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Posted 2/26/2017 11:44 AM (GMT 0)
Hi,

Just want to run this past you all.

Started azathioprine 150mg three weeks ago. At the same time am reducing pred by 5mg from 40mg every 10 days. I know it is early days as far as the aza is concerned but of course as I am reducing the pred the symptoms are gradually increasing. It is different this time though. I have bloody watery poo, some urgency and frequency but hardly passing any poo. This makes me think I could possibly be constipated. I am bloated and also having some stomach spasms and also feel like I need to pass some thing but can't. I know this could be tenesmus but even that does feel like it from how I have experienced it in the past.

Not sure whether to just ride it out or take something like physillium. Not even sure whether to get in touch with the IBD nurse. I hate always phoning her with silly questions but on the other hand am worried that my symptoms are coming back before the aza has had time to kick in and I am going to be even worsr before it does. It seems that only high doses of pred keep me semi okay now. It doesn't even stop the blood but only makes it so I can function.

I hate this!!
Posted 2/26/2017 11:52 AM (GMT 0)
It's likely the inflammation causing constipation. Yes, take a fiber pill you know agrees with yu (not all are the same). Maybe you shouldn't be decreasing pred yet if the Aza hasn't taken hold.

Are you using mesalamine enemas? You may think they won't help C but they do (for me). Get an RX and use them once or twice a day/night until things are better.

I also take spoonful of coconut or olive oil when constipated, drink water. But it's always the inflammation causing it or in my case when too much insoluble fiber was eaten and things just stop moving.
Posted 2/26/2017 1:34 PM (GMT 0)
HI,

Yes I have been using enemas every night for the last two years. I think they help a bit but not enough to stop the inflammation.

Thanks for your advice.
Posted 2/26/2017 3:17 PM (GMT 0)
Sure....you could start a fibre supplement, but please start realllly slowly.

I would suggest you start on a good probiotic.

I suggest you ask for steroid enemas and use them instead of the mesalamine....especially since you're tapering the,pred.

There are various taper regimens, maybe alternating would be better. Once you get to lower dosages, if tapering by 5 mg, the % drop will be greater.

q
Posted 2/26/2017 4:24 PM (GMT 0)
Thanks Quincy

Forgot to say that when I get to 20mg of Pred I have to stay there. When I have used steroid enemas in the past they have always made me worse and had no effect.
Posted 2/26/2017 7:58 PM (GMT 0)
Constipation = inflammation within the rectum. Agreed stay at 20mgs pred until the azathioprine has time to work (at minimum 6-8 weeks but it can take longer)
Posted 2/26/2017 11:20 PM (GMT 0)
I agree with the others. Don't decrease until you give the aza some more time. No reason to rush and end up back at square one. Take your time, be patient, in a few weeks, you will hopefully be in a better place to taper without too much up and down.
Posted 2/27/2017 12:17 AM (GMT 0)
You can try psyllum seed powder. It's much easier on the GI track. Start with a very low dose (1/4 or 1/2 spoon for the first few days). I bought mine online.
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