Occasional loose poops means what

Hi ,
So in my last post in Jan I had seen some blood and done a week of rowasa enemas twice a day and managed to nip that in the bud . However do any of you all get the problem where the morn bm is fully formed yet the second one after eating my breakfast is mushy and soft . That's been a pattern I see often though not every day . After that I am down for the day . This just causes me to worry though there is no blood or mucus .Maybe this is just the norm with us Uc people . I wonder if I have ibs as even prior to diagnosis I used to poop after every meal but in the good old days who checked their poop for consistency . Any of you all also have that happen . I do have psyllium at night .
My new gi actually is a firm believer of rectal meds and has actually suggested I do the enemas twice a day so he can reduce my oral dose but I want to save that as future ammo .
Await your responses , Quincy your input would especially be appreciated

Best
Ritu

Left sided colitis with patchy involvement in last scope and illeal ulcers diagnosed in 2012
My meds are 3.6 gm of mesalmine . Rowasa generic at night , every night for the past one year . One Canasa suppository during the day and tons of supplements like curcumin , omega 3 , l glutamine , l glutathione oral ( which I also took as Iv for one month on a weekly basis and plan to take bi weekly for as long as I can afford it )

I'd say it means nothing, having one solid bm and then a looser bm. I've always had great variety of formed/firmness of poops, since having uc and I'm in remission. They vary from well formed to softer, and it probably has more to do with what I ate, rather than uc symptoms. Also, having two poops a day is nothing to worry about, especially if there's no uc symptoms: urgency, blood, or mucus. Having 1 or 2 bms a day is great/ideal. If you were mention this to your gastroenterologist then I bet he/she wouldn't worry.

ya, you and your butt movements are in a good place - probably should just let it ride for a bit -

if it was me and i wanted to improve things (in your place i probably wouldn't tho) i would up the oral to 4.8, do the enema at nite, suppository in the morning, and that's it - do this for a few months and reassess -

if things have improved at that point. then keep doing it - if they haven't, then the next step i would take would be to eliminate all the supplements - and again, go a couple moths and see where you are at -

meds/supplements/diet are all a personal choice as to how you treat your UC - some folks will do everything to get off all meds - other folks are perfectly content taking drugs the rest of their life - which camp are you in ?

Hi ,
Thanks for All the prompt responses .
I am very anxious by nature and also take some antidepressants trying to deal with this awful disease . My breakfast is always an egg and a piece of toast . Maybe I should eliminate eggs . I do get the urge to poop during the day which makes me think it's ibs and hot showers calm me down . It's been two years since my last scoop , I hate the idea of getting scoped when there is no blood but I worry if there's some residual inflammation . Like today my anxiety made me take a teeny tiny poop in the evening but when I am up and about I forget all about it and go about my daily business . I have two small girls and sometimes I hate it that I spend so much time focussing on my poop instead of enjoying them . I know I am spending too much time focussing on my disease and wallowing in self pity . I definitely am a believer in meds , my parents are both doctors . How couldn't I be , lol !

I guess I will stick to the current regime and see if things continue on the right track

Best
Ritu

My breakfast is always an egg and a piece of toast . Maybe I should eliminate eggs

Maybe it is the eggs, or maybe it is the toast. There are many here who have found that gluten (wheat) can trigger flares.

Lactose intolerance is more common with uc patients. Some have seen benefits by removing gluten, alcohol, caffeine. Others, like me, see no benefit from altering their diet. I drink milk, eat gluten, drink caffeinated and alcoholic beverages without issue.

Spicy foods can be problematic for uc patients. Many pepper oils are completely undigestable and just inflame the intestinal tract. Not good for an inflammatory bowel patient. So, if you're a big fan of spicy chili, curry, etc then it might be aggregating your bowels. I do miss a good spicy chili, used to be fond of them.

I don't think it means much.

IF the 2nd stool is not long after the formed morning stool, I would speculate that overnight the morning stool had time to become formed. In the morning when you system gets moving, the next stool has comparatively less time to become formed.

At any rate, I would not worry until/if there was a more pronounced symptom

Hi Quincy
Was waiting to hear from you . Truly value your advise . So I am still on rowasa nightly for the past one year and my new gi wants me to continue . Sometimes after the diarrhoea episodes I take it in the morning as well like today . I don't have bowel movements more than 3 times a day but the second or third movement is loose and mushy . I take psyllium seed husk powder which is available in India . One scoop at night after dinner . Will add some with the noon meal as well to see if that helps . I suffer from a lot of anxiety which triggers off the gut and I end up pooping . Makes me wonder if this is ibs coz I see no blood and my first symptom is always blood . I also use a Canasa in the mornings . I am on 3600 gn of oral liada which I plan to stick to simply for the reasons you mentioned . My question is should I get a scope done , the last one was in 2014 , just to see what's going on or just wait . I would get it in a heartbeat except people say the scope can bring on a flare . I am sick of all the worry . My bowel patterns rule my life and mess with my head completely . This darn disease is ruling my life .
Thanks and will await your response
Best
Ritu

I think having the occasional loose movement means you're normal!! Congrats:)

We just tend to analyse and over analyse every poop.

Hi....best to not call it Rowasa as many will assume you are in US or that it's available in India. It's not available in Canada either... we have Salofalk and Pentasa.

I wouldnt say that I've heard horror stories about scopes causing flaring, but the preps can cause exacerbation of inflammation that's there and biopsies will cause bleeding for a few days.

A possibly better option at this point is to ask your GI to take a look-see with a rectoscope. If you arent inflamed, you might consider to go to a lower your dosage, by possibly alternating the enema one night and a suppository the next night to see if your symptoms change.

What's the normal dosage of VSL capsules daily as per the instructions?

Wow...getting stool samples every 3 months, you are a pro!!!! Lol

What time is the second soft bm?

q

Sorry Quincy , just read your post , yes it's a generic form of mesalmine suspension available in India. I get what you mean , the second stool is as soon as I have my breakfast , it's mushy and loose as I guess it's not had enough time to sit there. , lol . Sometimes the suppository triggers of a third one when it melts but mostly not . Then things calm down and I go about my business .

Vsl 3 is twice a day , that's what my gi says . Meeting him tomm , he's pioneered fmts in India and is actually willing to enroll me in a trial of it but I am not living in the same city so makes things tough . My local gi sucked and never wanted me on recitals so I switched doctors and fly down and meet this guy every three months . This disease sure is expensive on the pocket. Lol

What's a rectoscope , am gonna ask him about that tomm , will keep you posted
Once again can't thank you enough for helping out

Best
Ritu

Kickucbutt said...

I am an Indian , we live on flat breads , imagine trying to eliminate gluten ( wheat ) from my diet.

No offense Ritu, but we Indians are probably the most arrogant folks when it comes to the eating preferences. I am no different. My GI suggested me removing gluten and casein from my diet for years and I gave her exactly same excuse. It didn't dawn upon us until DS and DW were diagnosed with severe gluten allergy. Since then we removed gluten completely. Now you guess, how miserable we are, esp in the US where we do not have as much variety of non-gluten options. Bottomline, seriously consider removing gluten. Not too sure if there is any real connection, but since removing gluten, our health has improved noticeably.

Secondly, you are using psyllium seed husk powder. Try finding seed powder only. I could not find it personally so I took it from the US for my mom. There has been a lot of discussion about it on the board as why seed powder is preferred over husk powder.

Thirdly, VSL#3 is great but not enough (at least for me). You get Bifilac in India. Consider adding it to the regimen. Some folks are worried about S. feacalis in it, but personally I don't care. I usually get a big batch as and when I visit. This time I got 300 capsules. It also contains C. butyricum strain, helps getting more butyrate in your gut. If you can get Miyarisan from ebay (another strain of C. butyricum), it will be plus.

Play around with the food. If you can maintain a food diary, it will help you decide what bothers and what doesn't. While my mom can eat spicy food without any issues (pancolitis for almost 30 years, currently in remission), I do not stand spicy food.

I don't know if its really practical for you to use rectal meds twice a day, as you need to lie down for at least 2 hours after mesalamine (30 minutes after hydrocortisone) for all of the drug to do the job. Otherwise I end up pooping the enema. Your medication list is almost same as mine but recently left out Canasa for the cost issues (yeah, 'developed' country problems). If you happen to poop enema, consider taking dicyclomine/dicycloverine 10mg every night before enema. That will slow down your intestine and it will stay in for whole night.

Quick update - so today I went 4 times , all formed , not loose at all but the number went up from the normal 2-3 . this is after getting the clear of the doc from the rectoscope which I posted above so I think definitely nerves play a big part in my urges to poop in the mornings . If this is ibs what if any drugs do any of you take to check this or should I just not bother . I must say even prior to being diagnosed I always was a multiple poops a day person and joked that I pooped after every meal of the day .
Best
Ritu