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Urgency - how to deal?

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Posted 4/14/2011 10:10 PM (GMT 0)
I have extreme urgency right now, and have for months.. which is making me crazy. I feel horrible whenever I'm in a car, or anywhere I don't know (what if I don't find a bathroom in time? what if it's busy?) and that means I hardly do anything anymore.. I wouldn't be surprised if I become depressed soon.

Anyway, my thing is, I have noticed that since my urgency gets worse when I'm about to leave the house, when I am between places (i.e. out walking or in a car), or when the only bathroom in my apartment is in use, obviously, there is a strong mental component here. I have been mildly successful in controlling my mind in these circumstances in the past, I just have to concentrate and tell myself I don't really have to go, it's just the stress, I will be near a bathroom in 5 minutes, and so on.

So I'm curious as to what you guys do, whether anyone does this too? And if anyone has any tips?



Btw I saw a post earlier in which a lot of people said they went to the bathroom more often when they had little to do and easy access to one, but less often when they're busy. I have the exact opposite problem! confused
Posted 4/14/2011 10:33 PM (GMT 0)
Urgency is because of inflammation. Reduce inflammation, reduce urgency.
My tip is : mesalamine enema (Rowasa or generic) as the most basic thing you can do.
It took more than that to get my urgency gone but it will be a good start.

I have tried mental techniques including hypnotism but ultimately it is a physical problem.
Yes, stress can cause more urgency. Less stress is good for everyone's body and colon.
Posted 4/14/2011 10:36 PM (GMT 0)
runawaybride3:

I have had really bad urgency with my uc in the past.  Please keep in mind that having urgency is a sign that your rectum is inflammed.  What did your last colonoscopy show?  What meds are you on?  Are you on any rectal meds?  I felt just like you in the past, always worried with a huge mental component to boot.  For years I didn't go in other people's cars for fear of soiling myself.  Now that I have my uc undercontrol with Imuran and canasa I no longer have any issues and go wherever I want with no problems.

MyUC

Posted 4/14/2011 11:51 PM (GMT 0)
I have all the same fears and hate this urgency. I was just out walking my dog and as soon as I get so far from home it hits me. I just barely made it home. I am so tired of walking two blocks up and two blocks over but I am afraid to go far. I am using every rectal med under the sun and not much improvement. I hate this!!!
Posted 4/15/2011 12:11 AM (GMT 0)
I hate urgency too! It's the worst, that and frequency. When I say frequency I mean the kind where every time you sit down you have to get up again to go. That paired with urgency is unbearable. I agree with imagardener, you need to heal the inflammation to reduce the urgency. Are you having frequency and urgency or just urgency? What medications are you using?
Posted 4/15/2011 12:30 AM (GMT 0)
I never thought of it but I have the frequency too. Ugh!!
Posted 4/15/2011 1:32 AM (GMT 0)
Now I'm on Imuran and Lialda, and recently started taking Colestipol (cholesterol medication with constipation side effects, that haven't had any effect). I've been flaring since January, generally flare 2-3x a year and the only thing that works (-ish) are steroids, but as soon as I stopped taking them the flare resumed and hasn't gone away.

I have tried Asacol, Pentasta and some others I'm probably forgetting, but nothing had any effect. Have been taking Imuran for a few years now and I think it prolongs my remissions, and have been taking Lialda since this fall and I think it worked (haven't been as good as I was this fall since I was diagnosed 10 years ago!).

But now I'm desperate and have requested Remicade. Will hopefully be starting soon.
Posted 4/15/2011 6:40 AM (GMT 0)
wow...no mention of rectal meds on that list of possibilities. If you can take the Lialda, ask the doc for the Rowasa.

q
Posted 4/15/2011 8:52 AM (GMT 0)
I would wear overnight, extra long pads. It's one of the advantages of being a woman.

I had two accidents. I was wearing a pad both times. The pad caught all of it the first time and most of it the second time.
Posted 4/15/2011 9:26 AM (GMT 0)
I think urgency is 1 of the biggest factors of UC effecting lives - when it's bad, there's virtually no time to find a toilet so it's natural to start staying at home more often. The trouble is, you can't recreate this panic at home e.g. you might go to the toilet before you go out because you start to feel nervous, but the stress of being out where there are no toilets is something else.

I found being in a queue or in a traffic jam worst - the type of situation where you have limited options. However, I also found that a lot of this was in my mind. More often than not, I'd had so many BMs by the time I went out that I didn't need to go to toilet, I just thought I did.

A few things that might help are breathing/relaxation exercises - visualising yourself in these situations etc. this takes time and is something you have to keep doing. Also, go out to places that you know where the toilets are - this way you're getting out, but in a more relaxed state which is good practice and also, helps the colon as it's not being over worked.

Finally, over time, after eating the same bland diet, I started to get a cycle with my BMs - this was good for timing trips out.

Good luck
Posted 4/15/2011 4:42 PM (GMT 0)
I have frequency (35 + a day) and urgency. I have to take an imodium when I leave the house.
Posted 4/15/2011 8:08 PM (GMT 0)
hey runwaybride.....i like you, is new to this ive had some very close calls....after dealing with urgency for over a year. ...i usually leave the house with a extra change of clothes and wet wipes just incase...i was going between 15 and 20 times a day. my doc gave me lomotil to curb the urges while at work...good luck
Posted 4/15/2011 8:38 PM (GMT 0)
Thanks all.. Didn't know about Lomotil, wonder why my doctor hasn't recommended it yet, given how much I've complained! And I'll ask about Rowasa too. I asked him for Remicade (never tried it) because I'm just so desperate, but maybe I should try the other stuff first.

It's good to know I'm not the only one.
Posted 4/15/2011 9:57 PM (GMT 0)

Yea...nothing like gettign caught between bathrooms!

I use Tena underwear. It gives me peace fo mind. The only thing is it's best to be standing if your bowel let loose this way it fall nicely in the middle where it can be retained until you get to the bathroom.  Oh...don't sit down until after you change!

When I'm in my car I always get a cramping warning. I used meditation to get my mind off it and been lucky so far.  Meditation consiste of low deep breathe down to your diafram. Either concentrate on yuor breath at teh nostral area or the rising and fall of your chest and do it VERY slowly. Should be able to count to 8.  There are also bed pad you can get to protect your car seat. Alway have an extra pair of underwear, pant and wipes in the car too.

I'm also on Lomotil, but still averaging 9-13 trips in a 24 hour period.

Posted 4/15/2011 10:30 PM (GMT 0)

Peace&Harmony said...
The only thing is it's best to be standing if your bowel let loose this way it fall nicely in the middle where it can be retained until you get to the bathroom.

Gross. But very true. Brought back memories. turn
Posted 4/16/2011 1:04 PM (GMT 0)
runawaybride3 i feel the same. I am PERFECTLY fine but once i realize there aren't any bathrooms my stomach has more tendency to say hello to me. I think there is most certainly a mental aspect. There have been times where i refused myself to going to the bathroom and see if it goes away and sometimes it does.
Posted 4/16/2011 3:28 PM (GMT 0)
I agree with the dietary cycle routine that wavey mentioned. I've found that sticking to a consistent pattern in diet and not eating after, say, 7:00 PM helps in terms of getting all the stools out in the morning. Although this may be a little difficult, try to slowly weed out the foods, if any, that are causing some of the urgency and symptoms. For me, there are always certain kinds of foods (whole grains, certain fruits/veggies, and anything with roughage) which will linger in my colon for a while and cause pain along with urgency. So sticking to a regular, bland, dietary routine is very important in getting to remission.

There is a mental aspect, but as gardner mentioned, urgency is a physical problem. For dealing with the actual pain, all studies point to meditation techniques for pain management.
Posted 4/16/2011 4:01 PM (GMT 0)
Runawaybride3,

I agree with getting some LOMOTIL I always have it on me flaring or in remission.  It is the one medication that has stopped the mad dashes to the washroom and giving me the confidence to sit in cars with others, get out with three kids and do things and just be normal.  I only need to take I in the morning after my bM"s and I'm great for the rest of the day. No worries about the next washroom and if I'll find one.

Definately start on the rectal meds at night and if you can use cortifoam its a good one to use during the day for the inflammation.

Do you take metamucil to bulk up your stool?  Probiotics ??

Posted 4/16/2011 4:07 PM (GMT 0)
I had urgency issues for years ( I got UC at age 15 and I am now 65). I am mostly in remission these days. But in my 20s it was a constant issue and fear, especially since I was a classroom teacher. I used Imodium a lot. Though I RARELY use it now, I always have it with me.

For me, now, urgency is a non -issue. I take probiotics and I believe that has helped me a lot. I use VSL#3.
Posted 4/17/2011 4:13 PM (GMT 0)
I take probiotics, but I don't think they have any effect. I take them anyway because I know they're good for me, even if my absorption is minimal. I have taken Metamucil in the past but I never found it to have any effect, and in fact it increased cramping, so now I just try to stay away from fiber..
Posted 4/17/2011 5:25 PM (GMT 0)
I have terrible urges constantly and i believe i keep flare ups. I am on Asacol 800 mg a day. I did try steriods such as prednisone for a month but didnt help me. Now it is just the asacol. I complained to the Dr. that i wanted to try something for the urges. He prescribed me dicyclomine (substitute for Bentyl) I have only taken it for 3 days, i thought it helped but then again it seemed it didnt it was on and off. Maybe i need to stay on it a week or more but however it has alot of side effects i was concerned with.
The urges are the very worse for me in the mornings for the 1st 2 to 3 hours. I go constantly and then my rectum is sore and hurting. Usually it is nothing much happening when I go sometimes alittle blood or gas.
I have been reading people were suggesting Rowasa i will ask my Dr. about this. I think I need something to hit the rectum head on (sorry for the visual with words if that happened lol)
Most of the time i have to get relief by hot baths or heating pads.
Who has tried Remicade the injections?
I mainly feel better when my stomach is empty I just wish i didnt have to eat at all because when i do i feel bloated, crampy, gassy, and have the painful urges.
~UC is a pain in the ass literally~
Posted 4/17/2011 5:34 PM (GMT 0)
runawaybride3, 

If you found the metamucil to cause more cramping maybe you started off taking too much in the begining.  I was more gassy in the begining until my body adjusted to the fibrer.  Now I have increased the dose that I take and it doesn't affect me at all.

If you do decide to try it again start with a teaspoon in a full glass of water and take it before bed so that if it does cause gas or cramps at least your in bed.  It takes time to get adjusted to it but it is beneficial to us with UC.

Posted 4/17/2011 7:06 PM (GMT 0)

UCpainNass said...
I have terrible urges constantly and i believe i keep flare ups. I am on Asacol 800 mg a day. I did try steriods such as prednisone for a month but didnt help me. Now it is just the asacol...

I have been reading people were suggesting Rowasa i will ask my Dr. about this. I think I need something to hit the rectum head on (sorry for the visual with words if that happened lol)...

Who has tried Remicade the injections? ...

Yes. Ask for rectal suppositories.

Pred has some horrible side effects. It eats up the connective tissue. As for Remicade, patients taking the drug are at an increased risk for getting serious infections that can result in hospitalization or death.
Posted 4/18/2011 2:06 PM (GMT 0)
runawaybride

your description is an exact replica of my life, as soon as i leave my house or go into unkown terriotry my stomach panicks, someone stated earlier that when they take there dog for a walk they have to back after 2 blocks, i am exactly like this when i get in the car i will drive 1 minute then have to head back home!! I am going to try Immodium tomorow and see if that helps, if you get any improvements with anything please say so. I do belive stress triggers off the urgency, i.e it starts then your mind goes skitz incase there is no toilete or stuck in traffic and then the rest is history.

Hope you get it under control
Posted 4/18/2011 3:53 PM (GMT 0)
Exactly, @Hak! It's awful.

I find that I have to take a lot of Immodium to be okay for a few hours (like 4-5 capsules plus a swig of Kaopectate). And that is my savior when I have somewhere important to be, but I can definitely feel the consequences the next day. It makes me feel like I have a giant hangover; headache, nausea, extreme fatigue, cramping. So I only do it on special occasions.

My mental exercises often work, I do them whenever I get into a car. I breathe deeply through my nose and out of my pursed mouth a few times every once in a while, and I talk to myself (silently!) telling myself to calm down, to realize that it's just the stress, that I will be at a bathroom soon, that I can do this. Sometimes I visualize my stress leaving my body and the urgency disappears (at least momentarily, which is often enough so that I can pull into a parking lot or whatever and walk calmly to the restroom - instead of being afraid I'll just lose it right then and there).
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