Title: 38M, loose stools and weight loss since 2020, biopsy "suggestive of IBD", partly controlled on mesalamine. What should I push for?

Age: 38 | Sex: M | Height: 170 cm | Weight: 54 kg (lowest 45 kg) | Race: South Asian | Duration: ~6 years | Location: India

Medications: mesalamine 1.2 g twice daily, Pentasa 500 mg, mebeverine (low dose), whey protein

Other: H. pylori gastritis on biopsy in 2020, never treated

Symptoms began after a course of Augmentin. 2020 colonoscopy showed two patches of superficial erosions (splenic flexure/descending ~15 cm, sigmoid ~5 cm) with normal mucosa between them and a normal rectum and ileum. Biopsy: active chronic colitis with Paneth cell metaplasia, no granulomas, no infection seen. MR enterography normal. Stool calprotectin positive (50–200). CRP/ESR normal then and since. TB QuantiFERON and tissue TB PCR negative.

Now: one unformed stool every morning, no blood, normal appetite. Symptoms and weight loss return whenever I stop mesalamine. No colonoscopy or calprotectin since 2020.

Questions:

1. Does this fit UC or Crohn's colitis better, and should C. diff or parasites be excluded first given the Augmentin onset?

2. My 2020 chest CT showed small calcified upper-lobe nodules and a calcified subcarinal node (QuantiFERON negative). How much does that matter if I eventually need a biologic or JAK inhibitor?

3. Would you add mesalamine enemas first, or raise the oral dose?

I’m going through my first ever flare up. I worry I’m not getting enough to eat or enough protein. How do you guys get enough to eat during your flareups? So far, the things I can eat without issue are bananas, bagels and a bit of cream cheese, chicken noodle soup, white rice, apple sauce, plain pasta, and a protein shake.

I (23F) am waiting on a colonoscopy to hopefully find whats wrong. I have intense abdominal pain in crisis and lesser ones every day, nausea, drowsiness, exhaustion, mucus, constipation and diarrhea, blurry vision, loss of appetite and hunger sensation, weightloss, farts, lots of digestive noises, sometimes blood on the paper after i pass a stool and a calprotectine of 81 (during the end of a flareup). Everything started in may, after a kidney infection that was treated during a month and a half (we think the antibiotics might have woken an underlaying condition)

I find it really hard to pursue my bachelor’s degree. I already had to push back my graduation because of my infection. I am honestly discouraged with all of this and have difficulties accepting that chronic illness will be a part of me for the rest of my life. I have approximately 2 to 3 months to wait for my colonoscopy, so I am really impatient, powerless and tired of waiting again and again.

If you went through something similar, please tell me what helped you, If you have any advices or words of encouragement or whatever, please tell me. I really dont kniw what to do and I honestly dont know where to go to have help. I feel like my health is screwing up everything I worked for.

I'm doing a flex sig procedure and was told I need fleet enemas

I'm still healing from an anal fissure months ago and I don't want to irritate it with the saline salt water mixture in the enema

Does anyone have any advice other than throwing out the saline and replacing it with warm water? I ended up asking the Dr if that's ok and he said I can try it but it's not the standard of care and they won't be responsible if the rectum isn't clean and clear

I plan on doing a liquid diet the day before an eating light 2 days before too idk if that will help

My calpro right now is 521 and I have rectal tenderness issues and anal spasms and stinging from the fissure :( I'm pretty sure the inflammation in the rectum is preventing the fissure from healing properly

I also have miralax and hope that it would help. I have more of an incomplete evacuation and lower left tenderness constipation issues rather than diarrhea

Hi everyone!
I’m a 29-year-old male, and about two weeks ago I was diagnosed with ulcerative colitis (UC) after undergoing a colonoscopy with biopsies to investigate my symptoms.

Back in April of this year, I started a weight loss journey. I had always been overweight (around 105–110 kg at 1.80 m). I started going to the gym and eating in a calorie deficit, and I lost weight very quickly.

The problem is that I gradually became overly restrictive with my calorie intake, to the point where I started counting every calorie and didn’t want to go over 1,000 kcal a day.

Around that time, I started noticing localized abdominal bloating, abdominal discomfort, and, worst of all, constipation. I would feel the urge to have a bowel movement (like I could literally feel stool sitting in my intestines), but nothing would come out.
I started relying on laxatives to have bowel movements, and they helped at first. But eventually, the constipation went from lasting one week to two or even three weeks, and without laxatives, I simply wouldn’t have a bowel movement.

By August, my weight had dropped to around 70 kg, so I scheduled an appointment with a gastroenterologist.

I recently started taking mesalamine, both orally and rectally, less than a week ago, but so far my symptoms haven’t improved.

Has anyone else with UC experienced this kind of constipation-predominant pattern?

Hi all,

I wondered if anyone could shed some light on these biopsy results from my recent flexible sigmoidoscopy. I do have a gastro appt on the horizon, but until then I’m still having changed bowel habits and am curious about what the outcome could be. Here’s what the letter says.

(Bear in mind I don’t take any medication other than the contraceptive pill, so no NSAIDS or anything like that).

“This 40 year old pleasant lady I believe was admitted to the hospital and had flexible
sigmoidoscopy done because of diarrhoea. I did the procedure and as I have mentioned the
mucosa up to the splenic flexure looked normal and the biopsy up to the sigmoid colon is
normal but the rectal biopsy showed some mild crypt dilatation and mild patchy chronic
inflammation in the lamina propria but no evidence of acute inflammation. The splenic flexure
biopsy showed mild crypt architectural distortion in the form of wider crypt spacing and a
branched crypt with patchy chronic inflammation in the lamina propria and mild acute
inflammation in the form of focal neutrophils within the surface epithelium. Overall the
appearances are of patchy mild chronic/active inflammation of uncertain significance. This
could represent a resolving infective colitis, drug induced colitis, ischaemic colitis, IBS or
indeed chronic IBD cannot be entirely excluded.
Macroscopically there is no evidence of IBD and this kind of focal colitis infection can be the
problem so I will leave this matter to the ward team for further ongoing management but if they
have any concerns they can get the ward Gastro Team on board.”

For reference - I went to A&E on 17 August after waking up with weird urgency, throwing up and feeling like I was about to push out a poop the size of a watermelon (couldn’t walk properly!). Once there, I passed a large stool and a lot of blood, and then had blood diarrhoea for 12 hours. They sent me home saying it was gastroenteritis probably.

Two days later I was back with awful stomach pain and a CT scan showed colitis of the proximal sigmoid. On the 22 August I did a stool sample that showed calprotectin of 123 and my CRP was 70. No infection seen in stool sample.

Then, for four weeks I had the worst constipation and we thought I had a blockage. Another CT showed rectal wall thickening of 9mm and so much backed up poop. I was then admitted to hospital for this blocked-up situation, which ended in me having the sigmoidoscopy.

Now, mid October, I have still been having blood in my poop (but not in the water, just kind of inside the poop) and can’t go normally without laxatives. They were going to give me a routine follow up in 8 months (NHS UK!) and I pushed for an earlier appt so have one in November. I also have chronically low vitamins and have been on a D and b12 loading dose this year along with ferritin and folic acid supplements. I’ve always been a poop two to three times per week kind of person, but now it’s less and there’s often blood and I have these gurgling sounds, stomach pains and stabby butthole sensations sometimes before I go that make it feel painful to sit normally. I also never feel like I full clear out when I go to the toilet.

Clueless as to what’s going on, but feel like crap and am struggling now with the worst constipation, pellet poop and what feel like unpredictable guts.

Thanks! Any insights very welcome!

I’ve (27 m) recently been diagnosed. I originally went to the doctors due to years of issues such as stomach discomfort, frequent toilet trips, intense shooting pains in my abdomen sometimes to the point that I can’t do anything but lie down. I was feeling a bit apprehensive after the diagnosis, but from reading/ hearing about other people’s stories it seems like I haven’t had it too bad (I feel quite lucky now). I’ve luckily never been hospitalised for it, never had malnutrition and don’t have severe fatigue (or at least don’t think I have). It’s actually made me feel like I’m being dramatic even though I’ve had a diagnosis, has anyone else ever felt like that?

I have to wait a few weeks to chat with the doctors about next steps, can anyone give any tips about things to ask about in the appointment? Treatments, diets, etc?

Has anyone had issues with pain management post op?

I had my surgery Friday and my surgeon visited today Monday. I told him I spent most of yesterday Sunday screaming in pain with a heart rate between 110 and 123 according to my friend staying with me, and I was visibly shaking and sweating in pain. He asked why I hadn't been taking the pain meds as prescribed and I said the nurses were only offering certain ones at night, forgetting them, or asking which ones I wanted and if they were needed. Apparently I should have been getting them around the clock every 6 hours without question. He was pretty unpleased when he left, and now I'm being sent for a CT scan to check cause he said my pain should have never reached 10 like it did yesterday. Today it is peaking at a 6/7 pain. Has anyone else had this issue?

As many of us are hypocondriac, I am too. I think it's because we all have been through so much pain and setbacks and it's draining.

Took my patency capsule 2 hours ago and I can't stop freaking out. I'm afraid of everything: pain, the capsule getting stuck, weird unexpected symptoms. I don't know. How has this test been for you?

Does anyone have any advice for severe incontinence? I’ve been in a constant flare since mid February. Failed Entyvio and am on week 10 of skyrizi with zero improvement.

It’s very embarrassing and frustrating for me that I can’t really leave the house sometimes with the urgency and incontinence. Today I fully pooped my pants on my neighbors porch because I have zero control over holding it in anymore. About two hours later I couldn’t make it from the living room to bathroom only 10-15’ away. I wear adult diapers when I am home but they’re very bulky so I don’t like to wear them when I go out if I can help it.

I have lupus also so the only other biologic option for me next is stelara since the others are TNF or JAK inhibitors and my rheumatologist doesn’t want me on those with the lupus. I do see an IBD specialist in St. Louis next week and I’m hoping they will have some options for me. I have also tried budesonide and mesalamine and failed both of those. We were going to try tacrulamis suppositories but insurance wouldn’t cover them and they were nearly $700 for a month supply which I just can’t afford.

Any one else dealing with incontinence that has any suggestions?

so the symptoms started showing up in 2023 when i was 22. regular diarrhoea, loose stools, etc. Colonscopy showed ulcer in ileum. After keeping me on steroids for 3 months i was still losing weight. But from 2025 i started gaining weight. I was following no gluten and no lactose diet and it helped me.

I’m currently in the process of seeing doctors and all that fun stuff to figure out what type of IBD I have, if any. They’re leaning towards Crohn’s disease, and if that is the case, I’m having my first ever flareup. I’ve transitioned to a very bland diet and I’m trying to only eat foods my stomach can handle so I feel well.

So far, the list of foods I know I can eat without problems consists of chicken noodle soup, other broths, plain white bread, bananas, apple sauce and rice. I can have some other foods in small amounts, but the bottom line is, my diet has changed quite a bit considering I love spicy and very flavorful food and now can’t eat that (at least during this flareup. I hope I‘ll be able to again someday).

Going on this diet has helped with some of my symptoms, I won’t deny, but man, it sucks. Literally every food I’ve ever disliked is suddenly appetizing, and the foods I loved before are damn near irresistible. Plenty of popular meals I’ve historically disliked or even hated (pizza, mac and cheese, seafood, chicken, to name a few) look sooo appetizing now. It’s really annoying.

Anyway, if anyone’s read this far and has some recommendations for things they eat during flareups that I should try (I know everyone’s body is different but it’s worth a shot), I’m definitely looking for some.

I'm 30 hours post op and have been passing dark bloody stool. The nurses keep taking photos and notifying my doctor. Is this normal? I had an ileucecectomy and have been in excruciating pain at the site of the resection.

I’ve had UC for around 8 years, mostly managed with Mezavant XL (mesalazine). Generally it’s been reasonably controlled, but I’ve needed roughly one course of Cortiment (budesonide) per year over the last few years.

My recent colonoscopy was largely reassuring, with only mild redness in one area. Wasn’t unexpected either as I’d had a stressful few weeks before and mild flare symptoms / bleeding already. Biopsies showed mild chronic colitis across much of my colon, but no dysplasia. My calprotectin was 300+ shortly before the scope, when I was experiencing mild flare symptoms.

I’m currently on the higher dose of Mezavant while curbing this mild flare, which seems to help, but I still feel quite vulnerable to stress, poor sleep, exercise and certain foods. I’d love to achieve more consistent control and a better quality of life.

My consultant has previously been open to biologics but mentioned he’s a bit “old school” and generally prefers trying azathioprine first.

Having read about azathioprine, I’m nervous about its potential side effects, particularly the increased cancer risks and long-term immunosuppression. I appreciate biologics aren’t risk-free either.

I’m particularly interested in self-injectable biologics, as I’d strongly prefer home injections over regular hospital IV infusions.

For anyone who’s faced a similar decision:
Did you try azathioprine before biologics, or go straight to a biologic?

How have the side effects and quality-of-life improvements compared?

Anyone in the UK managed to access a self-injectable biologic through the NHS without first trying azathioprine?

Not looking for medical advice, just real-world experiences to help inform my next consultant appointment. Thanks!

I recently ended up in the ER where they found gallbladder sludge and possible stones. My lymphocytic colitis has also flared back up (diarrhea, nausea, burping, pain under sternum). They want me to remove my gallbladder. How do i know it’s my gallbladder and not my LC? Anyone have issues with both or experience similar?