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3rd Flare. Training for half marathon. Question about recent colonoscopy - help!

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Posted 7/13/2018 4:20 PM (GMT 0)
Hello all!

I had been in remission for several years but I am now experiencing my 3rd flare. I'm 35. First flare occurred at age 25. I had a colonoscopy last week and they found 2 inches of active disease at the bottom of my rectum, so we're doing nightly Canasa suppositories on top of my daily Lialda.

Since my colonoscopy, my symptoms have been worse. More mucous. More stomach "gurgles and grumbles". Continuation of blood. Has this happened to anyone else where their flare was mild but then was ramped up post-colonoscopy? I am wondering if my colonoscopy irritated things further.

I'm stressed because I am currently training for a half-marathon that is in August, and I'm worried my recent flare is going to slow down my training progress. Last night I had to stop mid-run for a bathroom break just to expel a tiny bit of bloody mucous. Am I making things worse by continuing to run? Any runners out there with experience with this?
Posted 7/13/2018 4:34 PM (GMT 0)
Welcome back but sorry to hear you are flaring. I'd expect the colonoscopy to upset your system for 3-4 days afterwards. Beyond that your flare could just be worsening. Try the canasa for a while longer and see if they take care of it. If not, ask about steroid suppositories, rectal foams, or enemas as they are much stronger and could help!
Posted 7/13/2018 4:46 PM (GMT 0)
Yeah, colonoscopies have made my flares worse in the past. I also feel like running sometimes makes me worse, but I never really know if it is a coincidence. All my doctors always tell me I can keep running and that it won't make anything worse.

I second the suggestion to request mesalamine enemas. Canasa never did anything for me, but the enemas do.
Posted 7/13/2018 5:00 PM (GMT 0)
I think the scope made things worse for sure. I would suggest either alternating canasa with a steroid suppository or trying rowasa to calm things down. I find that when I run when flaring it sometimes makes my symptoms worse but other times it does not. I find if I run more than a half that my UC does funky things, somehow 15 miles or more really upsets my gut. They say that distance running can change gut permeability and lots of distance runners suffer from D as a result. I suggest slowing down your training for a week or two (just maintain where you are) and then ramp back up. Good luck!
Posted 7/13/2018 8:14 PM (GMT 0)
This forum has numerous accounts of flares beginning right after a colonoscopy. I was deep into remission when I decided that I needed a colonoscopy since it had been some time since my last one. Soon I started having diahrrea again.

But when I looked at the ingredients of the prep I saw junk like maltodextrin, polisorbate 80, and other of my sure-fire triggers for inflammation.

Getting back to your maintenance meds, and as others suggested, adding some mesalamine enemas should help you return to remission.
Posted 7/13/2018 8:20 PM (GMT 0)
Thanks everyone! I'll give the Canasa another week or so to see if it helps, and then request what you suggested if not. It's hard to decipher (like Sara14 said) if the running makes things worse or if it's just coincidental, so for now I'm continuing to train. I'm glad other people have said that the colonoscopy could have irritated further. I've had colonoscopies before and don't remember being as irritated after, but it's been a while. I'm having mostly solid BMs but then a few mucousy-blood clot poops (gross, I know, but you guys get it!) throughout the day so it's confusing. It's not diarrhea. Every flare is always different for me, though.
Posted 7/13/2018 8:25 PM (GMT 0)
have you recently ramped up your miles in preparation for the half ? are you a veteran runner ?

most often the increased symptoms post scope are short lived -

i agree with adding enemas to the mix asap - better to stop things now -
Posted 7/13/2018 9:53 PM (GMT 0)
I think I'd say so. I prepared for a 10k from January - March with no problems. Ran the 10k at the end of March. Since March I've run anywhere from 2/3/4/5/6 miles every other day. Last week I only ran once (4 miles) to give myself a bit of a reprieve the week of the colonoscopy and this week I ran 5 miles on Tuesday and 5 miles last night. I'm supposed to run 8 miles on Sunday. I would say that no, I am not a veteran runner and have only started truly "running" since January but I've logged 226 miles since January 1.
Posted 7/13/2018 10:39 PM (GMT 0)
Katie

I am curious how you have listed your past meds as Humira and Remicade but you have been able to maintain on just Lialda now. How did you step back from the biologics?
Posted 7/14/2018 2:55 AM (GMT 0)
I personally stop running completely if I am in a bad flare or seeing blood. There will always be other races if you can't do this one. Not saying you have to do that, but we do need to take care of and listen to our bodies. I hope you get better soon!
Posted 7/16/2018 4:56 PM (GMT 0)
Hi Countess18! During my flare of 2008 I started on Remicade but then developed allergic reactions to it so I wasn't on it very long, but I'd had enough infusions to where they could just put me on Imuran. I took Humira for 2 years after my flare in 2011/2012 and my doctor said I could stop because he felt I achieved remission but to stay on the Lialda. The Humira cleared up that 2nd flare pretty quickly.

Update on colon: Feeling a little better with Canasa. Only had a few issues this weekend. Was able to run 8 miles yesterday with only 1 bathroom break but no pain so hopefully things are looking up!
Posted 7/16/2018 6:05 PM (GMT 0)
Good luck with your half marathon. I wish I had it in me to do that type of exercise. I've never been a good jogger or runner. I agree with the others, definitely get some enemas to have on-hand. I am happy you're doing better, but in reality, those suppositories only reach one to two inches. I realize they said 2 inches, but anything more and you're in enema territory. Can't hurt to have them around for when you need them. They are generic and inexpensive too usually.
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