Pills showing up in toilet?

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Jokerlola
Regular Member


Date Joined May 2010
Total Posts : 60
   Posted 1/16/2011 5:19 PM (GMT -6)   
Is it common in UC for pills and capsules to pass through the digestive system undissolved? My Dad, who is in a current flare finds undissolved supplement capsules and pills like Lialda in his stool. He finds vitamin and probiotic capsules he took in the morning, in his stools a few hours later. He has a very fast transit time. He found a completely undissolved vitamin E softgel in there today. He doesn't seem to find hard pills in there like his prednisone which is weird because you would think capsules would dissolve easier. So is this common with UC?

quincy
Elite Member


Date Joined May 2003
Total Posts : 25142
   Posted 1/16/2011 5:40 PM (GMT -6)   
Things wouldn't go through that fast...unless possibly he's on pure liquid diet.

I would think that the reason things aren't dissolving or breaking down has to do with his stomach or small intestine...he either doesn't have the right ph balance or bacteria in that area to dissolve the pills..

Is he eating food? or just liquids?

Is he still in the hospital?

Is he in on rectal meds?

How much weight is he losing?

Is he on fibre supplements?

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Symbicort/Airomir (asthma)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4000 IU
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

Media Composer
New Member


Date Joined Jan 2011
Total Posts : 2
   Posted 1/16/2011 6:07 PM (GMT -6)   
look out for issues with ASA -5 mesamelmines such as asacol, pentasa they can cause as in my case insanely fast transit times especially if they are not right for your system, prednisone at somewhere between 40 -60 mg a day work for some to decrease the transit times and inflammation, some sort of anti spasmodic might be needed also, if there is pain some sort of pain management can help to lower stress levels and additional cramping. the Dx should be able to tell him what is okay to take.
Diagnosed Moderate Ulcerative Colitis April 8 2010,
Most recent colonoscopy Dx: Severe Ulcerative Colitis, ulcers in sigmoid colon
Past Meds ASA-5 not working Asachol HD, Pentasa
Current Meds: (daily)Prednizone 40mg, Azathioprine 50mg
Under consideration: Remicade, Gerson Treatment, Probitotics

notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 9595
   Posted 1/16/2011 6:38 PM (GMT -6)   
I have seen asacol pills in my stool but I don't know whether there was any medicine in the pill or if it was empty.
Co-moderator: Ulcerative Colitis
03/07: Diagnosis: Mild Proctitis | 08/08: Diagnosis: Pancolitis - FLARE & Anemic! Asacol (3600mg) + Canasa (1000mg morning/night) | 01/10: FLARE! Prednisone + Cortifoam + Asacol + Canasa + Rowasa | Currently: stable - Asacol (3200mg) + Canasa (nightly) + 6mp + Allopurinol + Prednisone + Ponstel + Klonopin + Ambien

mjschl
Regular Member


Date Joined Jan 2009
Total Posts : 26
   Posted 1/16/2011 8:31 PM (GMT -6)   
When I am flaring bad everything goes straight through me - including pills. Try to add some psyllium or other fiber to bulk up the stool, and see if you can replace any of the pills with powdered or liquid forms of the medicines. For example, I used to take psyllium caps and VSL#3 caps, both of which I now take powdered forms.

Jokerlola
Regular Member


Date Joined May 2010
Total Posts : 60
   Posted 1/16/2011 11:20 PM (GMT -6)   
 
No. He isn't still in the hospital. He is eating food but not much. He has virtually no appetite. He takes Marinal but it doesn't help much. He eats mostly peanut butter, some yogurt, some bread, eggs and a whey protein drink with VSL3 in it. He is not taking rectal meds because it is too hard to give them himself. He has lost about 30 lbs since late November. He is not currently taking fiber suppliments. He's afraid they will start him bleeding again.
He started finding undissolved capsules in his stool from the beginning of the bad part of this flare. I don't think he ever has found a hard pill. He took a vitamin E softgel yesterday morning and 8 hours later, he saw it intact in his toilet. I observed it as well. The prednisone has stopped his bleeding but he is still having constant watery diarrhea several times day and night.
quincy said...
Things wouldn't go through that fast...unless possibly he's on pure liquid diet.

I would think that the reason things aren't dissolving or breaking down has to do with his stomach or small intestine...he either doesn't have the right ph balance or bacteria in that area to dissolve the pills..

Is he eating food? or just liquids?

Is he still in the hospital?

Is he in on rectal meds?

How much weight is he losing?

Is he on fibre supplements?

q

quincy
Elite Member


Date Joined May 2003
Total Posts : 25142
   Posted 1/16/2011 11:47 PM (GMT -6)   
8 hours isn't a few hours...definitely possible.

ah, Marinal...for what exactly?

What whey protein drink? does it have artificial sweeteners in it?

Is he having diarrhea?

What about a half of an imodium?

Is Lialda a capsule? I understand the capsule form 5ASA meds can be taken without the capsule but poured in applesauce or something like that...NOT CHEWED. maybe that will help.

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Symbicort/Airomir (asthma)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4000 IU
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

Jokerlola
Regular Member


Date Joined May 2010
Total Posts : 60
   Posted 1/17/2011 1:45 AM (GMT -6)   
It tends to be what ever he takes in the morning can show up in the toilet by that afternoon or that evening. These are capsules and softgels that will completely dissolved in a glass of water in 30 minutes yet won't dissolve in his digestive track in 4 to 12 hours. He says he has seen capsules show up only 3 hours after taking.

He was taking Marinol for his appetite. He has even tried medical marijuana with very little effect on his appetite.

I make protein drinks for him out of Jay Robb Whey Protein Isolate powder mixed with maltodextrin to try to duplicate Absorb Plus. Jay Robb is supposed to be the best Whey protein. It is sweetened with stevia and made with pasture raised grass fed cows milk.

Yes he is having constant watery diarrhea. The pred made his bleeding stop but not the runs. He has tried half and a whole doses of imodium with no relief.

Lialda is a coated caplet. He is no longer taking it because he started taking 2 a day to keep him in remission about 2 years ago. He started having a flare a year ago while on it. He was bumped up to 4 day but his flare just kept getting worse until he was hospitalized in late May and put on steroids. Despite the prednisone and Liada he was still flaring and bleeding. I started him on real kefir made with kefir grains and raw milk along with raw goats milk mixed with Jay Robb Whey protein and VSL3 and he went into remission in June. He continued the 4 Liada but stopped the goats milk whey VSL3 shakes and slacked off regular kefir drinking. He started this current flair in late October until it got really bad in late November and hospitalized in mid Dec while he was still on the 4 Lialda. So recently he quit taking it since it didn't keep him from going into 2 bad flares.

My Dad first got colitis in 1995 after he quit smoking. He was put on sulfasazine which didn't really help. I found Atkins Vita Nutient book and had him take pantethene and pantethenitic acid as well as fish oil and glutamine and that put him into remission for over 10 years. Then in 2005 he had knee replacement surgery and his colitis returned a few of months after. He was tested for c-diff several times and was always negative. He was put on Flagyl, Alinia and Colazal. He was then put on Asacol. Despite this he got worse and was hospitalized in Dec of 2006 and put on his first course of prednisone. The pred helped a little but he went home still flaring. I heard about Seacure and started him on it and he went into remission. He had a mild to moderate flare a year later and he took Leviquin for some dental work and that put him in remission which lasted for 3 years.

quincy said...
8 hours isn't a few hours...definitely possible.

ah, Marinal...for what exactly?

What whey protein drink? does it have artificial sweeteners in it?

Is he having diarrhea?

What about a half of an imodium?

Is Lialda a capsule? I understand the capsule form 5ASA meds can be taken without the capsule but poured in applesauce or something like that...NOT CHEWED. maybe that will help.

q

Cadillac Lover
Regular Member


Date Joined Feb 2009
Total Posts : 235
   Posted 1/17/2011 1:58 AM (GMT -6)   
My first real flare I had I was on asacol 400mg and I would find pills in the toilet every day, I think it was just the empty capsule though.

quincy
Elite Member


Date Joined May 2003
Total Posts : 25142
   Posted 1/17/2011 11:55 AM (GMT -6)   
My last colonoscopy...interesting little diddy. I took my asacol in the morning before the purge the night before the c-scope. I do the gallon prep.

I ate brunch...took my meds, vitamins, etc.

That afternoon at 5 00 I started the purge.
All went well...

C. scope happened, and lo and behold one lonely asacol somewhere in there (don't exactly remember where) dissolving happily.

So...what comes out doesn't mean it's from that day. Especially if one takes them regularly.

I think your dad should force himself to eat more, and I would personally nix the protein drinks and all the milk products you're feeding him and see if his diarrhea improves. He may be simply lactose intolerant.
Separate from the UC.

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Symbicort/Airomir (asthma)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4000 IU
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

Peace&Harmony
Veteran Member


Date Joined Jul 2010
Total Posts : 1082
   Posted 1/17/2011 3:11 PM (GMT -6)   
I had an issue with Asacol not dissolving. In fact they were coming out as hard as a rock. I would fish them out with a toilet brush. It's OK to see the shell left over but if your Ph level isn't 7.0 or higher the resin coating doesn't dissolve. Not everyone has a high Ph level in their digestive track...especially with UC. That how we are unable to break down foods and absorb the nutrients. if the resin coating isn't being dissolved then you're not getting the full benefit from the dose. My PH level tends to vary a lot...so my dose wasn't constant.

I just got a new GI who prescribed Apriso as it break down differently at a lower Ph level (6.0). Will start taking it tomorrow.
41 year old female, diagnosed July 2010
flaring as of 10/15/2010,
Rectosigmoid up to 30 cm....very mild?
Mesalamine 4gm enema daily
Asacol oral 2 pills 3x daily - due to tolerance level
Folic Acid 1 mg daily / Probotics / Vit D / Bene-fiber
Microgestin (birth control), Magnesium for leg cramp

Jokerlola
Regular Member


Date Joined May 2010
Total Posts : 60
   Posted 1/17/2011 3:19 PM (GMT -6)   
Right now he is not eating any dairy except for some occational 24 hour VSL3 yogurt I make. The protein drinks are made with water. He has never been lactose intolerant before. He thrived on the kefir and raw goats milk this summer before this latest flare but he refuses to drink any kefir or goats milk now. I wish I could force him to eat but he has no appetite and says that everything except peanut butter tastes bad.
quincy said...
My last colonoscopy...interesting little diddy. I took my asacol in the morning before the purge the night before the c-scope. I do the gallon prep.

I ate brunch...took my meds, vitamins, etc.

That afternoon at 5 00 I started the purge.
All went well...

C. scope happened, and lo and behold one lonely asacol somewhere in there (don't exactly remember where) dissolving happily.

So...what comes out doesn't mean it's from that day. Especially if one takes them regularly.

I think your dad should force himself to eat more, and I would personally nix the protein drinks and all the milk products you're feeding him and see if his diarrhea improves. He may be simply lactose intolerant.
Separate from the UC.

q

agt13girl
Regular Member


Date Joined Apr 2010
Total Posts : 64
   Posted 1/17/2011 4:52 PM (GMT -6)   
Whey is a milk product, and I have found out that most of the lactose in milk is in the whey. Just because you mix the protein with water doesn't mean that there's no lactose. I've drunk milk all my life, and decided about six months ago to start taking lactose enzyme supplements. I also cut back on my milk product intake, and I'm finally starting to feel better, having solid BMs, and less urgency. You could try that and see if it helps.
22 years old
Diagnosed with Pan Colitis ~ December 2009, Still flaring
Tried Asacol, didn't work and ended up in the hospital, February '10
Currently on Apriso, .375gm 4/day, Mesalamine enemas, 4 gm/60ml once a day
Was on Pred, end of Feb. '10- end of May '10
Lomotil, 2.5mg when I need it, usually when I go out, Wellbutrin, 300mg 1/day
Multivitamin/mineral tablets, 1/day

Jokerlola
Regular Member


Date Joined May 2010
Total Posts : 60
   Posted 1/17/2011 5:38 PM (GMT -6)   
agt13girl said...
Whey is a milk product, and I have found out that most of the lactose in milk is in the whey. Just because you mix the protein with water doesn't mean that there's no lactose. I've drunk milk all my life, and decided about six months ago to start taking lactose enzyme supplements. I also cut back on my milk product intake, and I'm finally starting to feel better, having solid BMs, and less urgency. You could try that and see if it helps.


Jay Robb Whey Isolate is supposed to be very low lactose. I was giving him lactase enzyme with it but there is no difference with it or without it. He doesn't have the whey protein drink everyday and there is no noticeable differences on the days he takes it from the days he doesn't. He went a long time with no milk products (about a month) during this flare and things weren't any better. He seems to do a little better on the days he eats my VSL#3 yogurt. I don't think the JIF peanut butter is that great for him but if I take that away, he won't eat anything.

quincy
Elite Member


Date Joined May 2003
Total Posts : 25142
   Posted 1/17/2011 6:48 PM (GMT -6)   
Any protein drinks I've tried gave me the most discomfort even compared to ice cream. Yogurt as well..., although tolerable, I only would consider to consume it in the evening.

Vsl can also cause gas...maybe his using it at night before bedtime would be good.


Regarding the asacol...mine are pretty much pulverised, flat and orange when they come out.

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Symbicort/Airomir (asthma)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4000 IU
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!
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