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Transit time and stool consistency

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Ulcerative Colitis
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Posted 1/22/2018 10:31 PM (GMT 0)
Hi everyone,

Just wanted to check in and talk about the last few months. I've been doing mostly well with my UC and I have an appointment with my GI on Wednesday. I've been taking my Asacol and my Salofalk enemas daily and things have been pretty good. I've gained some weight back that I lost last year after a bit of a stubborn flare and I've been watching what I eat more closely..More fruits and vegetables, less meat and no preservatives and sugar.

I still occasionally have some left side discomfort, but I really haven't been seeing any blood in my stool and I'm going to the bathroom about 2-3 times a day, usually after I eat. One thing I have noticed is that my transit time is still quite fast. when I eat dinner, I sometimes don't have to go before bed and can last till the next morning. When I make my smoothie for breakfast at 8 am (Kefir, blueberries, pineapple, papaya, banana, VSL3, hemp hearts and flax seeds - everything gets well blended including the hemp and flax) I seem to, at least pass some of the smoothie, around 2-3 pm the same day. I know this because the smoothie is blue/purple and there is no mistaking it. Also, my stool is quite soft. Literally like soft serve ice cream. It's formed when it comes out, but after a few minutes in the bowl and after wiping, it basically all dissolves when I flush...Not all the time, but most of the time. I occasionally have firm stool that doesn't dissolve.

I just wanted to ask if this is ok? It seems a little bit fast to me. In any case, although I'm feeling good and I feel I'm in remission, I feel as though I'm still precarious, like the balance of things could tip towards a flare very easily. Any tips for those who have felt like this too? Will it eventually level out and my stool will firm up a little bit more over time?

Many thanks
Posted 1/23/2018 4:34 AM (GMT 0)
That smoothie sounds like the type of thing that could send anyone to the toilet, but really you would need a scope to see what's actually going on. Overall, it sounds fairly normal, so that's positive. I wouldn't over think it. Let us know how it goes on weds.
Posted 1/24/2018 7:46 AM (GMT 0)
I think sort stools in remission is not uncommon, but it can't hurt to see your GI and ask for a fecal calprotectin test (rather than a full colonoscopy).

That said, I consider overly soft stools (and abdominal pain) a sign my remission isn't stable and do work on getting it to be more stable. Tumeric helps me as does oregano oil (but be careful with it--it definitely doesn't agree with some people).
Posted 1/24/2018 10:44 AM (GMT 0)
So you have a 7 hour transit time with that particular food, and it comes out the colour and consistency it went in. I would call that fast transit and the stool sounds undigested. To be fair, liquid meals transit faster. If you ate a higher fiber breakfast and then had the smoothie with it, I bet it would not transit as fast.

I'm very familiar with your stool description. Seems solid but then disintegrates upon flushing. Usually the colour is more pale. This is stool that has transited faster.

In healthy people, food takes 7-8 hours to transit the stomach and small intestine. Then when it hits the large intestine it takes at least several more hours to solidify.

But in UC patients, once stool hits the colon it transits more rapidly because the colon is in a constant state of irritation and low grade inflammation, so it doesn't want to have contact with food for very long.

I find that I have that stool quality you mentioned in the months after a major flare has downgraded, but my colon is still healing. It gets worse if I eat the wrong things, but on the whole it's still a sign I'm getting better.

Just a word of advice... I would not eat cold food. Your smoothie sounds cold, so it won't be digested. People with UC normally have a weak digestive system and cold food makes it worse. If you could somehow warm that smoothy up or add warming spices, I bet the end result would be better.
Posted 1/24/2018 12:20 PM (GMT 0)
"I would not eat cold food. Your smoothie sounds cold, so it won't be digested."

That is nonsense, derived from internet blogs etc.

"If you ate a higher fiber breakfast and then had the smoothie with it, I bet it would not transit as fast."

So much misinformation... it's hard to keep up!

Your smoothy is already high in fiber Rtp85, and this will stimulate peristalsis.

Glad you are feeling well, take care.
Posted 1/25/2018 3:30 AM (GMT 0)
Thanks for all of your replys.

The smoothie is not too much volume. I keep fruit cut up on he fridge and put one or two pieces of each kind in. It is on the cold side because of the frozen blueberries.

So I went for my appointment today and my GI tells me one of my liver enzymes is still elevated. I can’t remembe which one but it’s at 100 and she told me 50 is the upper end of normal. So now I’m concerned again. She’s sending me for an mri, ultrasound and blood and urine analysis. The fibroscan I did in November or December last year came back totally normal too.

Thing is, I eat a very healthy balanced diet, I don’t drink and I’m not working out like a maniac. I’m a bit stumped why it’s still elevated. It has been elevated since August of last year and the number has always been 100 every time the bloodwork comes back, which has been 3 times now over 5 or 6 months.

I feel completely fine and I have to liver pain or any inching or anything. I though maybe it was the Kombucha I was drinking in the fall but maybe that wasn’t it. My flare was still lingering in August of last year and maybe liver is slightly inflamed due to that flare, but right now, I don’t see blood and I’m going to the washroom 2-3 times a day.

Hopefully that enzyme comes down and the tests come back ok.
Posted 1/26/2018 12:22 AM (GMT 0)
So today, I worried myself to the point of feeling sick. I’m reading about elevated liver enzymes and psc and I feel absolutely terrible. Many people with elevated liver enzymes say they come down after a month or two and mine have been elevated since August.

One question I have is how long have some people enzymes been elevated for without there being a serious medical issue like psc? Also, is it possible that my asacol is causin the elevated levels? I’ve been taking it for almost 7 years with no issues. If it is the asacol, what will be the alternative that won’t mess up my liver?

I felt so lost and depressed today not knowing what’s going on with my liver and my UC.
Posted 1/26/2018 12:33 AM (GMT 0)
if it is the asacol, you can move on to 6mp or biologics - but there are some liver or kidney concerns with these as well.

let you doc investigate why your enzyme is elevate. may be an issue unrelated to UC.

depending on WHY the enzyme is elevated in could be inconsequential (in the long term) if it is elevated for weeks or even months.

good luck
Posted 1/26/2018 7:47 PM (GMT 0)
So I called my GI's office this morning to ask about the scheduling for my MRI....They said it's scheduled for JUNE!! I can't believe that. I'm not waiting till June, so I called the office back and told them to fax my requisition to a private clinic. In 20 mins, the private clinic called me and told me they can book me in for Monday.

There are many great things about the Canadian health system, but waiting 5 months for diagnostic imaging is crazy. I will gladly pay the 750 bucks and have it done in less than a week. One good thing is that my health spending account through my work will pay for almost all of it.

I may be overly nervous about this, but I would rather be safe about it.

I am also going for an ultrasound next Thursday. I have a fecal calprotectin requisition, as well as multiple blood work and urine test to be done over the next 6 months. Hopefully we'll be able to understand what's going on a bit better in the next week.
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