Jalapeño-burning stools & a lot of abdominal pain--Toxic Megacolon?

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Heptacampeâo
Regular Member


Date Joined Jul 2010
Total Posts : 56
   Posted 2/14/2012 7:10 PM (GMT -6)   
Hi everyone,

I've been doing fairly well lately; I started flaring in August-September, got really bad in October-early November, and started improving in late November. However, I haven't quite recovered.

For the last month this has been the pattern of my symptoms: Perfect to near-perfect bowel movements & stools for 3-4 days, then one day I wake up with pain, loose BMs, and urgency. The stool is as if I had eaten only Jalapeños the previous day... the stools are extremely burning and leaves my bum super irritated. Next day my stools are more normal, but I bleed. That lasts 1-2 days, and then I have again 3-4 days with perfect to near-perfect BMs & no blood. I've been on that pattern since late November.

Today it was one of the bad days, but it has lasted longer and has been more painful than usual... I was on the beach with my family and woke up with abdominal pain, went to the bathroom like 7-9 times, and after the 3rd time my stools were BURNING, as if they were sufluric acid. It was never like diarrhea, but it was loose and extremely painful. I was super crampy in the morning, from like 10 to 2 PM, and then I had to drive back to the city... I was able to make it, but now it's the evening here and the pain came back. No BMs yet, but I have a lot of cramps and abdominal pain.

If the pattern holds true, tomorrow I'll have more normal but bloody stools and in 2 days I'll be fine, however, I'm worried that this time i've been in a lot of pain for the entire day, so, questions:

1- What is it with the burning, sulfuric acid-like stools??? In my first flare in 2010 I never experienced something like that, and in this flare I only started having those burning BMs when I started to improve overall in November-December. Does anyone experience that? Is it normal? I've never read of anyone complaining about burning, irritant, acidic stools. I got a C-diff test and parasit tests in mid December and they were all normal.

2- I imagine that having such irritant stools going through my colon will exhacerbate its irritation, and therefore the next-day bleeding is normal. May this be a problem with another organ that secretes any sort of acids for digestion? (liver, pancreas, etc) that's causing the severely irritating stools?

3- How about toxic megacolon? Is that something I should worry about? Right now I feel like crap, I have cramps, no BMs, and my belly is a bit swollen, but I don't think I'm in risk of developing toxic megacolon since I've been doing fairly well overall with the exception of today. What do you think?

I'm sorry for the lengthy post, but I'd appreciate your help. If there's anything I can do to help you deal with this crappy disease, please let me know!

Cheers from South America
Male, 26, Mild Ulc. Proctitis, 10 cm, diagnosed on July 2010
March '10, bleeding began
July '10, Got worse, right after colonoscopy and diagnosis. Remission by Oct '10, minor flare in Jan '11
September 2011, New big, worse flare, New colonoscopy showed 15cm of rectum and 4cm in splenic angle (CD?)

Meds: HC Supp, 25 g (tapering), Pentasa Supp 1g 4x a week
Pentasa 3.5 g/day, considering Prednisone

46&crashing
Regular Member


Date Joined Sep 2011
Total Posts : 482
   Posted 2/14/2012 9:46 PM (GMT -6)   
I am fairly new to all this. All this started in May for me and I have only had a small window where I wasn't bleeding at least alittle. Praying for the opportunity to experience remission at some point.

I can tell you that I too am experiencing that acid burning bm. It's like you can feel it searing it's way through your colon. It is extremely painful.

I am currently on Lialda, but this summer I was on Pentasa. Pentasa didn't help me much at all, but all summer it was weird. I could be out in the sun at the beach in 100 degree weather and if you put your hand on my belly, it would be cool. I have recently wondered if I took Lialda and maybe 1 or 2 Pentasa if that would cool the burning bms. Silly, I know, but I am supposed to call my GI doc tomorrow and will probably ask him if it would help, hurt, or be a waste of time.
DX: May 2011
Current meds: 3 Lialda tabs each morning
Also on Prednisone 40 mg daily since 9/16
Prilosec as needed
And this too shall pass!

Heptacampeâo
Regular Member


Date Joined Jul 2010
Total Posts : 56
   Posted 2/15/2012 10:53 PM (GMT -6)   
I don't know if mixing Pentasa and Lialda will make a huge difference; they are both made up of the same active ingredient (mesalamine) and the only difference is that one gets released higher up in the GI tract (pentasa) than the other (Lialda). I've been on both and that's why I'm telling you hehe. I liked Lialda better, definitely, but there's no Lialda here in the country where I'm living

I'm still on pain by the way, but it has evolved. Now it's sporadic but intense, and focused in the center of my belly, as if someone grabbed my guts and twisted them for 10-20 second intervals, and then for a few minutes there's no intense pain... it usually hurts after I move or change positions (I've stayed still sitting and it hasn't hurt for like an hour). But when it hurts, it does hurt... everyonce in a while I pass some gas and this morning I had a nearly liquid BM--no blood...

My last colonoscopy was inconclusive regarding my diagnosis and there's a chance my problem is actually Chron's, and I've heard CD patients suffer from blockages... does any of you have experience on that? I know this is the UC forum and here's where I've posted most often because that was my original diagnosis, but do you think that with my symptoms I may be experiencing a mild-moderate blockage?
Male, 26, Mild Ulc. Proctitis, 10 cm, diagnosed on July 2010
March '10, bleeding began
July '10, Got worse, right after colonoscopy and diagnosis. Remission by Oct '10, minor flare in Jan '11
September 2011, New big, worse flare, New colonoscopy showed 15cm of rectum and 4cm in splenic angle (CD?)

Meds: HC Supp, 25 g (tapering), Pentasa Supp 1g 4x a week
Pentasa 3.5 g/day, considering Prednisone

notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 9930
   Posted 2/16/2012 12:12 PM (GMT -6)   
If you're concerend about a blockage or toxic megacolon, go get checked out right away. These aren't situations where you want to wait and see. I have the burning at times too, it seems to happen more when I have a hemmi or a fissure but it can happen at any time. I don't think that's worrisome - what's worrisome is the pain you describe. I also understand that UC is a painful illness when it is flared up and I understand questioning whether you need to be seen or if it's normal UC pain.

Is your signature up to date? It's unfortunate that you're having trouble getting a diagnosis. Have you had stool tests to cheeck for bacteria? Have you ever tried any antibiotics? Would you consider fecal transplant?

I had to start 6mp a bit over a year ago and since, I have been feeling quite a bit better.
Co-moderator: Ulcerative Colitis
Diagnosed with Pancolitis, Laryngopharyngeal Reflux & Migraines. Battling Extreme Exhaustion.
Currently: Asacol (2800mg) + 6mp (25mg) + Pristiq (50mg) + prilosec (40mg) +Canasa (1g PM) + cerazette

Heptacampeâo
Regular Member


Date Joined Jul 2010
Total Posts : 56
   Posted 2/16/2012 12:27 PM (GMT -6)   
Thanks Nososickgirl! I'm still considering starting on Azathioprine (my GI already gave me a prescription and orders to get my blodd count done), and I think that after this episode I will start... I'm glad that it has worked with you! My signature is almost up to date, I'm no longer on HC supps, but only on Pentasa supps 5-6 times a week and 3.5 gr of oral Pentasa. I've been avoiding Pred at all costs this time. I've had stool tests and they all came up good (no bacteria or other problems). I haven't tried antibiotics for treating my UC; a year ago I was on antibiotics for about 2 months and I was on remission at the time, and then about 3 months ago (my current flare had started already) I started on Ciprofloxacin and it made my flare worse after 3 days, so my GI asked me to stop. I would definitely consider fecal transplant but I don't know about the availability to do it here in Chile where I'm residing (Health Care here is pretty good and much better than in the US in many ways, but there are not as many things available).

I finally went to bed yesterday with a little less pain after having some warm water (I read that helps with mild CD blockages, now that I'm paranoid that it may be CD). It helped, but I woke up at 6 AM with heavy cramps and gas, and by 7 AM I finally had diarrhea and a lot of crampy pain! it lasted for about 30 minutes, then went back to bed and slept till 9, when I had D again, and went back to bed again till 10 AM. I didn't go to work this morning (I'm lucky my boss is very understanding and considerate regarding my situation).

Now I've gone two more times to the bathroom, it is still D, but I no longer have the cramps I had yesterday. I don't know what's better or worse, but at least I don't have the pain.

The D looks different than anytime before for me though, it's completely transparent, with a strong highlighter-like yellow color, and with some mucus. Don't know if there may be any other organs involved in releasing/forming such weird-looking diarrhea, but anyway...
Male, 26, Mild Ulc. Proctitis, 10 cm, diagnosed on July 2010
March '10, bleeding began
July '10, Got worse, right after colonoscopy and diagnosis. Remission by Oct '10, minor flare in Jan '11
September 2011, New big, worse flare, New colonoscopy showed 15cm of rectum and 4cm in splenic angle (CD?)

Meds: HC Supp, 25 g (tapering), Pentasa Supp 1g 4x a week
Pentasa 3.5 g/day, considering Prednisone

notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 9930
   Posted 2/16/2012 12:37 PM (GMT -6)   
Thanks for the very descriptive post :)

I think it is worrisome that you're having so much pain and these crazy BMs. I am happy you're not working and I hope things calm down. FT isn't really available here in the US either, only for c. diff, not for UC. People tend to try the at-home version if they have a good donor who is free of bacteria/illnesses. It's difficult to find a person who you're comfortable with - getting them tested would be quite expensive. I would be comfortable using my fiance but he's got bowel issues of his own (not as bad as mine but definitely not normal).

Azathioprine, in my opinion, is a better option than prednisone. The reality is that if you were to get on prednisone, it would just prolong starting Aza. That's how it worked out for me anyway. I was fine when I was on 15 or 20mg but I couldn't taper down without 6mp. I should have started 6mp sooner because I gained a ton of weight from the pred and I felt awful about myself. At least with 6mp, I am not dealing with terrible side effects. You should go get your blood work done in case you decide to start it. It takes a while to get into your system and stabilize your condition. The only thing that worries me in your case is that you have an indetermined case of "colitis", what if it's not UC? It would stink to take an immunosupressant and then find out you've had some kind of bug this whole time. Have you ever considered the triple antibiotic therapy? I would like to try that but my biopsies have always had clear results pointing to UC :(
Co-moderator: Ulcerative Colitis
Diagnosed with Pancolitis, Laryngopharyngeal Reflux & Migraines. Battling Extreme Exhaustion.
Currently: Asacol (2800mg) + 6mp (25mg) + Pristiq (50mg) + prilosec (40mg) +Canasa (1g PM) + cerazette

Heptacampeâo
Regular Member


Date Joined Jul 2010
Total Posts : 56
   Posted 2/16/2012 1:00 PM (GMT -6)   
Thanks again! I tend to be very descriptive (and sometimes "too" descriptive) at times, hehe.

What's the triple antibiotic therapy? Haven't heard about it! I think I'll start Azathioprine soon, especially considering that it takes a few weeks/months to really kick in... according to my GI there's not much risk of side effects with it; I remember he just mentioned a potential panchreatic inflammation, but is there anything else I should be aware of?

And well, regarding the diagnosis, I think the 2 colonoscopies I've gone through have been clear as far as showing whether I have an IBD or not, it's just that the last one showed an inflamed patch away from my previously seen rectal inflammation... but who knows. The fact that my 2 "big" flares have been quite different in terms of symptoms, tolerance to different foods, and other factors, makes me question what I really have, but I'm still quite sure it's either UC or CD.
Male, 26, Mild Ulc. Proctitis, 10 cm, diagnosed on July 2010
March '10, bleeding began
July '10, Got worse, right after colonoscopy and diagnosis. Remission by Oct '10, minor flare in Jan '11
September 2011, New big, worse flare, New colonoscopy showed 15cm of rectum and 4cm in splenic angle (CD?)

Meds: HC Supp, 25 g (tapering), Pentasa Supp 1g 4x a week
Pentasa 3.5 g/day, considering Prednisone

notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 9930
   Posted 2/16/2012 1:41 PM (GMT -6)   
I pulled this from the resources thread:
 
 

Anitbiotic Therapy: amoxicillin 1500mg/day, tetracycline 1500mg/day, and metronidazole 750mg/day
http://www.nature.com/ajg/journal/v105/n8/abs/ajg201084a.html

Descriptive is good. Sometimes I get a laugh out of myself when I am trying to be descriptive with my GI. She is interested in everything I describe and I will say things like, "it was fluffy and broke when it hit the bowl". I never imagined I would describe things such as this...

I think the majority of people on 6mp/imuran don't have too many side effects. The most common ones I see mentioned here are fatigue and nausea. I take my 6mp before bed and I don't have either of those side effects. I have dealt with fatigue my whole life but I don't think it's any worse. You have to get your blood checked frquently while on imuran, they check the liver every month - every 3 months, depending on yoru GI. Pancretitis is a serious risk that usually shows up shortly after starting the medication but it's rare.


Co-moderator: Ulcerative Colitis
Diagnosed with Pancolitis, Laryngopharyngeal Reflux & Migraines. Battling Extreme Exhaustion.
Currently: Asacol (2800mg) + 6mp (25mg) + Pristiq (50mg) + prilosec (40mg) +Canasa (1g PM) + cerazette

IndianaUC
Regular Member


Date Joined Feb 2007
Total Posts : 212
   Posted 2/18/2012 8:52 PM (GMT -6)   
[quote=Heptacampeâo]The D looks different than anytime before for me though, it's completely transparent, with a strong highlighter-like yellow color, and with some mucus. Don't know if there may be any other organs involved in releasing/forming such weird-looking diarrhea, but anyway...


I have these too. Still have no idea what causes them. I always thought it was my gallbladder retaliating for something greasy. And boy does it burn. Wow! I use Canasa suppositories and that seems to help. Of course inserting them after the searing pain is difficult to bear, but it all turns out well.

I use this rule of thumb: If it burns your mouth then imagine how it's going to feel on ulcers in your colon. Avoid spicy foods at ALL costs. It's not worth it.

deltaforce
Veteran Member


Date Joined Jun 2010
Total Posts : 1838
   Posted 2/19/2012 10:03 AM (GMT -6)   
From what you say, I don't think you have megacolon, else you would be in pretty bad shape with constant diarrhea with blood and mucus. By now, you would have already lost some weight and pretty much bed ridden. However, I do think you are in good flare. I was in your shoe last month with bright tail light for a month, when not eating any Indian spices or chilli peppers. For a couple of weeks, only place I was sitting was, on porcelain throne, any other place I sit and my bum would irritate hell out of me. I used Lidocaine 2% gel too often to numb anus but it didn't work as expected. It only returned to normal after I started on Pred 40 mg (3+ wks on I am still on it and will be on for another 3 wks, yucks!!) The goal was to get flare under control, now that its getting under control, I will reduce it after colonocopy in 3rd wk of march.

In your case, I would start Azathioprine. It will be your long term solution (than using Pred on and often) Honestly, its not as bad drug as its perceived, its been a saver for me. You do have to give blood sample on and often till your dose is stabilized though but its worth it. You could do a course of Pred to get your current flare under control.

With rectal meds, esp. enemas, I am not really fan of it and avoid all the time. I just can not retain them well and it affects my sleep a big time. If I don't get sleep well, my next day gets really bad but thats just me. If you can handle it (with flare) go for it or you may want to couple it up with Bentyl so that you could hold it a little longer.
Diagnosed March 2007 with left sided UC at the age of 30.
Currently on,
Colazal 9 daily, Imuran, 200mg daily, Vit. B12, 1mg, Multivitamin, 1 tablet daily, Fish oil 2400mg daily, Vit D 2000 IU daily, Butterbur 150mg daily.

Verapamil 240mg for migraine, Migraine episode now at least twice a month,
Ibuprofen 400mg is the only solution (but leads to bleeding). Looking for alternatives.
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