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Need Advice - D and cramps

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Ulcerative Colitis
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Posted 4/23/2014 2:02 PM (GMT 0)
Hi all,

I had been fairly stable recently with the meds listed below, but as of the past week I have had extremely watery D (with no B...hard to tell if there is M), and I have moderately painful cramps in my lower abdomen through out the day. These are not flare symptoms for me as even during flares I usually have some form to my stool, and I have never had cramps. The D is particularly aggressive if I use rowasa during the day (which I have done with a lot of success for a month or so before this) - so I'm having to stop taking the very med that had helped me recently.

Does anyone have any experience with something like this? My GI wanted to put me on prednisone, but I refused and have requested for him to test my stool (and I'm using air-quotes around the word stool), and preemptively treat me with an anti-biotic.

Any insight would be helpful.

DX: Pan-colitis 2011
Current Meds: Asacol 3200mg, Azathioprine 100mg, Canasa and Rowasa (alternating)
Status: Was mostly in remission with the help of Rowasa, with occasional discomfort and maybe very little B on the wipe.
Posted 4/23/2014 4:43 PM (GMT 0)
Well, any GI worth his/her weight will have your stool tested for pathogens when suspecting a uc flareup. Because CDIFF is one pathogen that can cause the same exact symptoms as a UC flareup. Other pathogens can as well. Once that test comes back negative, and possibly after a flexible endoscope, your GI can confirm you have a UC flareup going on.

And to the rest of the UC world, cramps and diarrhea are uc flareup symptoms. If you mean you are having those symptoms all of the time, then you have a lot of active uc disease that is going untreated. Simmering uc, that isn't well treated makes it a lot more likely your uc will spread in extent and worsen in severity. Having simmering uc also makes it a lot more likely you will have a UC flareup. If you want to get into remission (an absence of all uc symptoms) and stay there for a long time then you must have deep-tissue healing.

Prednisone is the standard go-to for GIs when you have a confirmed UC flareup. What's your beef with pred? As it does the job of kicking uc flareups in the butt and it does it well. If you are worried about the nuisance side effects of pred, then take Uceris it is much more tame in that regard.
Posted 4/23/2014 5:00 PM (GMT 0)
I agree stool testing should be one of the first things you do. Keep in mind though that all flares may not be the same. What you felt before may not be what you feel now. And we all know treating a flare isn't always as easy as it has been at another time.

Hope you figure out what is going on.
Posted 4/23/2014 5:05 PM (GMT 0)
Well the thing is that, before this past week I have NEVER had these symptoms, and I have been in a flare 3-4 times since diagnosis. This just doesn't feel like a normal flare to me - I only have 1-2 BM's per day, and there's no B.

I just tapered off Pred in Feb, and don't want to go back so soon without legitimate reason.

I am surprised that he didn't want to have my stool tested after I told him the symtoms - he's usually the collect tons of data type. Maybe it was because I consulted him over the phone and that's not how the money comes in. Maybe I'm being cynical though.
Posted 4/23/2014 5:16 PM (GMT 0)
What meds are you on at this point?

You'd be best to push the doc for stool testing....

q
Posted 4/23/2014 5:20 PM (GMT 0)
Thanks quincy. I'm on Asacol 3200mg, Azathiprint 100mg, Canasa and Rowasa (alternating days).

I did push for a stool test, and he ordered one as well as a blood test. Secretly I was hoping he'd preemptively treat me with an antibiotic...but no luck with that.
Posted 4/23/2014 5:23 PM (GMT 0)
It's best to know before getting the antibiotics...just in case, for you don't want to set yourself up for something else.

Are you on probiotics as well? If not, consider it.

I'd also suggest you up the enemas to see if you improve.

q
Posted 4/23/2014 6:03 PM (GMT 0)
Yea I use VSL daily. I have also done some home FT's in the past with decent results...although it's not a "cure" for me like it has been for some.

Currently it seems like the Rowasa is making the D and cramps worse, so I am refraining.
Posted 4/23/2014 6:35 PM (GMT 0)
Not every flare is the same. Antibiotics can make you much, much worse so it's good the doc didn't just prescribe them willy-nilly. If your C-Diff test comes back positive then you need them.
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