Would greatly appreciate some guidance! CC: ulcerative colitis flare in a 32-yr-old F. She was diagnosed with UC 3 years ago. In February she had a flare-up with very frequent, urgent and painful BMs consisting of mucus and blood. Started 1 month of steroids in March and had immediate relief. She simultaneously stopped oral contraceptives and hasn’t had a period since February. UC sx returned 3 weeks after completing steroids, which was when she came in. When I first met her a month ago, her pulse showed what I read as a shaoyang flare. I put her on XCHT -RS/DZ + EJ + BS18. Both mucus and blood greatly reduced, and she stopped having blood-only BMs, but frequency of BMs remained the same. Nausea & post-nasal drip improved; sleep & anxiety slightly improved; and she had less nightsweats. However, she’s having more abdominal cramping, especially at night and in the morning. Then, two weeks ago I switched her to THT + YYFZBJC. Pulse: L1 deep slippery, Dong 1/2, L2 deep thin wiry slippery, L3 deep rapid wiry; R1 deep rapid, R2 upper level slippery thin, R3 deep rapid tight. I’ll be seeing her on Friday, but when we checked in, she doesn’t seem to be doing as well as I’d like to see her be. She’s having a mix of diarrhea and loosely formed stool now, still 5-6x/day and 2-3x/night. There’s still a small amount of blood, but almost no mucus. Abdominal cramping is more frequent and more severe. Sometimes it resolves with BM and sometimes not. Cramping is waking her up at night. Abdomen feels distended and hard, and she’s having more night-sweats. On the bright side, she’s having some pink vaginal discharge, so we think she might be getting her period back.
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