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Flaring after antibiotics

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Posted 8/5/2019 9:17 PM (GMT 0)
2019 is turning out to be a monumentally forgettable year for me, health-wise. In May I got sick with a bad cold, but due to work pressures, mostly worked through it. I never quite shook it, and it came back as a postviral illness. My doc put me on a 10 day course of prednisone, which helped break the back of it. However, it also trashed my immune system (which was probably already compromised). I had two bouts of athletes foot that simply would not respond to treatment, minor cuts that would not heal, and worst of all, an ingrown nail that was causing a LOT of discomfort (and got so bad the nail has died off and is currently regrowing).

I had a script for some doxycycline, which I held off taking for some time, but eventually caved and filled it. It was exactly what I needed to fight the many skin infections I had, but now a week after finishing the course, I'm flaring quite badly. Oh, and I'm also sick with a weak cold again sad

Do others find the same thing after taking antibiotics? My doc is always reluctant to prescribe me antibiotics because of my UC, and this may well be the reason why, but I'd just like to hear from others who have been through the same thing and see how they managed to pull themselves back out of it.

Thanks
Posted 8/6/2019 12:36 PM (GMT 0)
When I have to take antibiotics, I load up on probiotics. Antibiotics are a last resort for me.
Posted 8/6/2019 4:04 PM (GMT 0)
I've not had issues with antibiotics, but in saying that...I haven't been on all antibiotics. Doxycycline isnt one I've used.

I always use probiotics and double up with antibiotics.

You are not on enough rectal meds as per your signature. 4g mesalamine enemas is what I suggest to get on at this point. As well, get stool samples checked

Hope things improve for you....please update us on how you're doing.

q
Posted 8/7/2019 7:58 PM (GMT 0)
I’m currently on a Z-pack for the second time in 8 months for a viral infection (chest cold). I’m a bit nervous as well but I did okay after the first course 8 months ago. Luckily it’s a short course antibiotic. I was diagnosed with UC about 8 months after a 5 month course of doxycycline.
Posted 8/7/2019 8:05 PM (GMT 0)
Knock on wood, my UC seems to get better while on antibiotics. But I have heard from a lot of people here that antibiotics make them flare, so I don't think what you're experiencing is uncommon. Sorry, I have no advice, but I'm sorry to hear you're going through all of this. My first year with UC, I got a nasty tonsil abscess that would not respond to antibiotics or being drained with a huge needle, so I ended up needing my tonsils out, so that year and 2016 were both pretty bad health years for me, so I can relate in that way. When I do need antibiotics, I always make sure the prescribing doctor is aware that I have UC and they try to prescribe one that has a lower chance of aggravating it.
Posted 8/10/2019 3:13 AM (GMT 0)
Update for those interested, I'm pretty sure I have got this flare under control. It's early days so I don't want to speak too soon. If I'm still improving after a couple more days, I'll post an update and explain.
Posted 8/14/2019 3:49 PM (GMT 0)
That's great to hear! I hope you are still improving.
Posted 8/16/2019 9:29 AM (GMT 0)
Well that recovery was short-lived. My flare calmed down over the weekend, but slowly came back and seemed to fluctuate over the week. However, today I had my first ever "HAVE TO GO RIGHT NOW" moment. Ok, I probably didn't do myself any favours by eating a couple of cakes that had a lot of whipped cream in them (dairy doesn't always agree with me), because within about 20-30 minutes I simply HAD to go to the loo. It was a stream of D, followed by blood that turned the water in the toilet bowl red - the first time I've done that since being DX. So it was game over on the 'self help' front.

I promptly left work and went straight to a doctor to get a script for a flare dosage. I'm on the same Asacol dosage I went on earlier in the year when I had my earlier flare.

I'm not sure whether I was just lucky for the first two years of having UC in that I never once had a flare, or if this year has just featured a LOT of stress and aggravated things. It definitely has been quite stressful in many ways. I had been doing a lot of work over the past week trying to become more spiritual and more calm, which has done wonders for my anxiety (which I partly blame on setting off the flare) but ultimately it seems I tried that too late to recover from this flare alone.

When I got home, interestingly, I had massive chills, a headache, and my feet felt a little tingly - almost like they do after a vasovagal reflex, which I sometimes get after needles. I think that's just shock from seeing the water in the toilet like I did, and perhaps a bit of fear that I might be heading into something more serious. I'm feeling better about it now, though.

But it's been a bit of a wake-up call, to tell the truth. Made me realise that I'm dealing with a serious disease, and one that's not to be messed with. If I show signs of flaring, I really need to make provisions to get onto a higher dosage immediately, before it escalates. You guys here have said that to me before.
Posted 8/16/2019 3:47 PM (GMT 0)
Yes...4g mesalamine enemas asap....nightly for at least a month. Keep us updated.

q
Posted 8/16/2019 11:43 PM (GMT 0)
Sorry to hear that. What did the doctor give you to treat the flare?
Posted 8/17/2019 5:03 AM (GMT 0)
The same as last time. Oral Asacol, 4g per day for a week.
Posted 8/17/2019 5:33 PM (GMT 0)
Why no enemas?

q
Posted 8/17/2019 6:38 PM (GMT 0)
You should probably stay on max Acasol for maintenance since dropping the dose doesn't keep you in remission. It's safe to stay at max to keep you from flaring.

And I agree with the others ... get rectal meds too.
Posted 8/19/2019 5:48 AM (GMT 0)
Antibiotics are what caused my UC in the first place. Now that I'm in remission I avoid them like the plague. This past winter I had strep throat and I fought it using natural methods because I was absolutely terrified of taking an antibiotic.

At this point I would have to have an actual deadly infection to take abx because they are the root of all evil in my UC world. The last time I had abx was through IV following surgery and they obliterated my bowels, followed by a 10/10 flare that almost killed me.
Posted 8/20/2019 5:10 AM (GMT 0)
I've made an appointment to see my doc on Thursday. In saying that, I've also made an interesting discovery over the past 24 hours. On the advice of a nutritionist I saw speak a few months back, I decided I would try cutting gluten out of my diet completely. Today I have had two BMs, no blood, and only a very small amount of liquid with my first BM of the day. This could have been the suppository I took last night.

Most importantly, I can pass wind again when standing, which is a luxury I haven't had for weeks.

I'll monitor how things go over the next two nights and still go to my appointment on Thursday if things don't keep heading in the right direction. This is showing all the right signs though.
Posted 8/21/2019 9:49 PM (GMT 0)
After continuing to improve but very slowly, I've decided I will keep my appointment with my doc this afternoon. I'm going to see how long he thinks I should be on the flare dosage of oral meds, and see about getting onto enemas until I'm through this.
Posted 8/21/2019 10:59 PM (GMT 0)
I guess this time could be different, but you flared after you dropped dosage already once this year. I would want to stay at the max dose for at least a year of solid remission before I started dropping. Why do you want to drop the dosage?

What did your doc say?
Posted 8/22/2019 7:36 PM (GMT 0)
I dropped the dosage last time as that was all my script allowed for.

I'm not sure how scripts work in other countries but here you are only prescribed with up to 3 months' worth at a time. The script I had was for my regular dosage. When I flared last time, I was given another script for the flare dosage, but with only enough meds to last me for 7 days at that level, and no subsequent repeats. The same thing applies in this current case.

Admittedly, through having taken none of my 'routine' supply for the last 7 days I can extend the flare dosage for probably another 2 weeks or so before 'catching up' to where I was, but after that I will be eroding into my essential regular supply, which is only given one month at a time.

Sometimes, given the kinds of advice others give here, it almost seems like other countries allow you to pretty much walk into a clinic and ask for 'one of those, those, and those' and to be given it all without question. I can suggest to a doc what I'd like to be on, but if they don't agree then unless I want to go hunting for a second opinion, that's what I have to base my dose around.

Yesterday I raised a) the duration of my oral dose and b) enemas. My doc advised me to continue with the elevated oral dosage I am on at the moment, and sent me for some bloods to check my current CRP levels to get a sense of whether the inflammation is at a level where enemas would be more useful.

He also suggested I check in with the gastro clinic at the hospital as I was supposed to be seen by them two years after my last visit, which was in September 2017.

Symptoms are still improving.
Posted 8/27/2019 2:38 PM (GMT 0)
Only one week of increased 5-ASAs? What country do you live in?
Posted 9/3/2019 7:04 AM (GMT 0)
I'm in New Zealand
Posted 9/7/2019 8:54 AM (GMT 0)
Update for those interested. I phoned the gastro clinic at the hospital last week, as I was due for a 2-yearly checkup with a GI doc. Last time I saw him, I was in the throes of blissful remission (I didn't appreciate it at the time, but geez I'd love to be there atm). They agreed I was due for a checkup, and as luck would have it, they had an opening next week. I either took it, or waited until November. Yeah right.

So I'm seeing him next Tuesday. This flare just isn't budging. I've "thought it was improving" so many times that I've now all but given up getting excited about any subtle changes in symptoms.

BMs aren't really the issue. Today, I had one. Some days, I've peaked at 5, but generally it's between 2-4. That was close to my normal frequency when in reission. Yes, there's more urgency. But it's mostly manageable.

The main issue is the watery mucus. Any time I eat any food that gives me gas, I'm inevitably off to the toilet to expel it into the bowl. I tried some VSL3, but even with half a sachet, the gas and bloating is uncomfortable and just causes too much mucus.

I'd really like to be able to get out of this flare using mesalamine alone, and don't want to have to start introducing other meds. Currently, I'm on 4g/day oral and 1g per day suppository. As many have said, I should also be using enemas. To me, I could go up to 4.8g/day oral, needs to be for much longer than 7 days, and needs a decent regime of enemas. At least I had the bloods done recently to show a recent CRP level.
Posted 9/7/2019 1:42 PM (GMT 0)
Mesalamine 4g enemas nightly for at least a month or two....but the schedule solely depends on your symptoms and it may take longer.
You could also ask for steroid foam enemas to use during the day.

Ask the doc for a stool testing kit just because.

You can try other probiotics....the ones I use are in my signature.

Are you seeing the doc this tuesday or the next week? Awesome to get in this soon.

q
Posted 9/7/2019 11:34 PM (GMT 0)
I'm seeing him this Tuesday (10th). I know right? I was stoked when I heard they had an appointment then. Being the public health system, you take what you're given. The woman I spoke to at the gastro clinic said it would be either this Tuesday, or wait until November.

I actually had an appointment with my GP on Monday (9th) to discuss my bloodwork and see whether I could persuade him to give me enemas and a decent oral script, but when I got an appointment with a gastro the next day, I promptly cancelled my GP appointment.

At the moment, I'm eating into my supplies of asacol, as here we only get given a 3-month script max, with monthly repeats from the pharmacy. So I'm taking 5 a day when my supplies only allow for 3. I don't really have much choice. I ordered a repeat from my GP last week anyway, but at some point this whole situation will need sorting. Tuesday should clear it up.

What would the stool testing kit show? Are you talking about one that gives a full bacterial count, or looking for something specific?
Posted 9/8/2019 4:41 AM (GMT 0)
I suggest it because you mentioned being on antibiotics, and you seem to be concerned about not feeling quite right. It would be good to rule out anything else rather than assuming it's only a flare.

Looking forward to hearing your update on Tuesday.

q
Posted 9/9/2019 6:09 PM (GMT 0)
Yeah, I have no idea why they'd only have you go up to the max dose of Asacol for 7 days. Did a gastroenterologist tell you to do that? At least your symptoms aren't bad. Definitely get the mesalamine enemas.
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