How to manage ulcerative colitis flare-ups in men?

Question

Hello doctor,

I am a 34-year-old man, and over the past six months, I have been experiencing recurrent episodes of diarrhea, sometimes mixed with blood and mucus. I often have abdominal cramping and an urgency to pass stool, especially in the mornings. I also experienced fatigue and mild weight loss of about 8.8 to 11 pounds over the past few months.

My recent laboratory tests showed:

Hemoglobin 10.8 g/dL.
CRP 18 mg/L.
ESR 38 mm/hr.

It suggests inflammation, while liver and kidney function tests are normal. A colonoscopy performed last month showed continuous inflammation in the colon, and a biopsy confirmed features consistent with ulcerative colitis.

I am concerned about managing flare-ups, preventing complications such as strictures or anemia, and controlling symptoms on a long-term basis. I would like guidance on treatment options, including medications such as aminosalicylates, corticosteroids, or biologics, and the potential side effects of these therapies.

In addition, I want advice on dietary modifications, lifestyle adjustments, and monitoring schedules to prevent relapses. I am also worried about the impact of ulcerative colitis on my work and daily life and would like strategies to maintain quality of life while managing the condition.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

UC (ulcerative colitis) typically causes continuous inflammation of the colon starting from the rectum and extending upward. Your symptoms, bloody diarrhea, mucus, urgency, abdominal cramps, anemia, and weight loss, reflect active disease.

Your raised CRP (C-reactive protein) 18 mg/L and ESR (erythrocyte sedimentation rate) 38 mm/hr also indicate inflammation, while mild anemia (Hb 10.8 g/dL) is likely from chronic blood loss.

Investigations that you need to undergo are as follows:

CBC (complete blood count).
LFTs (liver function tests).
RFTs (renal function tests).
Serum electrolytes.
Viral markers.
Colonoscopy.
Ultrasound abdomen and pelvis.

I suggest you follow this management plan:

You need to consult a consultant gastroenterologist.
A consultant psychiatrist.
A consultant psychotherapist.

To maintain remission (preventing relapses):

The treatment depends on the extent and severity of your UC (ulcerative colitis), mild, moderate, or severe, but here is a structured overview.

Medications used in UC are Aminosalicylates (5-ASA drugs):

Examples: Mesalamine (Asacol, Pentasa), Sulfasalazine.
Use: First line for mild to moderate UC.
Induce and maintain remission.
Usually given as oral tablets and rectal suppository or enema for the best effect.
Side effects: Headache, nausea, mild kidney effects (rare), need annual kidney monitoring.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.

How to manage ulcerative colitis flare-ups in men?

Is your ulcerative colitis well-managed?