Q: I am a confirmed patient of ulcerative colitis. Initially I benefited from a course of norfloxacin. Then I started steroids orally or enema (Betnesol or entofoam) atleast for once or twice a year as norflox did not give me any relief. I have taken local enema 3 to 4 times and a course of Wysolone starting from 40 mg and going down to 5 mg alternate tapering 5 mg every 5th day. But number of motions go upto 7-8 times a day within 7-10 days of giving up local or oral steroids. What should I do? I am taking 6 (2 tds) Mesacol plus other vitamins. I consulted a doctor who said that I should raise the consumption of mesacol to 4.8 gms. (i.e. 12 tablets a day). For how long should I depend upon steroids? I do not throw blood with stools. Only the frequency of motions is high and consistency of the stool is poorly formed. Urgency is uncontrollable.

A:The treatment of ulcerative colitis is highly specialised and you should be under the care of an expert, a gastroenterologist and not a remote panel of doctors since the treatment is very individualised. Steroids should only be used to control an acute relapse and should not be used as a long-term basis. The best long-term medication is sulphasalazine or mesalamine in proper doses. If these are not effective in preventing relapse, you may need immunosuppressive therapy like Azathioprine. However, this has to be determined on an individual basis. I suggest that you contact a specialist as soon as possible.