Q: I am a 54 years old male diagnosed with ulcerative colitis in rectum and sigmoid colon for the last three and a half years. I have to go to toilet 2-3 times a day. Stool is normally formed but soft. Occasionally, there is presence of tiny blood clots in stool. Frequency of blood in stool is one or two days in a week. I also have symptom of flatulence after lunch and sometimes so severe that without going to toilet it becomes difficult to control. Such symptoms never occur after dinner. Now, I am taking Inflacol SR 2(OD), Folired and Entofoam enema. My earlier doctor gave me Balacol 2 x 3 times a day and Mesacol suppository / enema. My improvement is not substantial even after taking Entofoam enema daily once in bed time. I am taking Entofoam for the last 35 days. Can you suggest any alternate medicine / enema? How can ulcerative colitis be treated?

A:I think you have to increase the dose of Mesacol under the supervision of your doctor. I suggest increasing it up to 4 gm a day. Take some in the form of tablets and some in the form of enema. In addition, you may use Entofoam enema as and when required.

If all fails and symptoms become worse then you should take course of Prednisolone (starting with 40 mg daily till the symptoms settle, then reduce by 5 mg per week). All this has to be monitored by the gastroenterologist.

Management of ulcerative colitis can be at times quite tricky. Hence, a gastroenterologist with lots of experience in ulcerative colitis is sometimes called for.