I finally had my GI consult today.

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Treester
Regular Member


Date Joined Mar 2008
Total Posts : 73
   Posted 6/19/2008 12:54 PM (GMT -7)   
I'll try to recap  my story as briefly as possible ...
 
I had my gallbladder out in March/April 2006.  I expected some D issues, but they really weren't too bad.  Some D after eating "bad" foods, but mostly normal bms for the most part.
 
Around the end of November 2007, I noticed a significant, persistant change in my habits.  I had D as soon as I ate ANYTHING, and it was URGENT.  Plus the frequency had increased as well, I was going a bunch of times every day.  I never had any other symptoms, no pain or "sick" feeling or blood or anything like that.  But it was still a significant change, and by the time I got up the nerve to call my GP, it was April.  She did bloodwork for celiac's (negative) and a stool culture for c. diff (negative), and referred me to the GI. 
 
It took more than two months to get the appointment, during which time I found out I was pregnant.  My ob told me to keep the appointment, even though there's not much we could do in terms of testing or treatment.  So, I went today, and this is how it went ...
 
He's extremely confident that it's a bacterial issue, even though the original c. diff came back negative. 
 
His plan is thirty days of Flagyl, plus Florajen3 probiotic, plus high fiber diet and Fibercon (at my discretion).  He knows I'm 16 weeks pregnant.  He confirmed that Flagyl is Category B for pregnancy.
 
I'm reading up on Flagyl myself, and I'm going to call my ob tomorrow.  I'm not sure what I'm going to do.  He did say I could be more conservative for now, and just do the probiotic treatment, but it was up to me.
 
So, I know that none of you can tell me what to do.  That's not what I'm looking for at all.  Just ... I don't know.  Any thoughts?
 
Thanks for listening.

Keriamon
Veteran Member


Date Joined Jun 2005
Total Posts : 2976
   Posted 6/19/2008 2:20 PM (GMT -7)   
C. difficile is not the only bad bacteria. There are a bunch of them. Yeast (like from vaginal infections and thrush in the mouth) is also one.

I'd see what your OB thinks about taking the antibiotic. If she's hesitant, or if I felt hesitant, then I would do the probiotic thing until the baby is born, then see the GI again a couple of months afterwards (give your hormones time to straighten out) if I was still having problems, then do the antibiotic.

While on the antibiotic, and for a while afterwards, you should take probiotics. While the next antibiotic dose will kill the good bacteria you just put in, studies have shown that people on probiotics while taking antibiotics have less diarrhea (because antibiotics cause diarrhea all on their own). I have certainly found this to be true in my case. You have to continue to take them after you get off the antibiotics to make sure that you get your guts repopulated with the good stuff, or the bad stuff can easily take over again. For a week's antibiotics, I continue probiotics for a week to three weeks afterwards. For a month's antibiotics, I would stay on probiotics for 1-3 months after stopping the antibiotic. And since I do dairy products, even after stopping the probiotics I would drink acidophillus milk and consume yogurt as wanted; that's a light, but constant update to your good bacteria.

One thing about the high fiber diet and fiber supplements. I am one of a few weird people (some others on here) that get worse when I get into fiber. Weirdest thing, but one fiber supplement made me more constipated when I took it, and when I had D, it made that worse too. I was never bold enough to try another fiber supplement. Especially not after I ate some blue corn chips and got diarrhea. I eat yellow/white corn chips all the time with no problem. The only thing I could see is that the blue corn chips are like massively full of fiber. So too much fiber appears not to agree with me. You may be normal and get better bowel movements with the introduction of fiber, but if you notice a sudden change for the worse, stop it. You may be weird like me.

Treester
Regular Member


Date Joined Mar 2008
Total Posts : 73
   Posted 6/19/2008 5:24 PM (GMT -7)   
Thanks for the cautionary tale on the fiber. I will take it slow on that front, for sure! Diarrhea sucks, but I hate HATE being constipated even more. I hate it so much that I didn't even take vicodin after my gallbladder surgery!

I forgot to mention, he suggested the probiotic "for life." I think I also forgot to mention (in my post) that I had strep in September of 2007 and took a traditional course of amox, which is what he thinks triggered my problems, even though I didn't notice the change until November.

Thanks for reading my post. I'm a little hesitant about the flagyl, mainly because I'm afraid of the D getting worse before it gets better. Being pregnant is enough of a stressor on the body, and I'm pretty much "used to" my current D habits, I'm not sure I want to throw the old monkey wrench in the works right now.

7Lil
Veteran Member


Date Joined Apr 2005
Total Posts : 3269
   Posted 6/19/2008 6:06 PM (GMT -7)   
Flagyl is an extremely strong antibiotic. There have been a few people come through here (Sarita for one has taken it MANY times) and everyone has felt pretty crappy while on it. Pun very much intended. Flagyl is notorious for making people feel nauseous and have lots of D. I would definitely hold off until you talk to your OB.
No matter what you decide to do, you should difinitely consider probiotics right away. I don't even have a bacterial problem and I take at least 2 versions of it a day. It has kept my IBS in check for a couple years now. Probiotic pills are wonderfully efficient, so are yogurts and milks.
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Sarita
Veteran Member


Date Joined Mar 2005
Total Posts : 2486
   Posted 6/19/2008 9:25 PM (GMT -7)   
Hey Treester! I think your doc has come up with a good plan but I agree the Flagyl is always a sticky situation. I took it several times, as Lil said, and sometimes I felt "okay" while I was taking it and other times I felt monstrous. Usually, though, it has worked wonders for my diarrhea for a while at a time. I actually just tried another round recently - my D has been back up to 10 times a day and I need that to stop - but after a particularly intense few days of it (500 mg 3x/day, which is a lot - I was supposed to do that for 2 weeks) I just couldn't take it. It was really wreaking havoc on me this time. I'm sort of darned if I do and darned if I don't at this point...

I think you might ask your doctor about trying everything EXCEPT the Flagyl at first to see how that works for you; maybe the probiotics and fiber therapy will be enough. Those are definitely a good idea and are very easily tolerated.

Congratulations on your pregnancy!!!
Co-moderator - IBS Forum

Please always remember to consult your medical professional regarding your medical questions; this forum is intended to provide patient-to-patient support. Although some of us have healthcare backgrounds, we cannot diagnose or treat patients on the board.


Keriamon
Veteran Member


Date Joined Jun 2005
Total Posts : 2976
   Posted 6/20/2008 7:27 AM (GMT -7)   
<<I forgot to mention, he suggested the probiotic "for life." I think I also forgot to mention (in my post) that I had strep in September of 2007 and took a traditional course of amox, which is what he thinks triggered my problems, even though I didn't notice the change until November. >>

I read up on this a few years back when I suspected a round of antibiotics had triggered a bad bout of diarrhea in me. It's called antibiotic-associated colitis, if you want to look it up. If your D is caused by just not enough good bacteria, then probiotics for a month or so could have you right as rain again. If it's bad bacteria in there, then the probiotics might not help at all, might help some, or, if taken long enough, might correct the problem. If they don't help at all or enough, then you'll have to combine it with antibiotics.
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