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Question About Food Journaling

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Ulcerative Colitis
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Posted 2/9/2017 1:50 PM (GMT 0)
Hello,

I'm in the middle of a flare - taking meds and now working with a nutritionist. How can you tell if something you ate has a negative effect? My symptoms were getting better on prednisone, but in the last couple of days they are getting worse again as there is more blood again. I'm not going to the bathroom 15-20 times a day like I was over a week ago. I'm wondering if it has something to do with drinking orange juice and eating grapes. Would it be possible to drink orange juice in the afternoon and then have a problem reflected at night and the next day with extra blood? Could it be something I ate 2 days ago? I understand that nutrition is very individualized, but I'm having a bit of trouble understanding how long it can take before I can tell if a specific food hurts me or helps me or has no effect.

Diagnosed with UC July 2016. Flaring since January 22, 2017.

2x25mg Prednisone per day
1 Pentasa 1g enema each night
1 mesalasin suppository per day
Posted 2/9/2017 2:15 PM (GMT 0)
are you leaving out a drug on your list because you should be on an oral mesalamine along with your rectals and pred -

eating and food are very subjective - you first need to get on the right meds and then figure out the right foods -

it can be difficult in general, but especially so when you are flaring -
Posted 2/9/2017 2:30 PM (GMT 0)
They told me to start oral mesalamine on Monday, 2/13 - 3x800 mg per day.

I also just talked to the doctor a few minutes ago and they told me to go back up to 2 suppositories per day now instead of 1.

So until 2/13, here are my meds.

2x25mg Prednisolon per day
1 Pentasa 1g enema each night
2 mesalamine suppositories per day 500 mg each

On 2/13, I'm supposed to start tapering the prednisolon to 45 mg per day and start the oral mesalamine.
Posted 2/9/2017 2:44 PM (GMT 0)
ya, well, the standard treatment is to start you on the oral mesalamine from the get go - it can take some time to start working - the purpose of the pred is to take care of immediate symptoms while waiting for the mesalamine to work, and then once symptoms are controlled, start tapering off the pred -

i would ask them (dr, nurse,etc), why the delay in starting the mesalamine - you should have been on it since july -

btw, where are you located ?
Posted 2/9/2017 3:05 PM (GMT 0)
I'm an American living in Copenhagen, Denmark for the last few years.

They had me on one suppository per day since I was diagnosed in July. The problem was only in 2 centimeters of the rectum (when they did sigmoidoscopies in July and November of 2016). The doctor was telling me that my symptoms would probably disappear. I would take the suppository for 30 days and then go off of it for a few weeks and then go back on it when some blood came back. I didn't have any issues with diarrhea until the flaring started a few weeks ago. The latest sigmoidoscopy a week ago showed inflammation in at least 70 centimeters. I will probably get a colonoscopy in the future.
Posted 2/9/2017 3:10 PM (GMT 0)
Have you had a stool test to look for infectious causes to your symptoms, like c diff? It's possible your flare is just getting worse.

You can start with a very restrictive diet: bland chicken and potatoes every night as a baseline, and reintroduce foods one at a time and journal your symptoms the next morning. It might help. If there's too much variation then how can you tell what's causing what?

If you're flaring badly then it's going to be hard to tell as most food is going to upset you.
Posted 2/9/2017 3:18 PM (GMT 0)
and that's why you should have been on the oral from the beginning to prevent the spread - nobody wants to be on medication, but sometimes it's a necessity - no one can say for certain if that would have prevented the spread, but it is a definite possibility -

you really need to get them to agree to the oral now ! and up the enema to a higher dose of 4G - time to kick this flare to the curb !

good luck -
Posted 2/9/2017 4:11 PM (GMT 0)
While flaring with bleeding and inflammation, I could NOT tolerate grapes or citrus fruits unless they were juiced and even then I'd stay away from citruses. My bowel transit time usually took 1-3 days depending on how well I digested other foods, but sometimes negative effects were immediate. I ate copious amounts of melons and had runny bloody diarrhea within hours of consumption. Just make sure you take other food combinations into account. This is how eating simple mono meals allowed me to determine what was cause and effect. Good luck with your journaling and recovery!
Posted 2/9/2017 4:36 PM (GMT 0)
Yes, I did 3 swab tests a week ago and a stool test a few days ago and they have all come out negative for infection. So far, it's a little worse in that I'm using the bathroom 5 times a day with urgency. It's down from 15-20 times per day, but up from 2 to 3 times day. I'm hoping it's a combination of the food and the extra dose of a suppository. I will call the Dr. tomorrow to see about starting the oral mesalamine earlier.

Makes sense to narrow the foods I'm eating in order to focus on whether 1 food or not affects me.

Also makes sense that the time varies between 1-3 days and just a few hours. I guess I won't always know right away, but have to keep the previous foods in mind. Thanks.
Posted 2/9/2017 4:45 PM (GMT 0)
controlling uc with diet is a great idea - many people do - but it's much easier to figure what works and what doesn't when your symptoms are controlled for a time - not saying complete remission, but at least something consistent that's manageable -

diet modification toward symptom control can be very challenging - certainly attainable but it can take time - some folks don't have the time, they just need to get back to functioning, work, family, responsibilities, etc -

for now, try to eat easily digestible foods and go light on fibrous things, especially raw vegetables -

and chocolate is always good smilewinkgrin
Posted 2/9/2017 4:56 PM (GMT 0)
Hi...now that you're doing a med increase with the mesalamines...hold with that until you are off the pred and afterward. You have improved a lot....but you do have to go through the pred taper which might have a few setbacks. If so, there are steroid enemas you can add to help along. I agree with Soy to increase the Pentasa enema to 4g.

Regarding food....what goes in will come out in a hurry because of the inflammation. If you have fruit, peel them and chew really well. Have them with food rather than alone between meals.
If you focus on the food, believing it's causing your bleeding while you are in this flare, it will only confuse you more.

Meet your nutritional needs as best you can. If you're eating lots of fruit and vegetables, and that type of fibre .....you might have much more loose stool and diarrhea and cramping.

We all tend to eat differently and different foods bother us subjectively while in or not in a flare.

So, generally what do you eat for meals? And what supplements do you take?

q
Posted 2/10/2017 10:35 AM (GMT 0)
I'm eating cooked beef and chicken and sometimes in soups - with a side of cooked vegetables like bell peppers, onions, mushrooms. I'm not eating any grains - no rice, no bread, no dairy and no sugar except for fruit. When I cook the food, I cook it in coconut oil - unless it's a stew or roast beef. Scrambled eggs every day for breakfast - sometimes with vegetables mixed in. I have bananas and avocados as snacks. I also drink unsweetened almond milk.

I'm taking vitamin D and calcium supplements. The nutritionist recommended that I start to take a couple of supplements - repairvite and another one (the name is escaping me) - so I'll start on those soon.

Looking forward to getting this under control and to maybe having formed stool again. I'm back at work now and hope to keep it that way.
Posted 2/10/2017 6:13 PM (GMT 0)
You should also be on a mixed b vitamin since they are found in grains mostly.
q
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