terrible flare

Hello I`m a 50 year old male diagnosed with Ulcerative Colitis about 10 years ago. The affected area is limited to the lower part of my colon. I live in Kobe, Japan. The medicine and treatments are for the most part similar to the US. Last October I switched from Asacol to Lialda, 4 tablets in the morning. I was fine until mid-January. I starting having a horrible flare in mid-January.

It has been the worst I`ve ever had. The bleeding hasn`t been a problem. like in previous flares. But the urgency has been horrible and I had at times non-stop bowel movements and discomfort at night a few hours after dinner. I`ve never had problems with urgency before. I can`t stop and at times can`t hold it in. It seems worse when I`m home all day, like now because of the virus.

The cycle is the morning is bad, bathroom 4 or 5 times, afternoon is fine I feel good, after dinner is awful. I`m using steroid suppositories occasionally in the afternoon and canasa supp or enemas before bed.

I drink a few beers at night and one cup of coffee in the morning. The alcohol doesn`t really seem to affect. On fact when I was able to go and meet a friend and drink for a while.. I didnt really think about it and it seemed better.

I know Lialda is supposed to be time released but does anyone else feel the medicine is less effective at night? (I was taking Asacol 2/3 times a day) Is it just a combination and the cold weather and anxiety?

You should ask about a course of Prednisone

My doctor is on a wait and see approach now.. It usually took me a few months to recover from a flare and before I was fine. I`m also not having bloody bowel movements like previous flares. For the most part, I don`t have other symptoms. I work out every day. I eat well and haven`t lost any weight.. I`m about 6`2..190 so not overweight. I don`t have any pain jsut discomfort.

I`ve been trying enemas and suppositories every night hoping it would help over a month or two months.

I really want to avoid oral steroids, if possible. I`m curious about the biologic as I think it`s available in Japan now..

I had a scope about 7 months ago...my colitis is limited in the lower colon (I believe 6 inches but can`t remember exactly) Both suppositories and enemas are Canasa. I like the suppositories because they`re a lot less uncomfortable. I`m using the enemas about 6 nights and the enemas about one night per week not on the same night. I use the steroid suppositories occasionally during the day but they don`t seem to help.

I`m a university teacher in Japan so I`m going to be working at home for a while(all my classes are moving online) ..so don`t come in contact with anyone on most days..

Ironically my Japanese teacher`s husband also has colitis and I found out yesterday he`s using biologics. So it is available in Japan. I`m going to talk to my doctor at my next visit in May.