Sulfasalazine causing bloody stool

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Bigphule
Regular Member


Date Joined Dec 2007
Total Posts : 137
   Posted 2/28/2008 7:30 AM (GMT -6)   
Okay, just Tuesday I got put back on Sulfasalazine, 1gram twice a day.  Before that I was on just 40 mg of Pred.  My Pred also got backed off to 30mg, I've been on 20mg before but the darn doctors decided to screw up and not taper me just not give me any refils and then schedule my next appointment for a month after I ran out of the Pred. 
 
Anyhow, my stool was normal.  Wednesday I took my first two doses of the Sulfa. and boom today woken up at 4:30am with bloody diareaha!
 
I had been on the Sulfasalazine before and had a flare up get worse.  One doctor said it was probably a drug interation another said that since I didn't have any symptoms of an allergic reaction it was just coincidence. 
 
I'm done with the Sulfasalazine, I'm going to self medicate my Pred back up to 40mg untill I can get in to the doctor (thank you VA health care system).
 
Has anyone ever had Sulfasalazine take them from near remission right back into a flare up?
Diagnosed UC 12/2007
 
 
Folic Acid 1mg x 1/day ~ On going
Asacol 400mg x 6/day ~ Failed (Allergic)
Prednisone 30mg x 1/day ~ On going recent change 2/26/2008
Sulfasalazine 1g x 3/day ~ 2/26/08 


tjf
Veteran Member


Date Joined Dec 2005
Total Posts : 3238
   Posted 2/28/2008 7:50 AM (GMT -6)   
Hey! Okay so you were on 20m of pred. and stopped cold turkey? Why not just call the nurse or GI and ask for a refill? I run out of meds all the time before my scheduled appts. The only reason I say that is b/c if you have been on pred. for awhile you can really throw your body for a loop stopping cold turkey.

As for the sulfa....I"m allergic but my allergy didn't show up as bloody d.
Tabitha (Tab)

100mg Azathioprine, 2 Fibercon, Colazal-9 a day, Acidopholis Pearls, Nexium

http://www.healingwell.com/donate
Co-Moderator UC Forum


Bigphule
Regular Member


Date Joined Dec 2007
Total Posts : 137
   Posted 2/28/2008 8:04 AM (GMT -6)   
Yeah, the whole cold turkey drop off of pred happend a while ago after I was first diagnosed. I wasn't very clear in my orriginal post. I was pretty upset so let me reoganize what I wrote into something more cohearant. Totally my fault hehe

Okay after I was first diagnosed I got on 20mg of pred. I blame both myself and the doctors for the cold turkey drop off, so tjf, you were absolutly right. Fast Forward a little bit. When I went in for the appointment after my pred ran out, they put me on Sulfasalazine, I had a bad bad reaction during that time frame. I ended up back in the ER and they put me back on 40mg of Pred. One doctor, Dr. S. said that it might have been a bad reaction, possibly allergic. So Tuesday was my follow up from the 40mg of Pred appointment. I spoke to Dr. M. who was (I don't know his title) a honcho (someone a bit farther up in the chain of command) and he asked me about things like hives or other typical allergic symptoms. I had none. So, he thought it was just a coincedence that I had a flare up while on the Sulfa.

Now Wednesday (yesterday) I took my first two doses of Sulfa, today I'm woken up with bloody D. I don't think it is because I dropped down 10 mg in the Pred, because I've been on less (hence why I brought up the 20 mg of Pred.) so the only change I've made is the Sulfa. I think that though it might not be an allergy like one would normally see, it is definatly a bad drug interaction/reaction. And I'm not taking it anymore.
Diagnosed UC 12/2007
 
 
Folic Acid 1mg x 1/day ~ On going
Asacol 400mg x 6/day ~ Failed (Allergic)
Prednisone 30mg x 1/day ~ On going recent change 2/26/2008
Sulfasalazine 1g x 3/day ~ 2/26/08 


tjf
Veteran Member


Date Joined Dec 2005
Total Posts : 3238
   Posted 2/28/2008 8:13 AM (GMT -6)   
Got it now! Sorry my brain isn't fully functioning this morning even though I've been up for hours!

When I taper pred. I usually have a surge of symptoms for 1-3 days as my body adjusts to the new dosage. That would be part of the problem.

As for the sulfa...I didn't have a 'typical' allergic reaction either. No hives but I ended up in bed w/ a migraine for 3 days. If you have only taken 2 doses stopping the sulfa cold turkey shouldn't be a problem. Can you try Colazal or is that too close to the Asacol that you are allergic too? How about rectal meds?
Tabitha (Tab)

100mg Azathioprine, 2 Fibercon, Colazal-9 a day, Acidopholis Pearls, Nexium

http://www.healingwell.com/donate
Co-Moderator UC Forum


Bigphule
Regular Member


Date Joined Dec 2007
Total Posts : 137
   Posted 2/28/2008 8:26 AM (GMT -6)   
I can't answer your last two questions either way. I just don't know.

I find it interesting that you had a serge of symptoms while decreasing the Pred. Why don't doctors tell you that things like that could happen? I don't know what questions to ask and they should be familure enough with side effects and other things being GI's and just tell you what could happen.
Diagnosed UC 12/2007
 
 
Folic Acid 1mg x 1/day ~ On going
Asacol 400mg x 6/day ~ Failed (Allergic)
Prednisone 30mg x 1/day ~ On going recent change 2/26/2008
Sulfasalazine 1g x 3/day ~ 2/26/08 


Bigphule
Regular Member


Date Joined Dec 2007
Total Posts : 137
   Posted 3/1/2008 3:33 PM (GMT -6)   
Okay, update time.

After two days I finally got in contact with my GI Dr. M. He all but confirmed that it was the step down in the Pred that has caused my serge of symptoms, thank you tjf for your info on that. Once my symptoms are back under control I will start taking the Sulfa. again. Just as he perscribed.

So I would like to mooch off of the experiance of my fellow posters if they will allow it. I have gotten in on an earlier appointment, I need to know some questions to ask my GI. If you read my second post on this topic (the first is a little confusing) can anyone tell me what questions I should be asking?

I didn't go to work Thursday or Friday, and have pretty much had to cancel all my social plans for today and I don't know if I'm even going to be able to go to church tomorrow :( So my lack of being prepared has really thrown a monkey wrench in my life and I'm determined not to let it happen again, at least not to this degree.

Here is what I have come up with thus far:

When it comes time for me to step down my Pred again, would it be a good idea to go on a liquid only diet starting a few days before the appointment? If I don't get my Pred stepped down at the appointment I've not really lost anything.

Will taking Imodium A.D. for a day or two during the symptom serge to control the D/BD do me any harm or good, or will it really do anything at all?

Did you know that eating a whole package of blue jello and drinking 4 liters of orange Tang in one day produces comically colored BMs?




I'm pretty much stumped at this point, what else should I ask?


Thank you all in advance for sharing your knowledge and experiance.
Diagnosed UC 12/2007
 
 
Folic Acid 1mg x 1/day ~ On going
Asacol 400mg x 6/day ~ Failed (Allergic)
Prednisone 30mg x 1/day ~ On going recent change 2/26/2008
Sulfasalazine 1g x 3/day ~ 2/26/08 

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