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6 months post diagnosis and very confused

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Ulcerative Colitis
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Posted 5/17/2008 3:35 PM (GMT 0)

I'm a 34 year old male, was diagonosed with a "moderate" case of left sided colitis back in November 2007.   My GI originally put me on predinose, as well as colazal, and the prednisone made me feel great immediately.  As I slowly was weined off of the prednisone, I could notice my stools become a little looser, sometimes watery.

I've been solely on Colazal (9 capsuls a day) since January and the majority of the time, I have loose, watery stools.  I went back to see my doctor in March 2008 and he was not concerned with my symptoms.  Basically told me to not worry unless I saw blood, went "on average" more than 3 times a day, or was going in the middle of the night.   I had all of these symptoms at the time of my diagnosis, and honestly, have not had them since, although I do have a few days where I'll go 4-6 times.  I notice this particularly when I'm under alot of stress.

I've experimented a few times taken fewer Colazal capsules (I'm supposed to take 9), and I've noticed that helps a little.....  just really confused right now with what to do as I'm getting tired of having such loose/watery stools.  If I express additional concern to my GI, he acts as though he wants to do another colonoscopy or take me to the next stage of drugs/medications, which I understand, have ALOT of bad side effects.

Very confused and not sure what to do.  Is it just normal to have loose watery stools all the time if you have UC?  Is that just during a "flare-up"?

Any thoughts or comments are appreciated!

Thanks.

Posted 5/17/2008 4:10 PM (GMT 0)
Hi...welcome to the forum.

Your doc has NOT exhausted any of the first-line meds....Call and request a rectal 5ASA retention enema....It'll help with rectal and sigmoid inflammation....

Is your UC throughout or limited?

There are varying degrees of inflammation....bleeding is to the point of more fragile tissue....you should never have to wait till you get to that point.

You don't have to be on prednisone...please consier the rectal meds.

quincy
Posted 5/17/2008 5:49 PM (GMT 0)

Thanks for the reply.  Are you suggesting that the rectal enemas will help the watery/loose stools?  Also, from reading other posts, it really seems like the dosages for colazal vary from person to person.... I tend to believe that if I dropped to 6 pills a day, my symptoms would improve, but I'm afraid that drop my cause a full relapse.

My doctor also speculated that I have IBS, which I would not be surprised.... I've always had a very active colon.  I also have a job with ALOT of stress, and I really think that my stress (including my worrying about UC) is wreaking havoc with things.

Posted 5/17/2008 6:08 PM (GMT 0)
Welcome to HealingWell.

Oral 5-ASA medications such as Colazal are released in the colon, and often used up before they reach the rectal area. Since they are actually topical, working through contact with the bowel wall rather than by being delivered through the bloodstream, this means the upper colon is being treated but the rectal-sigmoid area really isn't being treated. Adding a 5-ASA enema provides the same treatment to the lower colon that oral meds provide to the rest of the colon.

Also, some of us do find that 9 Colazal a day will cause looser stools, while cutting back to 6 still controls the flaring without the loose stools. If you want to try this, decrease the dose gradually, dropping one capsule every couple of weeks to see how you do.

Are you on any probiotic? Probiotics are preparations of beneficial bacteria that inhabit normal, healthy colons. When we get UC, these tend to get stripped out of our colons, leading to more bowel dysfunction. You should be able to get a good quality probiotic at any health store or pharmacy. I take Primadophilus Reuteri by Nature's way. Other popular preparations are Culturelle and VSL#3. Often these will help with stool quality.

My final suggestion would be to try adding some good soluble fiber to your diet to see if that helps. You can get it with cooked fruits and vegetables, but it's easier to take a supplement - Metamucil, Fiber-con or the like.

I hope you're soon feeling better. Keep us posted!
Posted 5/18/2008 11:50 AM (GMT 0)

I have been taking a probiotic - just one capsule daily - should I consider taking 2?  I also have been reading about successes in taking fish oil and aloe vera tablets, but have not tried that yet.  Any thoughts on those?

In regards to the rectal 5-ASA, I assume this is prescription and needs to be applied by the doctor?  How often does this need to be applied?  Wondering how "uncomfortable" that may be and if there is something over the counter that could help alleviate inflamation in that area since you have indicated the Colazal may be absorbed before that point.

Thanks again.

Posted 5/18/2008 2:03 PM (GMT 0)
Rectal 5-ASA is in the form of enemas or suppositories. Suppositories generally treat the rectum only, while enemas also reach the sigmoid colon. They are self-administered (it's really easy to do, believe it or not), usually once or twice a day initially then tapered to a maintenance schedule as symptoms ease. The enemas can be somewhat uncomfortable and difficult to retain when the inflammation is bad, but our members have found several tricks to help, like warming the fluid a bit and starting with only half the fluid as you build up a tolerance.

There are a host of "natural" products that some of our members have found to ease their inflammation. I can't be very informative on them, because none have worked for me. I suspect some of the others will be along to share with you.

When in a flare with watery D., increasing your probiotic dosage is often helpful. Try doubling it, but be aware the changes sometimes are gradual and subtle. Reflect back in two to four weeks to see if your symptoms seem to be improved, then again in a couple of months.

Generally, anyone with left-sided colitis (and probably others, too) should be on a rectal medication if they can tolerate it. Because the Rowasa (Salofalk) enemas are Mesalamine, some of us with sensitivity to Mesalamine can't use them.
Posted 5/18/2008 8:15 PM (GMT 0)
All UCers should be on rectal meds...considering where it starts. Remember, it spreads upward, heals downward.

q
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