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Diseases & Conditions Ulcerative Colitis
1
Hello everyone,

Looks like the oral and rectal mesalamine may not be keeping things stable anymore. I have hemorrhoids, both internal and external, and my doc thinks that may be the culprit. But I keep having intermittent bleeding, every few days with some mild cramping. No urgency and stool remains fully formed. I go about 1 x per day. At a crossroads about whether to move to immunosuppressants. The other issue is that I am doing a lot of traveling in the fall, away 3-4 months at a time. My doc also suggested that I should consider imuran or Xekjanz to be on the safe side, just in case this is inflammation. Have never been on anything else but 5-asa. Would appreciate any feedback or thoughts. My last sigmoidoscopy found no signs of inflammation. That was in January 2021. So, at a loss as to what to do here. Thanks.
Dx: ulcerative proctitis 2009; dx with left-sided colitis in 2020.
Meds: Apriso, Rowasa
Recent scope: 8/2020 showed increased inflammation (left-side) but currently no symptoms since starting Apriso/Rowasa combo. Sigmoidoscopy in 1/2021 showed no signs of inflammation.
Supp: Vitamins, psyllium husk powder
Other: Eat a balanced diet with limited dairy, sugar and grains, exercise
2
when mesalamine reached the point where it wasn't giving me the results i wanted, i wound up focusing on my diet and lifestyle - i fortunately was close to a point in my life where i had the ability to fight UC more on my terms - through a few pretty good kick-my-butt flares, i found a pretty decent colon place -

just thought i'd throw that out there -

TT
dx'd with pancolitis 12/21/03
current supplements:vit D, vit K2, cal/mag - grain free/paleoish diet that includes 100% grass fed beef, raw goat milk, & local organic free range eggs, lots of all natural well water, exercise, sleep as much as possible & enjoy this great life that God has blessed me with !
3
It sounds like your hemorrhoids are the problem they are bleeding, why not consult with a colo/rectal surgeon. You had a recent scope that was clear so your meds seem to be working, I would be hesitant going up on my medications until I got some help with the hemmies. Just my 2 cents.
Susie
Moderator in Chronic Pain & Psoriasis Forums
4
I agree with Straydog -- get the hemmies taken care. If the problem if just the hemmies, increasing meds isn't going to change anything
62 yo female diagnosed UC 2013. Remission on Entyvio 10/2016-12/2017. Had response to Humira with loading doses in Nov 2018, but then lost response. Current meds: 10 mg/kg /6 weeks Remicade (5 mg 3/2019, 10 mg 8/2019, 6 wks 1/2020, 4 wks 4/2021), Asacol HD 2 Tabs 3x/day, Capozide 1/day (hypertension). Dexilant.
5
Have you tried any Rx foam medication for internal hemmies especially? I'm thinking particularly of Proctofoam HC, which is 1% hydrocortizone + 1% pramoxine, but there are others. Also, 5% lidocaine & 5% pramoxine lotions for external hemmies can now be found in some chain drugstores-- no Rx needed. It seems that your doctor should give you specific info on available hemmie meds because they're causing you needless misery. Surgery should be a last resort! / Old Hat (40+ yrs with left-sided UC; in remission taking Colazal)
6
Thanks all for the replies. I was given some promaxine. I think my doc was somewhat convinced it would help. He indicated that it is not always effective which is why it isn’t covered by insurance. I think I am afraid this isn’t hemmies and may be actually a flare looming. It just seems like too much blood for hemmies but i don’t really know what is normal blood for hemmies. I am trying the meds to see if it makes a difference.

Regarding diet and lifestyle, I have a pretty restricted diet already but I have a pretty demanding job. However, I don’t feel especially stressed by it.
Dx: ulcerative proctitis 2009; dx with left-sided colitis in 2020.
Meds: Apriso, Rowasa
Recent scope: 8/2020 showed increased inflammation (left-side) but currently no symptoms since starting Apriso/Rowasa combo. Sigmoidoscopy in 1/2021 showed no signs of inflammation.
Supp: Vitamins, psyllium husk powder
Other: Eat a balanced diet with limited dairy, sugar and grains, exercise
7
Hemmies can bleed a small amount to filling a toilet bowl full of bright red blood. My husband had internal & external, every time he had a BM the bowl was bright red. He waited too long & had to have surgery. You will be better served to see a colo-rectal dr now & not let them get worse over time.
Susie
Moderator in Chronic Pain & Psoriasis Forums
8
Thanks! Is the only surgical option banding?
9
No, there are other options, depending on how bad they are. You may not need surgery, but seeing a colo-rectal dr is the one to see, they know how to take care of them. My husband was doing OTC for a few years that did nothing, don't let yourself get to that point.
Susie
Moderator in Chronic Pain & Psoriasis Forums