Generally a flare-up is recognised as a return of the same symptoms experienced during previous flare-ups, although new signs and symptoms can also appear. Sometimes there is no distinguishable return of symptoms, but rather a continuation of symptoms. This can happen following treatment for a flare-up and as the treatment is reduced or withdrawn, symptoms appear to have only slightly improved or disappear initially and then re-appear soon after. This usually indicates that the inflammation hasn’t completely settled and so without specialist follow-up and further treatment, the inflammation and accompanying symptoms persist, although they may not be as severe. However for a small number of people, they are unable to get into complete remission and so they continue to have lingering symptoms, which are usually mild, yet very annoying. As a rough guide, having to go to the toilet 2 to 5 times a day (over 24 hours) is considered mild disease activity, whereas 5 to 10 times indicates a moderate attack, and 10 and above is severe. Bowel motions that are semi-formed, with 5 on the Bristol scale being soft blobs passed easily and 6 being fluffy pieces with ragged edges or mushy, can still be within the normal range for some people. However going to the toilet up to 10 or more times a day is reason enough to see your gastroenterologist for further review, even in the absence of other signs and symptoms. There could be other reasons for having to go to the toilet so frequently. Any dietary changes, if needed, should only be made after consulting with the gastroenterologist.
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