How to manage worsening ulcerative colitis with pain at 28?

Question

Hello doctor,

I am 28 years old, and my CRP level is 45, while my calprotectin level is 1200, which indicates significant inflammation. I am having bowel movements about 12 times a day, mostly with blood, and I feel extremely dehydrated and dizzy. My recent scope showed diffuse ulceration in the colon, but I do not understand why the Mesalamine is not helping anymore.

What happens if these medications continue to fail? Am I facing the possibility of surgery to remove my colon soon? Please let me know how to manage this horrible pain without worsening the bleeding. I cannot continue living like this; it is just too much to bear.

Please guide me.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query, and I am sorry to hear about your discomfort. Your symptoms and test results indicate a severe flare-up of ulcerative colitis, rather than a mild one.

Mesalamine alone is no longer sufficient because your inflammation is quite severe at the moment. You likely need urgent hospital treatment, which may include IV (intravenous) fluids and IV steroids, such as Hydrocortisone.

If steroids do not lead to improvement, doctors typically consider stronger medications like infliximab, which many patients find helpful. Surgery is not the immediate next step; it is only considered if all medical treatments fail or if complications arise.

Your dizziness and dehydration are serious concerns, so it is important that you seek medical care as soon as possible. For pain relief, avoid non-steroidal anti-inflammatory drugs (like Ibuprofen); safer alternatives include Paracetamol and medications prescribed by your doctor.

I hope you find this information helpful.

Thank you.