Jalapeño-burning stools & a lot of abdominal pain--Toxic Megacolon?

Hi everyone,

I've been doing fairly well lately; I started flaring in August-September, got really bad in October-early November, and started improving in late November. However, I haven't quite recovered.

For the last month this has been the pattern of my symptoms: Perfect to near-perfect bowel movements & stools for 3-4 days, then one day I wake up with pain, loose BMs, and urgency. The stool is as if I had eaten only Jalapeños the previous day... the stools are extremely burning and leaves my bum super irritated. Next day my stools are more normal, but I bleed. That lasts 1-2 days, and then I have again 3-4 days with perfect to near-perfect BMs & no blood. I've been on that pattern since late November.

Today it was one of the bad days, but it has lasted longer and has been more painful than usual... I was on the beach with my family and woke up with abdominal pain, went to the bathroom like 7-9 times, and after the 3rd time my stools were BURNING, as if they were sufluric acid. It was never like diarrhea, but it was loose and extremely painful. I was super crampy in the morning, from like 10 to 2 PM, and then I had to drive back to the city... I was able to make it, but now it's the evening here and the pain came back. No BMs yet, but I have a lot of cramps and abdominal pain.

If the pattern holds true, tomorrow I'll have more normal but bloody stools and in 2 days I'll be fine, however, I'm worried that this time i've been in a lot of pain for the entire day, so, questions:

1- What is it with the burning, sulfuric acid-like stools??? In my first flare in 2010 I never experienced something like that, and in this flare I only started having those burning BMs when I started to improve overall in November-December. Does anyone experience that? Is it normal? I've never read of anyone complaining about burning, irritant, acidic stools. I got a C-diff test and parasit tests in mid December and they were all normal.

2- I imagine that having such irritant stools going through my colon will exhacerbate its irritation, and therefore the next-day bleeding is normal. May this be a problem with another organ that secretes any sort of acids for digestion? (liver, pancreas, etc) that's causing the severely irritating stools?

3- How about toxic megacolon? Is that something I should worry about? Right now I feel like crap, I have cramps, no BMs, and my belly is a bit swollen, but I don't think I'm in risk of developing toxic megacolon since I've been doing fairly well overall with the exception of today. What do you think?

I'm sorry for the lengthy post, but I'd appreciate your help. If there's anything I can do to help you deal with this crappy disease, please let me know!

Cheers from South America

I don't know if mixing Pentasa and Lialda will make a huge difference; they are both made up of the same active ingredient (mesalamine) and the only difference is that one gets released higher up in the GI tract (pentasa) than the other (Lialda). I've been on both and that's why I'm telling you hehe. I liked Lialda better, definitely, but there's no Lialda here in the country where I'm living

I'm still on pain by the way, but it has evolved. Now it's sporadic but intense, and focused in the center of my belly, as if someone grabbed my guts and twisted them for 10-20 second intervals, and then for a few minutes there's no intense pain... it usually hurts after I move or change positions (I've stayed still sitting and it hasn't hurt for like an hour). But when it hurts, it does hurt... everyonce in a while I pass some gas and this morning I had a nearly liquid BM--no blood...

My last colonoscopy was inconclusive regarding my diagnosis and there's a chance my problem is actually Chron's, and I've heard CD patients suffer from blockages... does any of you have experience on that? I know this is the UC forum and here's where I've posted most often because that was my original diagnosis, but do you think that with my symptoms I may be experiencing a mild-moderate blockage?

Thanks Nososickgirl! I'm still considering starting on Azathioprine (my GI already gave me a prescription and orders to get my blodd count done), and I think that after this episode I will start... I'm glad that it has worked with you! My signature is almost up to date, I'm no longer on HC supps, but only on Pentasa supps 5-6 times a week and 3.5 gr of oral Pentasa. I've been avoiding Pred at all costs this time. I've had stool tests and they all came up good (no bacteria or other problems). I haven't tried antibiotics for treating my UC; a year ago I was on antibiotics for about 2 months and I was on remission at the time, and then about 3 months ago (my current flare had started already) I started on Ciprofloxacin and it made my flare worse after 3 days, so my GI asked me to stop. I would definitely consider fecal transplant but I don't know about the availability to do it here in Chile where I'm residing (Health Care here is pretty good and much better than in the US in many ways, but there are not as many things available).

I finally went to bed yesterday with a little less pain after having some warm water (I read that helps with mild CD blockages, now that I'm paranoid that it may be CD). It helped, but I woke up at 6 AM with heavy cramps and gas, and by 7 AM I finally had diarrhea and a lot of crampy pain! it lasted for about 30 minutes, then went back to bed and slept till 9, when I had D again, and went back to bed again till 10 AM. I didn't go to work this morning (I'm lucky my boss is very understanding and considerate regarding my situation).

Now I've gone two more times to the bathroom, it is still D, but I no longer have the cramps I had yesterday. I don't know what's better or worse, but at least I don't have the pain.

The D looks different than anytime before for me though, it's completely transparent, with a strong highlighter-like yellow color, and with some mucus. Don't know if there may be any other organs involved in releasing/forming such weird-looking diarrhea, but anyway...

Thanks again! I tend to be very descriptive (and sometimes "too" descriptive) at times, hehe.

What's the triple antibiotic therapy? Haven't heard about it! I think I'll start Azathioprine soon, especially considering that it takes a few weeks/months to really kick in... according to my GI there's not much risk of side effects with it; I remember he just mentioned a potential panchreatic inflammation, but is there anything else I should be aware of?

And well, regarding the diagnosis, I think the 2 colonoscopies I've gone through have been clear as far as showing whether I have an IBD or not, it's just that the last one showed an inflamed patch away from my previously seen rectal inflammation... but who knows. The fact that my 2 "big" flares have been quite different in terms of symptoms, tolerance to different foods, and other factors, makes me question what I really have, but I'm still quite sure it's either UC or CD.

[quote=Heptacampeâo]The D looks different than anytime before for me though, it's completely transparent, with a strong highlighter-like yellow color, and with some mucus. Don't know if there may be any other organs involved in releasing/forming such weird-looking diarrhea, but anyway...

I have these too. Still have no idea what causes them. I always thought it was my gallbladder retaliating for something greasy. And boy does it burn. Wow! I use Canasa suppositories and that seems to help. Of course inserting them after the searing pain is difficult to bear, but it all turns out well.

I use this rule of thumb: If it burns your mouth then imagine how it's going to feel on ulcers in your colon. Avoid spicy foods at ALL costs. It's not worth it.