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How to bulk things up?

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Ulcerative Colitis
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Posted 10/7/2019 1:47 PM (GMT -6)
Hi all! I need your advice. I’m having some issues with bulking up my stool for quite some time. What really helps me is a product called Enterosgel, which I get shipped form my home country. It is a silicon-based gel that acts as an absorbent. It really helps to keep thigs solid. The problem is, I’ve been using it for over three year, and I’m not sure what are the long terms effects. Plus, it is quite costly. Even though I’ve been using it only once a day, as opposed to three times - as indicated on the instructions, am still uneasy about it. I am looking to find an alternative. I tried fiber supplements like psyllium seed powder and husk, Metamucil, and most recently Citrucel. None of them seem to do the job, and Citrucel even made me feel worse. I must admit though, I tried very small doses of each, a teaspoon or so.

A little about my disease activity – I am now on three pills of lialda, nightly rowasa, canasa, and hydrocort sup every sixth day. I also take numerous supplements and probiotics. My diet is mostly low fiber, with lots of rice, potatoes, bananas, avocados, bread, and soft meats. I have one bm per day, with no blood. No major issues with bloating or cramping for the most part. My stool resembles soft, broken up chunks, or toothpaste-like soft snakes (apologies for being so descriptive). I suspect that I have a slight mesalamine sensitivity which is contributing to this consistency. Around a week ago I tried stopping my intake of Enterosgel, and my bms became even softer, yet still once per day. My GIs don’t seem to be concerned about this, and tell me to keep doing what I’m doing. I would greatly appreciate any ideas you might have for bulking things up.

I am so tired of this disease words can’t describe! My family keeps dismissing me, and saying that it’s all in my head. I’m glad there are places like this forum, with people who understand.
Posted 10/7/2019 2:38 PM (GMT -6)
Why does it matter if your stool is bulked up or not? As long as you are free of inflammation and going once a day, then that's "living the dream" right there.

Your diet is very low fiber, is there a reason? Certainly increasing natural fiber within your diet can help firm up your stools. I would start there if your system can take it.

Beyond increasing your natural fiber, the next standard answer is to take psyllium seed powder or husk to bulk up your stool. Start at low dosages and increase to full dose over a few days.
Posted 10/7/2019 2:55 PM (GMT -6)
ipoop, thank you for the reply! I noticed that fiber tends to aggravate my system, so that's why I try to avoid it. This was not always the case, and I was fine with any type of fiber before UC diagnosis. I suppose I can increase my intake of soluble fiber, with food. As for my desire to bulk things, I guess it comes from frustration with not being back to "normal". I just don't see why I am still having this symptom.
Posted 10/7/2019 5:27 PM (GMT -6)
Go slow with increasing your fiber intake. Since you have been low fiber for a while it will take your system a little while to get used to more fiber in your diet. Maybe add some well cooked vegetables to one meal a day for a week and see how that goes. If no problem, add another serving of fruits or vegetable the next week. Or eat some oatmeal for breakfast occasionally. If you have a reaction then back off a little until you stabilize before adding more.

If I eat too much fiber things flow through me very fast. I am finding that the foods I react to the most are whole grain breads and pastas. I do better with fruits, cooked vegetables and oatmeal
Posted 10/7/2019 6:56 PM (GMT -6)
I start every day with 1 cup of oatmeal with raisins and bananas mixed in. 1-3 heaping tablespoons of organic psyllium husk mixed into OJ throughout the day. Helps a lot. You need to start slow and build up. You may get some bloating at first.
Posted 10/8/2019 5:47 AM (GMT -6)
This may be your new "normal".....most of us never go back to what it was like when we didn't have UC even in full remission.

I would stop worrying about bulking up your stool, if you're going once a day with no pain, no blood, no inflammation, then you're in remission where everybody hopes to go. You're just risking rocking the boat and flaring.
Posted 10/8/2019 6:59 AM (GMT -6)

Bull101 said...
This may be your new "normal".....most of us never go back to what it was like when we didn't have UC even in full remission.

I would stop worrying about bulking up your stool, if you're going once a day with no pain, no blood, no inflammation, then you're in remission where everybody hopes to go. You're just risking rocking the boat and flaring.

I'll add "no urgency" to this list, but I agree: If you've got UC and you've got one BM a day without pain, blood, inflammation, or urgency, count your blessings and don't rock the boat too much!
Posted 10/8/2019 10:25 AM (GMT -6)
I remember a conversation with my gasteroenteroligist, early on. I asked him "Will I ever have a normal looking bm again?" He shrugged, and said some do and some never do, wait and see! And that's my and others point here. In a remission I have some form of solid, it's consistency is greatly variable from barely formed, to toothpaste consistency, to solid and little pieces, to the occasional/rare trophy poop that looks pre-UC. I've described this to my gasteroenteroligist, who said that's perfectly normal and expected of us. He offered his congratulations, said do not worry about it, and said I am doing great! So, I'd extend the same to you smile
Posted 10/8/2019 2:47 PM (GMT -6)
This Bristol Chart and explanation may help all the poop description talk:

[img]//www.webmd.com/digestive-disorders/poop-chart-bristol-stool-scale[url]
Posted 10/8/2019 2:59 PM (GMT -6)
Thank you all for your suggestions! When I begin increasing fiber, should I expect to have a looser bms initially, until my body adjusts? Or are increased gas and bloating the only symptoms? In other words, doe sit get worse before it gets better?
Posted 10/9/2019 10:27 AM (GMT -6)
You might see some differences. Just add fiber slowly and stay at a level for a bit for your body to adjust before adding more. If you have issues that don't stabilize move back to the previous fiber level for a little longer before adding more. You may never be able to eat as much fiber as you did before (I can't) but you should be able to get more fiber from food and be less reliant on supplements.
Posted 10/9/2019 11:01 AM (GMT -6)
You're not eating fiber so of course your stool has no bulk. You're over complicating things. Skip the stool bulking agents and eat vegetables and/or oats. If you can't tolerate those and you have no bleeding/mucus, there's no reason to worry.
Posted 10/12/2019 12:12 PM (GMT -6)
Katerina - I don't tolerate psyllium seeds etc so this enterosgel sounds interesting. Where do you get it from, Russia? I am from Poland where there is a probiotic called 'enterol' and it is Saccharomyces boulardii which I don't tolerate well either. I wonder if this enterosgel is similar.
Posted 10/14/2019 6:07 PM (GMT -6)
I've already found it in Poland, it is not boulardi smile
Posted 10/15/2019 3:35 PM (GMT -6)
Ewa, glad you already found it. I get mine from Ukraine. It really works quite well.
Posted 10/16/2019 8:13 AM (GMT -6)
I have not read the comments above. Try soluble fibers first and then head on to psyllium seed powder.

If you prefer, you could eat loads of chia seeds (in pudding form, soak chia seeds in a liquid of your choice, I use full-fat coconut milk), mix with loads of blueberries and thats my breakfast. You could get flax seeds and chew flax seeds as long as you can, more you chew, more saliva you mix, the more soluble fiber becomes available.

There are ready to go soluble fibers too if you wish to try, like Bimuno, Inulin (keep low on dose or you may toot), Glucomannan, TruFiber, Sunfiber etc. Enterosgel is good but expensive
Posted 10/16/2019 6:21 PM (GMT -6)
They are probably soft partially because of the Rowasa. Mine are the same way usually. It probably won't ever be "normal" like pre-UC.

Chia seeds are one of the only foods that seem to upset my gut, so be careful if you start eating tons of seeds.
Posted 10/16/2019 6:23 PM (GMT -6)

chocotofu said...
You're not eating fiber so of course your stool has no bulk. You're over complicating things. Skip the stool bulking agents and eat vegetables and/or oats. If you can't tolerate those and you have no bleeding/mucus, there's no reason to worry.

I completely agree. And fruit.
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