Next level drugs

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.

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.

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)

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.

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.