Cause of fatigue

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puglover13
Regular Member


Date Joined Aug 2007
Total Posts : 25
   Posted 9/18/2008 6:20 AM (GMT -6)   
I went to my GI complaining of constant fatigue and she sent me for blood work to check all my levels, everything is back to normal, but I tested positive for Lyme disease and now have to go on antibiotics.  I'm afraid this is going to make me flare up again, I finally got my UC under control and have been slowly tapering off the meds (with the exception of Remicaid - WONDER DRUG!!!)  Has anyone else experienced this?  Any tips for keeping my gut OK while on antibiotics for 3 weeks???
Diagnosed UC June 2007 (mis-diagnosed with IBS for 3 years)
Current meds: Asacol 6/day, Forvia multivitamin, 6-MP 25mg, Cortenema as needed,
Remicade, Lexapro 10mg/day


men8ifr
Regular Member


Date Joined Jul 2008
Total Posts : 124
   Posted 9/18/2008 6:47 AM (GMT -6)   
Take lots and lots and lots of pro-biotics - see my reply to the Phillips health thread today on how to make Yoghurt take the stuff while you are on the anti-biotics as well.

I found this - may be worth trying though I have no other information on taking glutamine before/after anti-biotics

"Those who use non-steroidal anti-inflammatories or antibiotics may have a special need for supplemental glutamine. Both can damage the gut lining and set up gastrointestinal disturbances or leaky gut syndrome. Fortunately, sufficient glutamine can undo the damage caused by antibiotics or NSAIDs, maintaining permeability at a healthy level. For those with any disturbance of the gut the soothing effects of glutamine taken as powder dissolved in water makes itself known quite soon after ingestion."

Also I found this below

ICAAC: Tetracycline May Protect Against C. difficile Colitis
SAN FRANSICO, Sept. 28 -- Though antibiotic exposure typically increases the risk of Clostridium difficile colitis, tetracycline may protect against it, researchers reported here
Tetracycline decreased the risk C. difficile colitis (odds ratio [OR] 0.6, (95% confidence interval [CI] 0.5 to 0.9) while other antibiotics, particularly imipenem, raised the risk, according to a case-control study presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy in an oral session.
Antibiotics with the highest risk included:
• imipenem (OR 3.31, CI 1.27 to 8.62, P=0.02)
• ceftazidime (OR 2.45, CI 1.48 to 4.07, P<0.01)
• clindamycin (OR 2.02, P<0.01)
• moxifloxacin (OR 1.66, P=0.03)
"In hospitals with high rates of C. difficile, physicians should consider using antibiotics with lower associated risk," said Roger Baxter, M.D., of Kaiser Permanente Northern California in Oakland.
Surprisingly, meropenem had one of the lowest associated risks (OR 1.05) though imipenem in the same class of drugs had the highest risk. The lowest risks were from tetracycline (OR: 0.6, CI: 0.5 to 0.9), doxycycline, ampicillin (often faulted as the main cause of C. difficile, noted Dr. Baxter), metronidazole, and erythromycin.
Antibiotics in the middle range with increased risk of C. difficile colitis, though not significantly so due to wide confidence intervals, included piperacillin/tazobactam, cefotetan, ampicillin/sulbactam, ceftriaxone and others.
Many earlier studies looking at risk from individual antibiotics had problems with sample size. Dr. Baxter and colleagues drew data from the Kaiser Permanente Northern California system of 54 clinics and 16 hospitals that have the advantage of consistent inter-institution infection-control standards.
The retrospective study included 696 cases seen from 2000 through 2004 of first-time C. difficile toxin assay positive infection in patients who had been exposed to antibiotics in the 60 days prior to the positive C. difficile test. Each patient was matched with eight controls (total 2,058) with the same number of days in the same hospital in the same year and quarter, same diagnosis at discharge, and who had also been exposed to antibiotics.
about half of the patients were male and the average age was 68 years for both cases and controls. However, cases had more hospitalized days (14 versus 9) and more proton pump inhibitor use (42% versus 30%).
All odds ratios were determined after controlling for prior hospitalization days, number of prior different antimicrobials and proton pump inhibitor use in a regression analysis.
Dr. Baxter cautioned that these results are somewhat different than other studies have found because of the limited power due to matching criteria. Further study will be needed to confirm the findings with regard to ceftriaxone, which has been much higher on other studies' risk findings, and the apparent protective effect of tetracylines.
Also, the newer antimicrobials like linezolid, tigecycline and daptomycin were not used frequently enough to make statistical comparisons with other agents, he said.
This study confirmed what clinicians thought was true, that broad-spectrum antibiotics increase the risk of colitis more and, therefore, are particularly going to be problematic in hospitals where there is C. difficile exposure, Dr. Baxter concluded.
Other risk factors identified in the study were older age, number of hospital days in the 60 days prior to index date, and high medical costs in the year prior to index date.

IBD and C. Difficile Make Deadly Combination
MILWAUKEE, Sept. 26 -- A Clostridium difficile infection sharply increases the risk of death for patients with underlying inflammatory bowel disease, researchers here said
People admitted to the hospital with a combination of C. difficile and either Crohn's disease or ulcerative colitis were nearly five times as likely to die as those admitted for inflammatory bowel disease alone, according to David Binion, M.D., and colleagues, at Wisconsin College of Medicine.
They were also more likely to die than patients admitted with just C. difficile associated disease, Dr. Binion and colleagues reported in the online issue of Gut.
Doctors should engage in "prudent use of antibiotics" for patients with inflammatory bowel disease to reduce the incidence of C. difficile disease, the researchers said.
Their findings came from an analysis of the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample for 2003. The sample for that year covered 37 states, 994 hospitals of all sizes and types, and more than 38 million discharges.
The investigators found that the discharge diagnosis was both C. difficile and inflammatory bowel disease in 2,804 cases, C. difficile alone in 44,400 cases, and inflammatory bowel disease alone in 77,366 cases.
A multivariate analysis showed that:
• Patients with both conditions were significantly more likely (at P<0.05) to die in the hospital than those with inflammatory bowel disease alone. The adjusted odds ratio was 4.7, with a 95% confidence interval from 2.9 to 7.9.
• Patients with both conditions were twice as likely to die as those with C. difficile associated disease alone. The adjusted odds ratio was 2.2, with a 95% confidence interval from 1.4 to 3.4, which was also significant at P<0.05.
The analysis also showed that -- compared with patients with inflammatory bowel disease alone -- those with both conditions had a longer hospital stay (3 days on average), higher hospitalization costs ($11,406 on average), and higher rates of lower GI endoscopy.
Patients with both conditions were half as likely, however, to have bowel surgery as those with inflammatory bowel disease alone (the adjusted odds ratio was 0.6), but they were much more likely to have surgery than those admitted with C. difficile alone (the odds ratio was 6.6).
Interestingly, having C. difficile and ulcerative colitis was more dangerous than C. difficile and Crohn's disease. Specifically:
• 5% of those with ulcerative colitis and coexisting C. difficile died in the hospital, compared with 3% of those with Crohn's and C. difficile. The difference was significant at P=0.01.
• Ulcerative colitis patients also had higher rates of lower GI endoscopy -- 56% versus 46.9%, which was significant at P<0.01.
• And they had higher rates of bowel surgery -- 10.4% versus 8%, which was significant at P=0.04.
Among the study's strengths, the researchers said, is the fact that it uses a large nation-wide sample. On the other hand, the researchers were unable to adjust for the severity of underlying inflammatory bowel disease.
Also, they said, it is possible that some patients classified as having inflammatory bowel disease alone also had mild C. difficile disease, but were not tested for the toxin, which would reduce the magnitude of the associations.
Ian

6 Asacol tabs/day
1 Pentasa Suppository / day
Fish oil 3/day (omega 3 only)
Multivitamin and mineral 1/day
Folic Acid 1/day
Aloe Vera 3/day
Specific Carbohydrate Diet SCD
Turmeric 3/day
Currently in no mans land between flare and remission


men8ifr
Regular Member


Date Joined Jul 2008
Total Posts : 124
   Posted 9/18/2008 6:57 AM (GMT -6)   
Found the article I was looking for - basically some japanese researchers seem to have improved colitis condition with some specific anti-biotics.

While i'm certainly not a doctor have a look at the information - i'd prefer to take anti-biotics that may appear to help my condition rather than run a risk that they may make me worse - I believe colitis is related to bacteria and anti-biotics 'messes' with then in very different ways so I believe it would make sense that it can make the condition better or worse - most evidence would support making it worse and the following article one of the few if only evidence I know of for improving symptoms - it would be good if a doctor could comment on the suitability of taking these anti-biotics rather than whetever he feels like/normally gives out.

apologies for the long post (again) I don't have th elink to this

DDW: Antibiotics Improve Colitis Symptoms
WASHINGTON, May 24 -- A combination of antibiotics aimed at Fusobacterium varium offers ulcerative colitis patients improved symptoms, a Japanese researcher said here
The finding, from a double-blind, placebo-controlled trial, supports the idea that bacteria may play a role in the pathogenesis of the condition, according to Toshifumi Ohkusa, M.D., of the department of gastroenterology of Juntendo University in Tokyo.
The proposed pathogen is a member of a genus of anerobic, Gram-negative filamentous bacteria, Dr. Ohkusa told researchers at Digestive Disease Week.
Dr. Ohkusa and colleagues have been suggesting for several years that the bacteria play a role in ulcerative colitis. Two years ago he reported a small trial that showed inhibiting the bacteria benefited patients with mild to severe colitis.
But that study was small and not double-blind, so he and colleagues enrolled 210 patients with active colitis and randomized them to placebo or to a combination of three antibiotics -- ampicillin, tetracycline (both at 500 mg three times a day), and metronidazole (at 250 mg three times a day.)
The treatment period was two weeks long, followed by a year of follow-up. Concomitant medications for colitis were maintained throughout the study, with the exception that steroids were tapered off if the patient went into remission, he said.
The primary endpoints were clinical response at three months on Lichitiger's symptom score, St. Mark's index, and Mayo score, and mucosal healing on Matt's grading score. A range of secondary endpoints was evaluated at 12 months, he said.
The analysis found:
• For placebo patients, the Lichitiger's symptom score fell by one at three months, compared to a drop of two for antibiotic patients, a difference that was significant at P=0.0007.
• For placebo patients, the St. Mark's index fell by one at three months, compared to a drop of two for antibiotic patients, a difference that was significant at P=0.0002.
• For placebo patients, the Mayo score fell by one at three months, compared to a drop of two for antibiotic patients, a difference that was significant at P=0.0001.
• For placebo patients, the Matt's grading score did not change at three months, compared to a drop of one for antibiotic patients, a difference that was significant at P=0.0013.
Also, Dr. Ohkusa said, scores of frequency of watery diarrhea, nocturnal diarrhea, fecal incontinence, and general well-being were significantly improved in the treatment group.
Adverse events were higher in the treatment group -- mainly nausea and fever -- but there were no serious adverse events, Dr. Ohkusa said.
He concluded that the two-week antibiotic treatment is both effective and safe.
The study was weakened because the researchers did not check to see if the presence of the F. varium in the stool changed after antibiotic treatment, according to Hillary Steinhart, M.D., head of gastroenterology at Toronto's University Health Network, who was co-chairman of the session.
Dr. Steinhart said he wasn't persuaded by the results that the bacteria play a pathogenic role in ulcerative colitis.
"It doesn't convince me," he said. Among other things, he said, the researchers "didn't really make any attempt to look at either the fusobacterium itself in stool or other microbes."
Other studies suggest that inhibiting other microbes has a similar effect, he said, so that "it may be a general effect on the microbiology of the gut."
Dr. Steinhart said the currently accepted theory is that the ulcerative colitis is caused -- not by a pathogen -- but by alterations in the normal flora interacting with the host immune response.
"So that's another possible hypothesis as to why that study seemed to show a benefit -- it wasn't treating the fusobacterium, it was altering some other bacteria," he said.
Ian

6 Asacol tabs/day
1 Pentasa Suppository / day
Fish oil 3/day (omega 3 only)
Multivitamin and mineral 1/day
Folic Acid 1/day
Aloe Vera 3/day
Specific Carbohydrate Diet SCD
Turmeric 3/day
Currently in no mans land between flare and remission


men8ifr
Regular Member


Date Joined Jul 2008
Total Posts : 124
   Posted 9/18/2008 7:01 AM (GMT -6)   
Interestingly tetracycline is mentioned in the 2 articles - to help prevent c.difficile and also was one fo the 3 drugs to improve symptoms...
Ian

6 Asacol tabs/day
1 Pentasa Suppository / day
Fish oil 3/day (omega 3 only)
Multivitamin and mineral 1/day
Folic Acid 1/day
Aloe Vera 3/day
Specific Carbohydrate Diet SCD
Turmeric 3/day
Currently in no mans land between flare and remission


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 9/18/2008 2:10 PM (GMT -6)   
Cause of fatigue can come from your body constantly fighting inflammation as well.

:)
My bum is broken....there's a big crack down the middle of it! LOL :)


jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10407
   Posted 9/18/2008 5:07 PM (GMT -6)   
Tetracycline also gives most of us massive, long-lasting D. Just be advised.

I do need to remind all of you that copying and posting copyrighted information here not only wastes bandwidth, but is a violation of copyright laws. Please try to post links instead of copying and pasting. Thanks!
Judy - Southern US 
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from Entocort.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


mh53mike
Regular Member


Date Joined Aug 2008
Total Posts : 149
   Posted 9/18/2008 6:42 PM (GMT -6)   
follow up with probiotics to help your gut maintain its good bacteria :)
26y old male medically disharged USAF veteran.Diagnosed with UC (lower proctitis) in 2004.
 
Current daily treatment:                               Probiotics & supplements:
1000mg sup asacol                                      50 Billion CFU's acidopholis daily
2400mg oral asacol                                      Digestive enzymes before each meal
30mg prednisone tapering                             5grams of glutamine
75mg azathioprine                                       folic acid & calcuim with V-D
20mg Nexum                                               Whey protien  
 
Diet:Little/no sugars, fats, carbs, caffine. Stay natural as possible.  
 
Results:1 Bowel movement in the morning no blood!


men8ifr
Regular Member


Date Joined Jul 2008
Total Posts : 124
   Posted 9/19/2008 1:44 AM (GMT -6)   
Sorry I was wasting bandwidth - perhaps I should not have posted that info? I did not have the links to it as I mentioned so it was a choice of posting it or not at all. I felt if I had to go onto anti-biotics the information I posted would be very useful and something I would definately want to know - hence why I posted it.

Re - tetracycline anyone else been on this and had severe D - the article suggests the opposite with improvements to d and incontenance however perhaps it was the combination of the 3 anti-biotics they used.
Ian

6 Asacol tabs/day
1 Pentasa Suppository / day
Fish oil 3/day (omega 3 only)
Multivitamin and mineral 1/day
Folic Acid 1/day
Aloe Vera 3/day
Specific Carbohydrate Diet SCD
Turmeric 3/day
Currently in no mans land between flare and remission


love4cats
Regular Member


Date Joined May 2007
Total Posts : 458
   Posted 9/19/2008 7:21 AM (GMT -6)   
I was on Doxycycline for almost a month after a tick I had pulled off of me tested positive for Lymes. I upped my probiotics, ate very healthy, eliminated milk products, except yogurt, and reduced carb intake. I made it though with no flare.
 
 
Dx:  UC Proctitis 2006 
Meds:  None so far. Garlic works to ease flares. My GI laughed when I told him and said it was just coincidence. 
Started Meds:  Apr 9 08 500mg 5ASA (salofalk) to ease flare, tapering, stopped. 
Diet:  Regular fresh garlic, Biobest yogurt daily, Omega 3 supplements, very limited junk food, carbs and processed food, low fat diet.  Lots of fresh fruit and veggies (limited potatoes). 
 Added: tumeric and probiotics.
 
 

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