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Has anyone found biologics caused hard stools/constipation?

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Ulcerative Colitis
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Posted 2/29/2020 1:33 PM (GMT -5)
Hi all,

So I’ve been on remicade 3.5 weeks (had 1st and 2nd loading doses) and due my 3rd and final loading dose in 2.5 weeks. Before I went on remicade I had been on humira and am still on 6mp and mesalazine. After the first infusion, I can’t say I notice much improvement but then I was already okish (1-2bms per day, bit loose, some cramps) but since the 2nd infusion, I’ve definitely been better. However, in the last week my stools seem to have become much harder and they have caused a previous fissure to become painful again. I had exactly the same effect from humira. I’m just wondering is this common? Today I have some stomach pain which I’m wondering might be constipation or the beginnings of it? Any thoughts?
Posted 2/29/2020 4:57 PM (GMT -5)
As our colons heal their ability to absorb water increases (why the diarrhea goes away). My first thought is to drink more water and add soluble fiber to help keep your stools soft since the fiber absorbs water so your stools won't get dried out.

Good that remicade is working for you already!!
Posted 2/29/2020 5:02 PM (GMT -5)
Thanks for the advice -I definitely don't drink enough so that’s a good suggestion. Sorry probably being dumb but what counts as soluble fibre? Yes I’m glad but wondering how long it will last since I developed antibodies to humira pretty quickly sad
Posted 2/29/2020 5:53 PM (GMT -5)
I'd rather have 1-2 somewhat loose stools than be constipated. That sounds like you were already in remission to me.
Posted 2/29/2020 6:02 PM (GMT -5)
Hi Sara, yes so would I! Well my fcp was 100 whereas it had been 40 so they thought i was headed in wrong direction and I was getting cramping again in the morning ... but yeah my trouble with biologics seems to be hard stools
Posted 2/29/2020 10:20 PM (GMT -5)
"Most foods contain both insoluble and soluble fiber but are usually richer in one type than the other. The easiest way to tell them apart: Soluble fiber absorbs water, turning into a gel-like mush (think of what happens when you add water to oatmeal) while insoluble fiber doesn’t (think of what happens when you add water to celery)."
https://www.webmd.com/diet/features/insoluble-soluble-fiber

You can also supplement with benefiber or metamucil
Posted 2/29/2020 10:22 PM (GMT -5)
but sounds more like you need to drink more water. I think I would start with that.
Posted 3/1/2020 2:56 AM (GMT -5)
Part of healing, and I would wager your inflammation is limited in the rectum. The butt rules this one, and will slow down the peristalsis. It also causes constant stomach discomfort and cramping for me as well.

This phase takes a while. I do suggest adding rectal meds...i cant remember if you can use mesalamine rectals. Do you have dicyclomine (antispasmodic)?

Definitely increase fluids, fibre supplements such as metamucil (which increases peristalsis, bulks and fluffs up stool for easier passage), eat enough food in general.

q
Posted 3/1/2020 8:04 AM (GMT -5)
Thanks Quincy. I’m not on any rectal meds... unfortunately I can’t get on with the mesalamine rectals (I had salofalk for am which was awful!) and here in UK, they don’t seem to make a big deal of using rectal meds especially when you’re on biologics :/ I know you’re a big advocate. I have used budenofalk foam enemas which I get on ok with ... I still have some so maybe I should ass them back in? Yes I agree it’s most likely lingering inflammation in rectum, so hard to get rid of!
Posted 3/1/2020 10:20 AM (GMT -5)

ribbon23 said...
Hi Sara, yes so would I! Well my fcp was 100 whereas it had been 40 so they thought i was headed in wrong direction and I was getting cramping again in the morning ... but yeah my trouble with biologics seems to be hard stools

Ah I see. I hope you can get it worked out. I had really hard stools and was constipated while taking zofran and also before I got UC, I was constipated a lot of the time but I think back then it was just due to diet. I used Miralax while on Zofran and it helped when fiber was not helping.
Posted 3/2/2020 2:09 PM (GMT -5)
I would suggest using the uceris enemas....can you take mesalamine suppositories?

q
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