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Still bleeding and now mucus

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Ulcerative Colitis
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1Wish
Regular Member
Joined : Mar 2018
Posts : 132
Posted 3/19/2021 5:35 PM (GMT -6)
Hi everyone.

Im feeling very lost right now. I had been on retention enemas since last November until January due to calprotectin rising. Had no blood or mucus at the time.

Transferred over to foam enemas nightly and budesonide in February due to the inflammation being last 4cm.

Still wasn’t helping after a month and I asked for suppositories instead due to pelvic floor issues with holding in enemas. Urologist gave me tranquilizers for that too which Ive been on for 2 months.

about a month and a half ago I started bleeding, colorectal surgeon saw me and said the blood was a cut probably from inserting the enema incorrectly. Gave me Flagyl that completely destroyed me and I still have diarrhea some days 3 weeks later.

He saw me again, had a look and said no hemmies and the cut had healed, didn’t see signs of inflammation. I also didn't see blood because every time I went it was diarreah.

Continued with supps and started seeing bleeding again last week, went back and he said no hemmies or cuts and is probably the colitis. 4 days later Im still bleeding and for the first time in a long time, I went today and only mucus came out... so now Im even more worried.

I go 2-3 times a day usually. Ive been on Imuran for 2 years. Pentasa since late august, recently changed to 4 big pills a day vs the pellets, 1.2 each pill. Also on clipper 5mg x2 daily for 3 weeks now (type of steroid).

Im very frustrated because I don’t understand how I still have inflammation after so many months of rectal therapies + all the other pills.

Do you have any advice?

Thanks
1Wish
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quincy
Elite Member
Joined : May 2003
Posts : 32625
Posted 3/19/2021 9:58 PM (GMT -6)
Hi... your inflammation seems to be very limited regarding your symptoms. I take it your doctor didn't check your rectum or he would have noted inflammation? I don't know the original location extent of your UC was... but if beyond, it seems your meds have been working if your symptoms are much improved overall.

Since the enemas tended to create an injury in the anus, they're are probably out for the time being.
What about trying steroid and mesalamine suppositories daily. When do you usually have your bms?

q
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1Wish
Regular Member
Joined : Mar 2018
Posts : 132
Posted 3/20/2021 3:24 AM (GMT -6)
Hi Quincy,

So the colorectal surgeon performed a rectoscope in the office the first time, which detected the cut he thinks from the enema and was worried of infection so gave me flagyl which gave me diarrhea for 3 weeks which probably helped in healing the cut as no solid bm was passing through.

A week later he did it again and saw the cut had healed and said he even saw no signs of inflammation.

Fast forward about 10 days and I had to see him again because I started bleeding again and he did the scope again and said no cuts, no hemmie but the mucosa looked a bit inflammed therefore he reckons it is the colitis and said to mention foam enemas again to my GI next week.

If I do have to go back I guess I will have to be very careful..

I didn't know there were steroid suppositories.

Im worried about steroid suppositories and enemas since I saw on here the post about how it can permanently thin the colon walls.

My original diagnosis was pancolitis and recent rectoscope by my GI said it was limited to 4cm. That was about 2 months ago.

I usually have bms in the morning. Thing is, if I have the supps nightly I usually will go in the morning but lately its been loose and I go couple times morning and maybe afternoon, this is since taking the antibiotics.


If I dont take a supp, some days I dont go, Im never frequent or always go at the same time. Its like I go from multiple to constipated quite often.

Last couple of days Ive started to notice intestinal noises.

1Wish

Post Edited (1Wish) : 3/20/2021 3:31:46 AM (GMT-6)

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geezernow
Regular Member
Joined : Nov 2017
Posts : 234
Posted 3/20/2021 4:35 AM (GMT -6)
SEEMS to me, you need to consult with a gastroenterologist instead of a surgeon. Have you ever had a colonoscopy? Hope you feel better soon.
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1Wish
Regular Member
Joined : Mar 2018
Posts : 132
Posted 3/20/2021 5:01 AM (GMT -6)
Yeah Ive been with my GI for years, it was her that referred me to the colorectal surgeon to determine where the blood was coming from as it was suspected hemorrhoids, turns out it wasn’t.

Had plenty of colonoscopies, last one she did was a sigmoidoscopy and determined 4cm inflammation
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quincy
Elite Member
Joined : May 2003
Posts : 32625
Posted 3/20/2021 11:17 AM (GMT -6)
4cms is tough to deal with, but suppositories are the best bet for you at this point...as to not anger the previous injury.

Yes, steroid comes in suppositories. I dont know the dosage variations tho, but you can ask for the mesalamine supps to be used up to 3x daily. Or one steroid and 2 mesalamine or one steroid and one mesalamine. Regardless...you have to treat that area.

I suggest probiotics, and maybe try a fibre supplement with meals to fluff and soften stool since you mention up and down regarding consistency.

q
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1Wish
Regular Member
Joined : Mar 2018
Posts : 132
Posted 3/25/2021 8:59 AM (GMT -6)
Hi Quincy. I mentioned the steroid suppositories to my GI but it seems in Spain those don’t exist. Just the foam enemas.

Anyway my recent calprotectin is 505 up from 400 a month ago so now I have a colonoscopy on Monday.

Back on the 4g retention enemas at night and budesonide foam in the mornings until then and after my GI takes a look, will let me know what to do..
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quincy
Elite Member
Joined : May 2003
Posts : 32625
Posted 3/25/2021 11:22 AM (GMT -6)
Hi...didn't realise you were in Spain. It's awesome your scope is on Monday! Let us know the outcome and med plan.
Ask him to take a pic or two for you...unless youre awake to see what's going on in there.

Thanks for the update...
q
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1Wish
Regular Member
Joined : Mar 2018
Posts : 132
Posted 3/25/2021 11:25 AM (GMT -6)
Oh I hope Im not awake, looking forward to the fuzzy sounds and then zzz, Ive had about 5 now and I remember the first one where I was sedated but still kind of awake and could feel the air and tube move around. Not nice!

I will get the pics after though.

Hopefully it will be a good diagnosis.

Cheers
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quincy
Elite Member
Joined : May 2003
Posts : 32625
Posted 3/25/2021 5:45 PM (GMT -6)
Yes...those fuzzy sounds!!!
Good on the pics...hope prep goes smoothly 😊

q
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Seeker275
Regular Member
Joined : Feb 2021
Posts : 31
Posted 3/27/2021 12:05 AM (GMT -6)
Flagyl has triggered and set me of on a proper flare before with bloody stools before. It might be a good idea to let your GI know that you didn't tolerate it well. Unfortunately it is one of the preferred anitbiotics for UC so not sure what the alternative to it could be (should you require it another time that is).

I would find a probiotic that can re-balance the gut and look into a gut healing regime.
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1Wish
Regular Member
Joined : Mar 2018
Posts : 132
Posted 3/27/2021 4:04 AM (GMT -6)
I had some blood before but the abx definitely messed me up. In fact almost a month after Im still having diarrea everyday.

I was starting to get sort of solid again last week, then my GI put me back on Salofalk enemas and Budesonide foam in the mornings. Ever since starting I have diarrea again.. I don’t know if its that Im reacting bad to the enemas, still bad from the abx or is the colitis...

When I put the enema in, I can hold it and sleep no problem.. I understand that means theres not much inflammation? Or maybe I just got used to it...
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quincy
Elite Member
Joined : May 2003
Posts : 32625
Posted 3/27/2021 11:45 AM (GMT -6)
Hi Wish! I second the probiotics.
Regarding the enemas...maybe try one type for a few days then the other and see which one seems the offender. How many times a day are you going?

Hopefully, the scope will reveal what's going on.

q
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FlowersGal
Veteran Member
Joined : Feb 2017
Posts : 943
Posted 3/27/2021 3:43 PM (GMT -6)
I’m one of those who doesn’t tolerate flagyl well. It makes me extremely nauseous and sickly to where I can’t eat. I refuse to take it orally any more. Unfortunately I am prone to diverticulitis attacks. Previous one dr put me on levaquin and the last one it was Augmentin.
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1Wish
Regular Member
Joined : Mar 2018
Posts : 132
Posted 3/28/2021 11:39 AM (GMT -6)
Since starting the nightly enemas and morning intestifalk (budesonide) Ive been having diarrea, 2-3 times a day. Today has been the worst. Diarrea like a tap, same as I was on the antibiotics... I haven’t even started the colonoscopy prep yet and been 3 times..

I start taking the 2 pills in one hour then the sachets for the prep.

Really don’t know why all of a sudden I have this terrible diarrea.

Starting to worry me what the outcome of the colonoscopy will be, trying to stay positive but its hard sad
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quincy
Elite Member
Joined : May 2003
Posts : 32625
Posted 3/28/2021 8:05 PM (GMT -6)
Discuss with your gastro doc before the scope that you've had diarrhea since the flagyl, and that the enemas haven't helped at all. Ask him if biopsies would show if you have a bacterial infection.

Hope prep went OK....let us know how tomorrow goes.

q
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