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Constipation vs rectal inflammation

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Ulcerative Colitis
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Posted 1/29/2015 1:59 AM (GMT 0)
I'm on a pred taper for a flare and eating cautiously because of nausea. Yesterday evening I developed cramping that was painful enough that I went to the ER. As always, I got IV fluids, zofran and dilaudid. I explained that cramping for me is a huge red flag and that I was worried because I had dropped to 30 mg of pred on Sunday.

They did an abd X-ray which showed "excess feces." I was surprised because aside from cramping, there was nothing. No bloating, no discomfort that made me think I was full of poo other than knowing I had not gone in 2 days. This will sound stupid, but how do I know if this is "constipation" from rectal inflammation or actually from suboptimal diet? When I have a bm, I'm not straining but sometimes it's painful upon exit.

My GI doc had me do 1/2 of a miralax bowel prep today which would ordinarily clean me right out but I've had 3 BMs which started as poo pellets and have progressed to soft normal poo.

This isn't my normal so that's why I need some input. Cramping always means impending doom for me and the quality of my poo is normally soft serve.
Posted 1/29/2015 3:01 AM (GMT 0)
Interesting question, I'm afraid I have no answer though. In my experience if I'm backed up for a couple of days when I do go it's pellets, then nice formed poop, then soft serve and then liquid. Maybe you're not done pooping yet and there's still more to come out! I tend to think (might not be right) but if my guts can make solid poop then the can't be all that inflamed. When I had inflammation-even when it was just rectal- there were no formed turds. I'm not sure if this is the norm or not, just my two cents.
Posted 1/29/2015 4:36 AM (GMT 0)
Thx for the feedback. At least I'm not alone in the transformation of UC poo!
Posted 1/29/2015 7:24 PM (GMT 0)
Since you're tapering pred and taking in maybe less food in general, I'd lean to the sense of still flaring and slower functioning of your colon.

The nausea, while it's from the prednisone probably, if it's recently started it's also a symptom of slowed colon, spasming and probable limited rectal inflammation.

Are you still on rectal meds while tapering the pred?

I'd expect you to have those ups and downs as you're tapering and healing. Fine line with food intake to keep things moving and nausea.
Are you using any fibre supplements?

Feel better soon...
q
Posted 1/29/2015 7:39 PM (GMT 0)
I get nausea when too constipated and do not feel like eating, so unlike me because I love to eat.

If you have UC in my opinion it can be both inflammation as well as food issues causing constipation (based on my own experience so you decide if that's your situation). So I treat both: use enema and/or suppository (mesalamine and Vit E suppos.) and cut back on fiber or any foods that slow things down.
Never hurts to attack on all fronts.
Posted 1/29/2015 10:32 PM (GMT 0)
Thanks q and gardner. I am using canasa every evening and had actually started alternating with rowasa. The last few nights I was lazy and used canasa. The nausea I've had for several months but does get worse sometimes before a bm. That's a newer symptom where I'll have a huge wave of nausea without any GI symtpoms and then within minutes, I'm running for the toilet to poop. I'm not using any fiber. I've been eating a lot of English muffins, bananas and hard boiled eggs.
Posted 1/29/2015 11:40 PM (GMT 0)
Bananas have too much fiber and fructose for my gut to handle. Fiber clogs me up and fructose gives me IBS, the worst of both worlds. But there are many here that LOVE bananas. I love them too but my gut does not :-(
Posted 1/29/2015 11:50 PM (GMT 0)
I love them too. I'm actually meeting with a dietician next week and have been keeping a food journal along with any symtpoms I have throughout the day. I'm interested in his feedback because I've never tweaked my diet...haven't really needed to until now.
Posted 1/29/2015 11:58 PM (GMT 0)
Flax seed has really helped me move things along. I love bananas but have issue if i eat too many days in a row.
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