typical of flaring. Although...nothing like adding more to an already ailing butt.
*Heather*Status:mini flare June 23* 6asacol daily+ Salofalk (tapered every 4th night)
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~Probiotic 2 (Natural Factors Protec) + 1 (Primadophilus Reuteri) at bedtime
~Natural Factors Multi Digestive Enzymes with supper
~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 !!!