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Transit time and diagnosis

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Ulcerative Colitis
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VanJordan
Regular Member
Joined : Dec 2019
Posts : 98
Posted 1/29/2020 12:04 AM (GMT -7)
My current bowel transit time is 12 hours. I can predict almost to the minute what will be coming out. If it's 8pm, then it will likely be breakfast that I ate at 8am. My CRP has finally entered normal range and my bleeding has totally stopped. Stools are formed although delicate and break apart easily on flushing, with undigested food in them. Hemoglobin and RBC are rising. I'm gaining weight. I've tapered prednisone down to 20mg from 40mg. Things are looking up, I just have to go realllllllly slow.

But this transit time is bugging me. I spoke to a patient-expert online today. She's not a doctor but she runs a support group for IBD patients and herself has had complicated Crohn's for 20+ years. She told me that if I'm having such rapid transit with undigested food, she wonders if I actually have small intestine involvement or even Crohn's. My latest CT scans did not indicate this. All my bowel thickening is colonic (I have pancolitis), it said my small bowel seemed normal on the scan. I know that colonoscopy is the gold standard for knowing for sure, but nobody has ever mentioned small bowel involvement in my previous checkups. Not even my ileum. This flare could be different though, I guess?

Can we really take guesses at the nature of IBD just from bowel transit time? I think about when my flares are severe and I'm going maybe 16-20 times a day with lots of blood and mucous. Food transits in mere hours. To me, 12 hours is actually an improvement! This idea that it may be Crohn's, or UC with small bowel involvement, does not quite make sense to me.

Could someone shed some light on this?
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16194
Posted 1/29/2020 7:27 AM (GMT -7)
Improvement sounds good. Bowel transit times should settle down as you continue to heal. I'd give it more time.

Even a small irritated patch can cause that conveyor belt to be full speed ahead (transit times). Where the inflammation is, does not matter, our system reacts the same.

I'd doubt a crohn's involvement as you have no history of it. Your CRP is down low, so they're not going to find anything in the small intestine.
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quincy
Elite Member
Joined : May 2003
Posts : 32560
Posted 1/29/2020 9:22 AM (GMT -7)
We dont break down or fully digest all the food we take in. When it's separated in loose stool, we see it.
What's the location involvement of your UC?
As well...all food has different transit times.

What do you eat for breakfast? What do you eat in general? How much water?
What are the now usual times for bms?


Do you take probiotics, fibre supplements? Are you on oral mesalamine, and which one?

If you have inflammation involvement past the rectum, you will have anywhere from loose stool to diarrhea depending on the severity.

You can test your actual transit time by adding something like beets for only one breakfact and see how long it takes.
q
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Sara14
Veteran Member
Joined : Mar 2007
Posts : 6235
Posted 1/29/2020 9:56 AM (GMT -7)
My transit time seems pretty fast too. I don't worry about it. Doesn't mean you have Crohn's.
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VanJordan
Regular Member
Joined : Dec 2019
Posts : 98
Posted 3/11/2020 10:19 PM (GMT -7)
Hi again, sorry to resurrect this thread. My transit time hasn't changed at all, and it's been 1 month. I have had a few blips here and there as I have decreased prednisone. I'm on 12.5mg, down from 40mg. I also take lots of curcumin and boswellia, or my bleeding seems to get worse again. I went down to 10mg of pred and I couldn't handle it, started bleeding again. So I bounced back to 15mg, and now I'm holding at 12.5mg. It's still an improvement from 20mg I was on a month ago.

I'm still flaring, obviously. My weight gain is very slow. Everything is made more difficult by the rapid transit time. The ND I'm seeing is checking me for hyperthyroid because she said this can also cause rapid transit time, and my TSH levels in December were low... but I was also super under weight and malnourished, and on high doses of prednisone. That would affect TSH too, I imagine. My thyroid antibodies show negative so I don't think I have hyper, but you never know.

Are there any tips out there for slowing bowel transit time? I take low dose naltrexone to help repair my immune system, which means I can't take anything opiate based like loperamide, otherwise I would! Slowing down transit would really increase my absorption. Adding fiber doesn't seem to slow things down all that much, sometimes it even makes it go faster. Liquid stuff transits fast too, obviously.

For breakfast I usually have pureed vegetable soup with GF bread and avocado and hummus on it. Lunch may be a fruit smoothie with protein powder or veggie sushi. I usually eat GF pasta for dinner with thoroughly cooked veggies.

My diet is not super diverse right now. I found that going vegetarian really helped me flare heal faster, but I'm having a hard time figuring out what to eat. Between no animal products, no dairy, no sugar, and no high fiber, I wonder what the heck to eat half the time.

Anyway, I'm more concerned about transit time. It's the bane of my existence right now. I guess 10-12 hour transit is better than every half hour when I was at my worst. I've just never taken so long to see even the smallest turnaround. I made the first post above Jan 29 and it's now March 11. Transit time is identical, or even slightly worse!
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ambling
Veteran Member
Joined : Feb 2011
Posts : 1037
Posted 3/12/2020 4:35 AM (GMT -7)
Hey van,

I think you really need to be patient...it's very hard to see big improvements while still flaring. Holding ground is about as good as it gets.
Your diet is healthy but is fairly high fibre. Pureeing and even cooking things well, doesn't remove fibre. It does make digestion easier which reduces residue, but not fibre. You might want to try a low residue diet for a short time. See if that helps transit time.
But I wouldn't get too hung up on the transit time. Getting inflammation down is what you're after. What needs are you taking other than pred?
Hope things settle for you
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Sara14
Veteran Member
Joined : Mar 2007
Posts : 6235
Posted 3/12/2020 4:56 AM (GMT -7)
Can you eat vegan dairy products or soy products? Things like vegan yogurt, vegan cream cheese with bagels, potatoes and some of the vegan processed faux meats would be higher calorie. Nut butters, hummus, coconut milk (can use in curries or your smoothies), and soymilk are all high in calories and easy to digest. You could add ground flaxseed to your smoothies for more calories and Omega 3s. At least your diet sounds nutritious!
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Spring
Veteran Member
Joined : Jan 2017
Posts : 528
Posted 3/12/2020 8:08 AM (GMT -7)
Even in my best months (only had a handful), I cannot gain weight very well. I did find eating a 4th time beneficial when food was rolling through fast.
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