rowasa and thim BMs

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lemonhead
Veteran Member


Date Joined Dec 2007
Total Posts : 1028
   Posted 7/16/2008 9:19 AM (GMT -6)   
Just a question for you Rowasa users.  I have been taking 2 a day for a while and was afraid to go off of it.  But I decided to drop down to 1 a day.  Then recently went to one every other day and the day after I take the rowasa I have really skinny poo.  Thinner than a pencil.  No blood but you can definately tell there is a lot of inflammation there.  The mornings after I don't take one, the poo is definately thicker and looks more "normal".  Does anyone else have this and do you know why.  I am thinking I may have some sensitivity to something in the enema??? 
diagnosed with left-sided UC in 1997. (45cm)
Currently on 10mg Prednisone
12 caps of colazal    9 caps Colazal
2 rowasa enemas nightly
35, female


TraciZ
Regular Member


Date Joined Aug 2007
Total Posts : 255
   Posted 7/16/2008 11:53 AM (GMT -6)   
Yes, that happens to me, too. Sorry, I don't know why.
Tressa 35 (F)
probably pancolitis, but almost in remission!
Canasa twice/day to get that last 5 cm
Asacol 12/day


quincy
Elite Member


Date Joined May 2003
Total Posts : 30389
   Posted 7/16/2008 3:18 PM (GMT -6)   
rectal inflammation and/or a tight sphincter from stress or IBS can cause pencil thin stools. Since they improve after you've used the Rowasa, I'll assume it's inflammation.

go back to nightly enemas and stay on them for at least for another week or two...then start tapering to every second night.

Can you take fibre supplements?

quincy
*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


lemonhead
Veteran Member


Date Joined Dec 2007
Total Posts : 1028
   Posted 7/16/2008 6:58 PM (GMT -6)   
I am trying to mix a little fiber in with my meals (benefiber). I am just wondering why the inflammation occurs after I take the enema. I thought it was suppose to be an anitinflammatory. When I don't take them, I get bigger thicker BMs. Doesn't make much sense??
diagnosed with left-sided UC in 1997. (45cm)
Currently on 10mg Prednisone
12 caps of colazal    9 caps Colazal
2 rowasa enemas nightly
35, female


quincy
Elite Member


Date Joined May 2003
Total Posts : 30389
   Posted 7/17/2008 2:01 AM (GMT -6)   
Hi...I reread your posting and I got it backwards obviously.

Yes, 5ASA is an antiinflammatory medication, but it's not the only thing that would affect your stool consistency.

It could be that the nights you take it...the following day the colon is a bit slower therefore allowing the stool to have more water removed forming a firmer stool.

I personally would't worry about the consistency of the stool compared to increase symptoms. My stool varies in consistency most likely influenced by food and stress levels.

How long have you been on the every second night enemas?
How long were you on the twice daily enemas and how were your stool consistency when taking them?

Hang tough and try not to micromanage your symptoms. Take the meds and if you are having bms daily, once or twice, no rectal pain/ cramping/ discomfort, no bleeding..it's probably doing its job.

I think adding fibre is a good idea. Have you been having any discomfort from the Benefibre that you've noted?

quincy
*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


lemonhead
Veteran Member


Date Joined Dec 2007
Total Posts : 1028
   Posted 7/17/2008 6:13 AM (GMT -6)   
No discomfort, but I seem to be a little constipated. which is weird....never have that problem, always going too much. I took 2 enemas 2 nights ago and had very thin BM, but took none last night and am having even thinner bms, so maybe not the enemas as I thought. But I am just getting off my monthly visitor, so that may be another factor. I have had this for over 10 years and it still baffles me.
diagnosed with left-sided UC in 1997. (45cm)
Currently on 10mg Prednisone
12 caps of colazal    9 caps Colazal
2 rowasa enemas nightly
35, female


quincy
Elite Member


Date Joined May 2003
Total Posts : 30389
   Posted 7/17/2008 1:05 PM (GMT -6)   
I think consistency in your meds would be a good place to start. I think 2 enemas daily at this time for you are a waste of money and meds. Besides, it raises your likelihood for side effects that can mimic UC.

Yep, periods and the hormonal changes will affect your bowel.

Stay on the nightly enemas for at least a week or two, then start to taper. Too much then nothing will cause you some confusion regarding symptoms.

Please consider the suggestion. I can tell you from my 19+ year experience from enemas that it's a good plan.

What's your end desire regarding the enemas? how long were you on them twice a day?

When did you go on them nightly?

When did you taper to every second night?

quincy
*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


lemonhead
Veteran Member


Date Joined Dec 2007
Total Posts : 1028
   Posted 7/18/2008 5:41 AM (GMT -6)   
I used to only take them when I needed them. But I had a horrible flare last July and started the double dose around October. My GI suggested teh double dose (I take 2 at the same time) to force the medicine higher up my colon. about 2 months ago, I went down to one, and then recently went to every other night and that is when I am seeing such a difference in BM size. I don't really care bout conisistency as long as I am not having diarrhea. My end goal of the enemas is to not have any blood and it does help with that, But if for some reason it was causeing additional inflammation in my colon I wanted to not have that.....really I really want to be normal, but that is not going to happen, so I am trying to get to a point where I can lead a mostly normal life.
I will take your suggestion. I took just one enema last night and will keep that up for 2 weeks and then taper to every other and see how that goes. Thanks for your help
diagnosed with left-sided UC in 1997. (45cm)
Currently on 10mg Prednisone
12 caps of colazal    9 caps Colazal
2 rowasa enemas nightly
35, female


Kiss520
Veteran Member


Date Joined Jun 2008
Total Posts : 742
   Posted 7/18/2008 5:52 AM (GMT -6)   

Hi Lemonhead,

Are you leaving the Rowasa in all night when you do your nightly dose?  I have found that that gives me terribly runny icky poops the following morning.  Its like the medicine turns whatever is in there to mush.  So now I do 30 minutes and go to the bathroom and let it empty out and then go to bed.  This really seems to help the problem of consistency.

I always thought the more time I could keep the meds in the better, but that doesn't seem to be the case with enemas.   I share your frustration with not understanding this stuff.  There's so much trial and error to sort through.  Good luck!
 
Katie
Female, 30.   Chicago 'burbs.
DX:  Ulcerative Proctitis (10cm) January '08
Current Treament:  Rowasa 60 ML 2X daily, Cortenama 100 ML 1X daily, Bentyl 20 MG 4X daily (as needed), Tylenol, and Acidophilus 2X daily.
Diet/Exercise:  No sugar (including fructose, sorbitol, mannitol, and lactose) or wheat bran fiber.  Daily yoga, walking, or cardio w/weights.
Previous Treatment:  Canasa suppositories, Cortifoam, Prednisone, Colazal, Symex DuoTabs, Vitamins.
Status:  Flare (showing some improvement)
 
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30389
   Posted 7/18/2008 10:43 AM (GMT -6)   
Katie, Try not to confuse a mushy stool with no success....it is what it is and the fact that the med stays in the lower part of the colon is a good thing.
30 minutes and then expelling it is a waste unless you have no way to control it.

lemonhead.....I think there's such a thing as overkill....5ASA is a med that takes a while to work. You don't need it to go any farther into the colon than it does because you're on an oral 5ASA med.

Let it do its stuff. The problem with using a high dosage to start is you don't know what is the med and what is UC. As well, you can't increase because you've taken up the wiggle room.

A perfectly formed stool is certainly not my measuring stick for a successful bm...the fact that it's out on a fairly good schedule is a good thing. I eat fruits and salad....that in turn will cause a looser stool for me.

The fibre will bulk things up.....

Diarrhea isn't a problem for me if I've eaten something....it'll only be a problem if it's consistent or increases.

quincy
*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


Kiss520
Veteran Member


Date Joined Jun 2008
Total Posts : 742
   Posted 7/18/2008 11:38 AM (GMT -6)   
Quincy - The problem I have with leaving it in is that not only does it make a mushy poop, it makes me crampy and uncomfortable. So I think what you said to Lemonhead applies here, too - you can have too much of a good thing. I really feel like I was overmedicating when I left it in all night. Plus, it was my doctor who told me to leave it in for 30 minutes. I left it in longer thinking longer was better, but that's not been the case for me. Not only is the poop not mushy the next day, its not horrible smelling and I generally feel much better.

I tend to disagree with not using the solid BM as a measuring stick - how else are we to know if our inflammation is dying down?

I hope I don't sound argumentative. I'm still learning about all this and clearly different things work for different people. I can relate to Lemonhead's concern and have found a way around it that works for me, so I just wanted to share.
Female, 30.   Chicago 'burbs.
DX:  Ulcerative Proctitis (10cm) January '08
Current Treament:  Rowasa 60 ML 2X daily, Cortenama 100 ML 1X daily, Bentyl 20 MG 4X daily (as needed), Tylenol, and Acidophilus 2X daily.
Diet/Exercise:  No sugar (including fructose, sorbitol, mannitol, and lactose) or wheat bran fiber.  Daily yoga, walking, or cardio w/weights.
Previous Treatment:  Canasa suppositories, Cortifoam, Prednisone, Colazal, Symex DuoTabs, Vitamins.
Status:  Flare (showing some improvement)
 
 


quincy
Elite Member


Date Joined May 2003
Total Posts : 30389
   Posted 7/18/2008 4:29 PM (GMT -6)   
Low in the rectum inflammation can cause more solid bms and eventually constipation with lots of gas. The cue would be the consistency or increase of symptoms until it gets to a point where one confirms.

IBS can cause loose stool (there's a wide range of stool types from hard as a rock to water stools) even diarrhea...as can meds, foods, artificial sweeteners..etc.

I'm saying you'll learn the differences....but it takes time when one has inflammation. A solid poop can depend on what you eat...increased fibre, etc.

regarding the enemas...you can get a 2g dosage of the mesalamine and try to hold it in longer..I agree with some discomfort, however...especially if one has any gas. Good propellant for the morning bm, however..lol!

I don't perceive you as being argumentative in any way.
quincy
*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~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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