My GI's next step for me

Saw my GI, talked about my current state which is most days about 3 poops, but once a week or so I will go up to NINE times, occasional day of diarrhea(one off then back to solid next day). He told me he wants me on a regular schedule of suppositories (2-3 days a week) and he's sending me to a dietician (translation: he thinks a lot of remaining symptoms are IBS since last scope had only "very minimal rectal inflammation"). He mentioned that he doesn't want to "over medicate" if remaining is a lot of I(BS) lol. I'm not sure what to think. I will see him again in two months to reevaluate my symptoms after the regular suppository routine and the dietary mods the dietician recommends. (I stopped the suppositories because they weren't making any difference any more, it's like I've hit this plateau and upping my pentasa and or butt meds doesn't help further, so, maybe he's right, maybe what's left is ibs/dietary related?!? So frustrating.

Your docs reasoning sounds right to me. I have virtually the same symptoms as you (not 9 BM's however, 5 is my high number lately but it has been 7 in the past, normal/average is 2-3) and in my case it is food-driven. So no I don't want more UC meds or stronger ones, I'd prefer to handle symptoms with diet mod. and enemas. Canasa suppositories do little for me although I'll use them from time to time, mesalamine enemas do the job.

For me not eating inflammatory foods or trigger foods keeps BM's low but quite honestly some days I want to eat certain foods even though I know the next morning will be multiple BM's. Kinda like choosing to have alcoholic drinks knowing you'll have a hangover.

Healing the last inflammation is a long process. I prefer to do my healing without upping my RX.

I agree with your GI's suggestions TMP, cuz mine told me the same thing, with the exception that all my CD inflammation had cleared up nicely in the colon and rectum with just a little rectal scaring.

Keep in mind that yes diet and stress are 2 key components to IBS, but sometimes it can just be one or the other affecting ones IBS, so far my dietitian says my food/BM journal is showing her that stress is the driving force for my IBS, after she saw 4 weeks of what my guts been acting like still even though she's had me on the low FODMAP no fructose diet the only improvement is I'm less constipated/struggling on the toilet to pass movements (not completely backed up thank god cuz I've been there before and that was the worst) but she said I shouldn't still have so much frequency or any urgency while on this diet either so to her that indicates it's more likely stress than diet but since I've come so far on this diet we are of course continuing on it because I just started the re-introduction phase yesterday so about another 5 weeks and we should know what if anything is affecting my IBS diet wise at least.

I agree with you about your GI's thoughts since you do still have some inflammation but hey it is possible to have both conditions co-exist and it certainly will not hurt you to see a dietitian to help you with your diet, you might be surprised to find out maybe some foods you thought were safe for your IBD really aren't after-all and just adding to your tummy grief.

My dietitian has CD herself and is also my GI's patient and she plans to help me with an anti inflammatory diet to aid me when my CD flares back up again too so I see it as a double bonus if she can make sure there aren't foods that are bothering my IBS and create a diet to help my CD flares better than I'm all for it. Some common IBS trigger foods are spicy and fatty/fried foods and I really never eat any of those anyway so I agree with her and my therapist that I need to get my stress under control or my tummy will make me pay for it forever.

They can definitely coexist together GloGirl...and it sucks.