Ulcerative Colitis - Abnormal stool test and occult blood came positive
I have been using Ulcerative Colitis medicines for the past 2 years (taking mesalamine 1.2g tablets 4 per day). Early this year I was doing very well and the stool tests came normal. My Doctor reduced the dosage to 2 tablets. Eight months later,I had one flare-up (minor one) and had blood in my stool (a very small amount) for a day. Two weeks later I went for a stool test and blood test. The blood test came mostly normal (except high EOS absolute - 0.6). However, the Stool test shows inflammation (Calprotectin increased to 150 from 49 and Lactoferrin increased from 2 to 22 in 8 months) and also it occult blood test is positive (for all 3 days). The last time I had a colonoscopy was Apr 2022 and do not want to go again as it always aggregates my symptoms. Are these stool results very bad? Will the inflammation reduce if I go back to my prev dosage (1.2 g tablets 4 times a day)? I have a doctor's appointment in 3 weeks but wondering how long I need to be on the highest dosage (which is 4 tablets per day) and do we need to continue a high dosage even during remission?. After the minor flare-up a few weeks back I am doing fine (no symptoms other than not having so much appetite as before). Extremely sorry for the lengthy message. Just wanted to give a full picture. Thank you in advance for your help.
Hello
. We really appreciate you taking the time to reach out. It sounds like with the medication/dose changes that your doctor made you've had some increase in lab results and perhaps even an increase in symptoms (at least briefly). I wish that I could speak more specifically to your case, but unfortunately we are not doctors and so I can't really tell you what increasing back to your previous dose will do. I would image it's possible for the inflammation to reduce again, however it would be best to get your doctor's feedback and advice. Hopefully some of our community members who've decreased their doses and had similar experiences can share with you here as well. I'm sorry that I couldn't be more helpful, but please, if you're comfortable, keep us posted with how you're doing, and what your doctor says. -- Warmly, Christine (Team Member) Thanks Christine for the reply. Really appreciate your help. Yes, I did reach out to my doctor and he increased the dosage of Mesalamine and advised me to repeat the tests in 3 months. I am still having some symptoms but I am better than before. Hopefully, this increase in dosage bring the remission quickly and will keep the remission for a long time. Thank you.
Hi
. Glad it looks like things are improving. Did your doctor explain the different test results and what struck them? I know that the Calprotectin experienced a big jump, but 150 is still considered in the normal range (see: https://www.medicalnewstoday.com/articles/calprotectin-stool-test#:~:text=Calprotectin%20levels%20of%2050%E2%80%93200,may%20indicate%20an%20inflammatory%20condition.). The jump in lactoferrin on the other hand would be considered well above the normal range and can be indicative of a relapse (see: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383158/#:~:text=BA%20A%20fecal%20lactoferrin%20baseline,for%20further%20evaluation%20is%20clear.). I am curious, did your doctor increased the dosage back to four or is trying three? Hope you continue to see improvement and please feel free, if you like, to keep us posted on how you are doing. Best, Richard (Team Member)
Hi Richard - Thank you so much for the response and thanks for sharing the link. It's really helpful. Sorry I did not include unit of measurements in my prev message. my Calprotectin level is 150 ug/g (increased from 49) and labcorp measurements show it is abnormal. The link which you provided shows numbers in ug/mg (maybe that's why it is normal). I need to convert from ug/g to ug/mg. My doctor asked me to try with 3 tablets and repeat tests in 3 months. I also use Supposotory at night (in addition to the 3 tablets). I am feeling ok few days and having diarrhea few days. Bloating is also still there. I started 3 tablets 1 week ago. Hopefully diarrhea and bloating will come to normal soon. Please advise on any home remedies to control Diarrhea for Ulcerative colitis patients. Thank you so much.
Hi
. Thanks for the clarifying information. I found this article which does use ug per gram measurements: http://www.clinlabnavigator.com/calprotectin.html#:~:text=A%20fecal%20calprotectin%20result%20less,with%20an%20inflammatory%20GI%20disease.
Concerning complimentary and alternative therapies, our editorial team wrote this article on the topic, with links to more specifics: https://inflammatoryboweldisease.net/treatment/complementary-and-alternative-therapies. As with any addition to a treatment regimen, it is important to discuss anything you decide to try with your doctor to make sure it does not conflict with any existing treatment. Hoping you can get the diarrhea under control soon. Best, Richard (Team Member)
Thanks a lot Richard for the details. My Diarrhea controlled in a day but bleeding (with pus) is still coming every day. Not much. Very small amount but seeing small blood with pus every day. Bloting also reduced compared to last week. Hopefully bleeding will also stop soon. I did review alternative therapies, I have been using Turmeric and Probiotic supplements and it was helping. Any inputs on how much time flare-up lasts?
I'm so glad to hear that you're seeing some lessening of your symptoms. Unfortunately, we can't speak to the time length of flare-ups as it really varies person to person (and even flare-up to flare-up). Please, if you're comfortable, continue to keep us posted with how you're doing, and I'm crossing my fingers that you get some relief from this flare soon. -- Warmly, Christine (Team Member)
