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Well this is a new symptom for me...thoughts anyone?

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Ulcerative Colitis
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Posted 1/15/2010 4:18 PM (GMT 0)
Hi all:

Ok, so this is what's going on with me now.  Still on the Rowasa nightly and Asacol 9 a day.  I'm having an every 3rd day nightmare.  For about the past week or week and a half this is what's going on:

Day one:  I'll be perfectly fine.  I'll go in the am to expel the enema remains...very little stool, just mushy gray stuff...I assumed the enema.  Then I feel great the rest of the day.  Maybe a little gas but nothing that's a bother.  No blood.

Day 2:  Same.

Day 3:  It's like all the stool has waited and is wanting to come out all at once.  I'll have the urge to go and that'll be ok...enema comes out plus some stool, fine.  The stool is not D but not firmly formed...it's soft but does have shape. And it's ALOT.  Maybe a little bright red blood at the end, it is getting to be less and less when this happens.  Then I"ll have terrible stomach pain and feel like I have to go again.  So I do and it is like involuntary straining and it hurts...yikes!  Then that will go away and I'll try to go about my day then it'll happen again.  Sometimes there might be a little rust colored liquid that comes out...not much but some.  This goes on for about 3 hours then I'm fine for 3 days and we do this again.

I have no trouble holding the enemas, I keep them in all night. 

Any idea what this means or what I should do?  The blood is decreasing and the pain is not quite as bad today (this is a day 3 day).  Could this be part of the constipation healing process I've heard about?

Help!  Thanks :)

Posted 1/15/2010 4:20 PM (GMT 0)
It could be...maybe give your doc a call and see if you perhaps need to up your asacol a bit????
Posted 1/15/2010 4:32 PM (GMT 0)
Hey that sounds like my whole 17 year history with Uc! :) In fact, I still have that issue and I am back in remission. I go a little bit day one, same with day two and then day three - bam, here it all comes! I don't know why that is to tell the truth and I've often wondered myself.
Posted 1/15/2010 5:19 PM (GMT 0)
I have a similar experience too! Actually I tend to "bottom out", as I refer to it, particularly at the start of a flare. I have been tapering prednisone and the day after Christmas I went about 10 times in a 3 hour period, looser and looser each time I go. Then I may not go for several days (nothing left). Typically just a small amount. Needless to say my prednisone is back to a higher dose and I have just started, last night, mesalamine enemas (generic). It sounds like if the blood is lessening along with the pain that things may be generally moving towards improvement. Keep us posted...

49 Female
Posted 1/15/2010 5:58 PM (GMT 0)
Im the same way. Day 1 & 2, i feel the urge to go several times, but not much comes out (it looks like a little teaspoon full of dirt). when day 3 comes, it's like the flood gates open. it's usually pretty urgent, and the pain is like an involuntary dry-heave, but from the other end. it reeks!
Posted 1/15/2010 7:13 PM (GMT 0)
Hey Fruitgirl, so I just upped to 9 per day (on my own, I didn't call the doc, as he had mentioned it at a previous visit).  And I don't know if this is possible, but I feel that my colon is doing better...I feel that it's more the rectum that's the problem.  But maybe I'm just wishing...

Sherry...is there anything to be done to help the pain/spasms?  I mean, I'd be in trouble if I HAD to be somewhere on these days...and I have 3 little kids who have to go to school, etc.

beeswax...10 times in 3 hours?  yikes! I'm going about 5 times in the 3 hours..then...done...nothing...back to 'normal'

FamilyMan...involuntary dry heave from the other end...EXACTLY!  Well put!  And on my days 1 and 2 I don't even have the urge to go...I'd believe I was in remission...but then day 3 comes along and WHAMMO!

Anyone else have any suggestions? 

Posted 1/15/2010 7:19 PM (GMT 0)
If you really think it's rectal, maybe ask your doctor about a canasa (mesalamine) suppository...I've heard they're actually better for rectal inflammation than enemas, because the enemas can "skip over" (or something?) the rectum, but the suppository sits right there. You could use it after your morning BM(s) are done, and still use the rowasa at night.

There's also a medication for the spasms; I think it's called bentyl???
Posted 1/15/2010 7:20 PM (GMT 0)
I don't (have any suggestions!)- I'm the same way- going along great for 1-3 days, then day 4 it's like an explosion, over &over, pain, etc. My theory is that my colon has basically forgotten what "normal" peristalsis is (or it's too ulcerated to experience normal peristalsis!), so my colon is like a giant holding tank. It empties out, then gets filled up again. When it's reached it's limits, boom! My diet doesn't alter much, nothing changes with my meds, etc. On days that I have to be somewhere, I pray I make it! Or I use my DIY port-a-potty. I wish I could give you more info, but looks like you are definitely NOT the only one going thru this!

Posted 1/15/2010 7:27 PM (GMT 0)
Fruitgirl...I had actually thought about using the suppository in the morning, enema at night.  They are easy to use in the morning?  Won't give me the urge or leak out?

Eva Lou...yeah, I now see that this is more normal than I thought.  And yes, that's it exactly...the colon is a holding tank...instead of letting it out as it moves down it holds it until it's full...great day! 

Posted 1/15/2010 7:36 PM (GMT 0)
I remember going through a period of time the first and second year where I was so frustrated with my bms and the constipation type symptoms. It was most difficult to deal with, but I can't say that I paid attention to the every third day aspect...interesting.

Maybe you could ask the doc to prescribe you an antispasmodic...I use dicyclomine, but would only suggest you start with 10mg and take it about an hour before bedtime and during the day if you really need it. If the colon is more "relaxed" it might not spasm as much during the third day bms.

The fact that it's not diarrhea is a good thing.

Yes, it could be that you have still extreme inflammation low in the rectum and it takes a long while for your colon to be working to produce a bulk of stook to be expelled...but since it takes more work to expel stool, your butt reacts because it's inflamed and is working hard to get rid of everything it can as quickly as possible.

How much metamucil are you taking?

Are you eating regularly throughout the day?

I would continue as you are with the enemas....maybe ask the doc for suppositories to use during the day to help heal what it can since you're not having more bms throughout the day.

I say all is going well....you're getting a lesson in the slow healing process....but one thing is that you'll recognise early flare symptoms quickly since it'll be the reverse (but probably without the blood).

I commend your consistency and patience with the meds and the healing process. I know my symptoms aren't the be all or end all, but with my flares being very mild, I'm on nightly meds for a month for sure before I consider tapering.

You're coming out of a bad flare...expect it to take time.

Again....hang tough!
quincy
Posted 1/15/2010 8:02 PM (GMT 0)
I use supps (Salofalk), up to three times daily when I am in a bad flare.  They are easy to retain for the most part. The only thing that I don't like about using them during the day is that I tend to get very gassy with them (more than usual) and if I do pass the gas, there is wax and some meds in it.  It can stain clothing.  But all in all, very easy to use and minor inconvenience compared to what we can go through on a daily basis.  Sometimes feel the urge to go to the bathroom with them but usually it decreases that feeling, for me anyways.  When I am doing well, I put one in at bedtime and am able to keep it in for up to 8 hours with no problems. 

Good luck.

Posted 1/15/2010 8:08 PM (GMT 0)
the other option is to use hydrocortisone suppositories during the day. Maybe they won't be as gassy....

I've used proctocedyl suppositories on occasion during the day when I'm flaring....but usually it's because I have hemmies as well. Helps.

q
Posted 1/15/2010 9:02 PM (GMT 0)
I've never used suppositories, so I can't help you on that one...sorry!
Posted 1/16/2010 2:12 AM (GMT 0)
Quincy,

Slow process indeed!  I so wish I hadn't taper so quickly,I was doing so well :(

I'm taking 1 Metamucil wafer a day, getting ready to go back to 2. 

I drink OJ in the morning, water during the day and a cola for dinner.

I do eat 3 times a day, less when I'm feeling bad but I do eat.

The actual BMs are not D, but sometimes I have like a liquid a couple times after..I think it;s just from irritation.

I'm trying to hang in there with the 5-ASAs.  I will give this another week and then see where I am.  I'll call my Gi for the suppository then if there's no improvement.

Thanks!!

Posted 1/16/2010 1:32 PM (GMT 0)
to be honest, I don't think this pattern you're experiencing is any sign of an impending flare, or the opposite, a sign of healing. It is what it is. I've been living the pattern for the past 2 years now, with basically zero change in my UC. I'd be surprised to hear if any rectal meds/supps do anything regarding this particular "symptom". If you choose to use anything, please let us know if anything changes! I've tried nearly everything to regulate myself, make each day a little more equal re. bm's... no go, it's pretty much the on-again/off-again syndrome. Which I've been able to deal with, much as one can!
Posted 1/16/2010 3:49 PM (GMT 0)
     Sounds like me too and I am on Remicade!  I attribute it to my diet though. I have been a bad girl lately.  I think I am in remission because I have felt so good after my first infusion of Remicade but my system is still in control.  The bleeding has stopped though.  I used to bleed all the time, bright red blood.  That stopped right after my first infusion.  However my bowels work the same way as yours.....day 1..sometimes no poop at all, others times maybe one normal poop....day 2.. same as day 1.  Then day 3...all Hell breaks loose...poopathon.

     Try the cort suppositories.  They work wonders for my hemorrhoids too.

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