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constipated during UC flare up?

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Posted 4/5/2009 12:09 AM (GMT -5)
I am 37, diagnosed with proctitis at 24, became colitis at 28. My last flare was 4 years ago.
After that I took my colazol religiously and avoided a flare until I realized the Colazol was the culprit in
the hair loss I'd been suffering for years. I stopped taking the colazol, my hair stopped falling out and now
6 months later I'm having my worst flare yet. For the future, I guess I have to endure baldness to keep my colitis under control!

In any case, this flare has been VERY different for me. There is the usual urgency, frequency, blood, gas, and horrible pain
but I am constipated and have to push past what feels like an obstruction. Of course I was terrified, but I had a colonoscopy 2 weeks
ago and there are no tumors or dysplasia just severe inflammation (I have left-sided colitis). I am taking Miralax so I can pass the stool
but even with this and when the stool is completely liquid, I have to PUSH it out. Normally my colitis is very typical and everything comes out - no
need to strain.

I was hospitalized for 2 days due to severe dehydration, potassium loss, etc. Given solu-medrol and sent home on 40mgs of prednisone. The frequency
has been reduced to 5 - 7 times a day but there is still blood and still this need to push past this obstruction.

Has anyone every suffered anything like this? I'm wondering if I could be having a colitis flare AND something else that is causing the constipation. Is it possible something in my small intestine is causing this? God forbid a tumor, maybe crohns or diverticulis? Also, my abdominal distention and bloading is above my belly button not below as I usually experience.

I run a fever of 99.5 pretty consistently. It had gotten as high as 102 before I was hospitalized. The prednisone is causing horrible muscle pain and blurry vision not to mention INTENSE hunger. I see my GI on Thursday and I'm just wondering what is next!
Posted 4/5/2009 2:16 AM (GMT -5)
Hi....what you're having is definitely a symptom of a flare and what I would classify still limited to the rectum...lower usually,but once it's a bit higher, diarrhea is a symptom, which seems to make it so much easier to expel.

Anyone with UC could have small intestinal problems not related to UC..but UC isn't into the small intestine unless there's a bit of backwash from pancolitis.

Your symptoms to me seem limited to the lower intestine, and the bloating and butt straining are definitely the worst.

You do need rectal meds to help with those symptoms and maybe eventually you could possibly try Asacol in place of the Colazal since it's no longer an option. 

As well, ask the doc if he could prescribe a mild antispasmodic like dicyclomine to help with the spasming in the rectum and in the gut from the gas.  It does help me...but I also use rectal meds to deal with flare symptoms...which does take a few days to notice an improvement.

You've definitely been through a very tough time, hope you'll improve soon.

There is always a possibility for misdiagnosis and you could have CD, but you will find out where to go next when you see the doc on Thursday.
Did you get the results already from the colonoscopy biopsies?..as per your comment regarding no dysplasia.

Welcome to the forum...
quincy.

Posted 4/5/2009 2:55 AM (GMT -5)
Quincy,

Thank you for your reply. It does ease my mind to hear that the constipation and symptoms I am experiencing do not
sound abnormal for UC (lord knows I don't need any other problems)!

I did get the biopsy results from my colonoscopy - everything is normal (other than wicked UC). I was just thinking that since
it's been 13 years since I had an upper GI, I wanted to be sure it couldn't possibly be something in the small intestine.

My GI did give me a script for Asacol so I am going to attempt switching to that in hopes that my hair will not fall out. I forgot
to add that I am on Rowasa enemas WHEN I can keep them in!

Last time I had a bad flare and spent 2 weeks on prednisone I ended up being very sick with everything from bronchitis, to a severe sinus infection,
and finally bilateral pneumonia which landed me in the hospital for 7 days and recovering for MONTHS! I hate prednisone!

Uggh, I just need to be better already!

Thank you again for your reassurance that this is normal for UC.
Posted 4/5/2009 2:40 PM (GMT -5)
Hi..good to hear your biopsies were fine regarding precancer..etc.

Regarding the biopsies, where did it mention your inflammation was...can you type them out just as a matter of curiosity.

The Rowasa can be difficult to hold in....but it's worth the effort even for a few hours.

I hope the Asacol works for you...how much did the doc start you on? If it's 12...maybe that's too high and a lower dosage could be started with increase if you need it...just a suggestion.

If you have trouble holding the Rowasa..you could consider Canasa suppositories used twice a day. Still better than not being able to use.


Adding a fibre supplement might help as well as an antispasmodic .... I've used dicyclomine for over 20 years....works amazingly well for me.

I've never been on pred, and just for the side effects mentioned by most...I'll avoid it forever if I can.

You've certainly been through a most difficult time with lung issues and being sick. Are you seeing a respirologist or through your GP in regards to that?

Hope this is the worst of it for you and that you'll soon have some reprive and on the way to healing.

quincy.
Posted 4/5/2009 3:25 PM (GMT -5)
Well you certainly don't want to keep straining, so try going to the washroom in a diff. position - instead of sitting straight... Bend your head forward and down to the position where your head is between your knees. Your back should be as close to parallel to the floor as possible. Your shoulders should touch your knees. This puts less pressure on your rectum and does not worsen things for you! it is an old technique but it is very useful! helps solve part of the constipation issue... best of luck!

Cheers
Posted 4/5/2009 5:06 PM (GMT -5)
I had this exact problem(and even brought the question here) and found that stool softeners worked for me.
Posted 4/5/2009 7:15 PM (GMT -5)

Wow!  I can't imagine constipation - NEVER had that even before UC.

Anyway, I so agree with rectal meds although none are working for me.  I can't take anything with mesalamine and all others so far make bleeding and swelling and pain worse.  Just got over trying Anusol and in 8 days had to quit. 

As for prednisone - so far I love it - I know I shouldn't but it works so good for me - arthritis, clearer skin, energy, etc.  Only thing is a little insomnia but not bothersome - I listen to radio.  Also, the munchies but I am obese and have eaten too much all my life so that is not really new.  I have only gained 5 lbs. and trying to keep it at that.  I tapered from 40 mg. to 20 and now back to 25 mg. because blood returned - ok after 3 days - little blood but better.  Geez, we are all so different in symptoms and I know I have IBS and GERD which means I have to watch the food, etc. 

We all have to find what works for us I believe and that takes so much time while we are trying to "live" our lives!

ElaineNY

Posted 4/5/2009 7:18 PM (GMT -5)
Thanks for the tip about the position, I never tried that. The Miralax is helping, but even though the stool is completely liquid, I still have to strain to push it out, just seems so odd for UC and so unlike any time in the past.

I just can't wait for this flare to be over already!
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