How do I manage ulcerative colitis after a colonoscopy at 29?

Question

Hello doctor,

I am a 29-year-old male who was recently diagnosed with ulcerative colitis after a colonoscopy. For the past few weeks, I have been having frequent loose stools with blood and mucus, along with lower abdominal cramps. Some days I feel extremely tired, and my appetite is also reduced.

Is this level of bleeding common during flare-ups of ulcerative colitis? How long does it usually take for medications like Mesalamine to show improvement? Should I completely avoid spicy foods and dairy during this phase?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Ulcerative colitis commonly presents with bloody, mucus-mixed loose stools, urgency, and lower abdominal cramps, especially during an active flare.

This type of bleeding can happen as a result of irritation in the colon, which makes it fragile. So rectal bleeding can be expected in case of a flare-up, but if the bleeding is very heavy or persists, you need to contact your doctor immediately.

Mesalamine is a first-line anti-inflammatory drug for treating ulcerative colitis. Most individuals start showing signs of improved stooling and reduced bleeding after one to three weeks, though it takes four to six weeks to experience the complete benefits of mesalamine therapy, based on the extent of illness and mode of administration.

It is important to take the medication regularly as prescribed, even if symptoms start improving.

During a flare, diet can influence symptoms, although it does not directly cause inflammation. A low-residue, gentle diet is often better tolerated.

Foods that are spicy, contain caffeine, alcohol, or are very greasy can make symptoms like urgency or cramping worse for some people. Unless one is lactose intolerant (bloated, gassy, or having diarrhea after drinking milk), one doesn’t have to stop all dairy products.

If symptoms persist despite treatment, or if weight loss, fever, or severe fatigue develops, follow-up with your gastroenterologist is important to adjust therapy and monitor disease activity.

I hope this has helped you.

Please feel free to reach out to me again if you have further queries.

Thank you.