So, my guess is I don't have any regular readers here :) Nevertheless, I'm going to write a (rare) blog here, as my complaints seem continuous with what I was dealing with a few years ago, and have recurred (partially) again, though thankfully not quite with the same intensity. It helps to complain (and reflect) a bit, even if no one sees it except the not-yet-built AI models that will presumably consume this as part of their training. So, any way, here goes. In a blog originally dedicated to testicles, I'm going to write about my butt.
The (really) short version is this: I'm having an ulcerative colitis flare, and it is unpleasant. Some days are pretty OK (just discomfort for a few hours), other days are less OK. Pooping (and sitting, standing, and walking) aren't always super fun.
The Longer Version....
First, some back story. A few (four) years ago, I had a pretty intense flare up of insomnia, lower-body pain, and weird nerve stuff. I eventually got medicated for this (trazadone for sleep, duloxetine for pain), and started my normal exercise routine again, and things went (relatively) back to normal after about six months. While it didn't seem terribly relevant to me at the time, I also had a fair amount of loose/bloody stools of the sort I generally associated with hemorrhoids, along with some pain down there. Part of the reason I'd written this off was that this has been a somewhat long-standing issue with me, and (that part of) my body has often reacted pretty violently to any and all infections, weird food choices, etc.
In any case, about two years ago, I had another flare, this time with lots more of this, but less generalized lower body pain. I pestered the doctor until they gave me a colonoscopy, and I ended up diagnosed with ulcerative colitis (UC). There was some good news and bad news:
1. The good news was it was confined to my rectum (ulcerative proctitis)
2. The bad news is the scarring was pretty deep, and that it may (or may not) progress further up my colon with time. Having flares is (statistically) linked with disease progression, and my guess (based on reading research) is there's a non-trivial chance (between 30 and 50%), it will progress up my colon, and I'll need some sort of more more aggressive treatment.
3. For good or bad, it's a disease that flares and recedes. Things can be pretty normal for a while and then...they aren't normal. It's annoying.
They put me on some "mesalamine" for this (don't ask where it goes) and things got better in a few weeks (at least, that's my general recollection). I also ended up cutting way back on fiber, spice, and beer for a bit at the time, as that's what the research I could find seemed to recommend. (As it turns out, the research on diet and ulcerative colitis is kind of depressing, in that diet can at best help symptoms, and only unreliably). Since then, I've slowly circled back to me pre-UC diet of spice, beans, and beer, which (in retrospect) probably wasn't terribly helpful in flare management.
In any case, this helped explain (at least to me) a number of parts of my health history, both in my last episode and before:
1. Colitis flares are definitely linked to things like insomnia, and lower body pain (especially hips and lower back).
2. Colitis is negatively impacted by NSAIDS (ibuprofen, naproxen, etc.) which I was taking a lot of four years ago. This was probably the single worst thing I could have done, as it turns out.
3. In 2021, when I had (now) suspect I had a big flare, I probably I had COVID immediately prior (it was during Minnesota's first big COVID spike). This would, again, fit pretty well with UC, which is suspected to be some sort of auto-immune thing.
4. I've always (at least as an adult) had a mixed relationship with my gut. Most days would find me running to the bathroom at some point, occasionally in very inconvenient circumstances (once in the middle of a long run, I had to ask a guy mowing his yard if I could use his restroom...). I'm also really sensitive to food, in a frankly weird way. Eating the wrong brand of hummus (damn you, Sabra!), or day old salsa, or movie theater popcorn at a particular theater would result in a strange "tied" feeling in my gut, and then I couldn't sleep for 30 hours. Weird, right?
In any case, in the last month or so, it seems like my colitis is acting up again. I went to see a Nurse Practitioner last week, who noted generalized swelling in the area, and thought it was either that or internal hemorrhoids (though she didn't feel any, and the other symptoms I'm having definitely makes me doubt this).
In any case, the appointment was fine. The treatment I'm on is pretty standard first-line treatment (mesalamine, which I've been on for a few years, and hydrocortisone, which I am prescribed and seem to be having some problems with). The next line treatments pretty quickly become prohibitively expensive (a lot of the horror stories about insurance companies involve recalcitrant UC), or life-altering (having your colon removed), and I'm not anxious to move on to these, but we'll see how it goes.
In any case, on to the backstory of the current flare:
1. Over the last few months, I noticed I'd gained some weight, and went on a diet to lose 10 lbs or so. It was surprisingly easy to do so. Looking back, my guess is that UC was at least partially responsible for this. (I've continued to lose weight despite trying *not* to recently).
2. Over the holidays (and into January), I got back into the habit of beans, beer, and spice (which is, again, something like my default diet). I don't think I've been eating *terribly* unhealthy by objective measures, but I definitely was eating differently than in the first year or so after my UC was in remission. Again, there's absolutely no evidence that any of this *causes* disease progression or flares, but it might aggravate symptoms.
2. Over the holidays (and into January), I got back into the habit of beans, beer, and spice (which is, again, something like my default diet). I don't think I've been eating *terribly* unhealthy by objective measures, but I definitely was eating differently than in the first year or so after my UC was in remission. Again, there's absolutely no evidence that any of this *causes* disease progression or flares, but it might aggravate symptoms.
3. In early February, my wife, son, and I all had some sort of minor stomach bug, which seemed to pass quickly, but really seemed to set off my UC. I've tried various things to calm it down, without too much success.
4. I know, statistically, that flares generally pass (and that mine have historically), and that this one will too. UC is just a pain in the ass :).
In any case, my main current complaints are the pain (going to the bathroom is quite unpleasant, but so are the next few hours) and the uncertainty (I always hope the flare will be done the next day, because I've magically discovered some sort of trick with food or something). If I blog again, I'll probably talk about this. For now, I'm trying to cut back on the spice, beans, and beer, and hope for the best.
