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Rifaximin for gas

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Ulcerative Colitis
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Posted 4/9/2020 7:29 PM (GMT -5)
Hi Guys I am on prednisone 30mg and having 5-6bm now. I have had a lot of gas especially in the evenings and I tried gas-x no help. My GI is suggesting to take Rifaximin antibiotic for gas. I generally know that antibiotics are not good with patients who have UC and I have not taken any since diagnosis. Any suggestions or experience on this med?

TIA
Posted 4/10/2020 5:35 AM (GMT -5)
D, I have not heard of anyone being rx'd Rifaximin for gas only. Diarrhea & gas that has not responded to other methods, yes. It is also used for travelers diarrhea, people with IBS-D & SIBO too. By the way, a lot of people have no problems taking a course of an antibiotic with a probiotic. I always take Floraster with antibiotics, taken 2 hours after the medication. This is the probiotic my drs recommend with antibiotics. Many of us cannot take probiotics long term.

I think you are very fortunate that the gi at the Cleveland Clinic is working with you, especially since you have not seen him since 2016. They are known for having some of the best gi's around. Out of curiosity, do you not trust the dr? I ask because you do not seem to be comfortable with his recommendations.

Did you get the results of your KUB scan?
Posted 4/10/2020 9:45 AM (GMT -5)
I have had extreme gas since the beginning of this flare ive never experienced gas before this. I question the doctor because i've had doctors prescribe me things before and then it ends up making me more sick. I have learned to be careful and do as much research as I can before causing myself a bad flare up. Few weeks ago I was on Uceris then the GI doctor on the island asked me to do Upper GI test in which I had to drink Barium which started a flare again and the Uceris stopped working just an example. I try to be as safe and cautious as possible.Even when it comes to medication its hard to explain but some doctors don't understand how easily I get side effects. I know my body and easily I start to detoriate and get sick and prednisone has given me major side effects since I started on 30mg. I have tried a lot for this gas to go away and nothing has worked. Fennel seeds, Gas-x, peppermint.
Yes I am lucky that this GI doctor has helped me especially with the circumstances I am in. No GI doctors around where I live and COVID-19. He looked at the KUB and said no dilation but it shows that my left side colon is really bad. He said your disease is severe and if you were in CC I would have hospitalized you. He asked me to continue the taper of prednisone until I reach 20mg. Do you suggest the antibiotic for the gas?
Posted 4/10/2020 12:19 PM (GMT -5)
I would try it...

And are you on rectal meds?

You could also ask the doc for antispasmodic such as dicyclomine.
q
Posted 4/10/2020 1:50 PM (GMT -5)
Fennel seeds, ugh! Doc says your scan shows severe left-side inflammation. You should be avoiding seeds and other roughage. Have you tried a low-fiber diet? Also avoid carbonated beverages, icy cold anything, hard candy, chewing gum. (The last 2 cause a person to swallow air.) That should help to reduce gas. I've not heard about Rifaximin being used to treat it. (R. is a supposedly non-systemic antibiotic that mainly treats traveller's D, as Straydog wrote above.) / Old Hat (39 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 4/10/2020 2:54 PM (GMT -5)
I am not going to say, yes you need to take it, that's your decision. It depends on how sick you are & how much longer you can maintain where you are at. Would I take it, you bet I would if I was sick of being sick, but that's me. By the way, it targets the gut.

Over the years I have seen members in this forum & the crohns forum be referred to the Cleveland Clinic because they were difficult cases. Some stay there for care or the CC would work with their local gi.

A lot of us have had bad drs. I went through 4 gi's in 2 years before finding my gi. By the time I got to him I was in terrIble shape & went straight to Remicade. I was tired of being sick all of the time, I'd had enough.

Your choice.
Posted 4/10/2020 10:48 PM (GMT -5)
@quincy no the doctor did not suggest rectal meds. What exactly would the dicyclomine be for?
@oldhat I am boiling fennel seeds into water and drinking the water ready to try anything to get rid of the gas. The gas mainly starts around 4pm everyday. I tried low-fiber diet and have not had any carbonated drinks or chewed gum.
@straydog I don't mind taking the medication but it does not seem like much people have heard of antibiotic for gas including the research I have done also. I need to get rid of the gas ASAP but I would want to make the correct step especially because I live in a area where there are no GI doctors at all currently. I have'nt been in touch with this doctor much but had no option as the doctor who used to be near me has moved and I am unable to get in touch with him.
Posted 4/11/2020 9:19 AM (GMT -5)
Do you have cramps from the gas or do you feel an urgent need to expel it? And if you expel it, does gas only come out or does gas with mucus, blood, or stool come out? I'm probably thinking along Quincy's lines, that you might need an anti-spasmodic, which she recommended. But if you're not have painful cramps, mainly bloating from the gas, and can expel dry gas-- and it tends to happen in late afternoon & evening, then think about what you're doing earlier in the day with regard to eating & taking medication. (Timing/spacing issue) Most UCers with severe flares report gas issues here that are most troublesome when the gas is accompanied by pain & causes one to expel it with gooky discharge = a shart, in Forum vocabulary. (Something that stains underwear.) If gas only comes out it means that the med you're taking is reducing your inflammation, a sign of improvement that can lead to remission of UC. / Old Hat (39 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 4/11/2020 10:07 AM (GMT -5)
I don't have cramps with gas mostly, sometimes there is slight pain. I pass only gas mainly sometimes I pass stools because of it not mucus or blood. The gas goes on constantly throughout the evening and night. I have tried looking at my diet and fixing but no help. I am taking prednisone three times a day. Even before I started the prednisone or was any medication during this flare I still had gas in the evenings and recently it got worse and there is now a really foul smell.
Posted 4/11/2020 11:34 AM (GMT -5)
You mentioned Gas X not working, was it the one that has 80mg of Simethicone? I use Phazyme maximum strength that has 250mg of Simethicone, works great.
Posted 4/11/2020 11:38 AM (GMT -5)
I was taking the 125mg gas-x extra strength. The GI said Phazyme has the same ingredients and wont make much of a difference.
Posted 4/11/2020 11:39 AM (GMT -5)
Regarding foul smell and excessive gas...can happen with bacterial imbalance as well as flaring. I would still try the Xifaxin since your GI suggested it. I have a friend with CD who tried it and it helped.
q
Posted 4/11/2020 11:46 AM (GMT -5)
@quincy I am a bit scared honestly since its a antibiotic I am thinking maybe digestive enzymes before trying the antibiotic?
Posted 4/11/2020 11:51 AM (GMT -5)
If that's your plan, then try them. So many kinds...maybe one that is multi that covers many types of foods.
q
Posted 4/11/2020 1:39 PM (GMT -5)
@quincy I think I might want to give it a chance just trying to find the right one.
Posted 4/11/2020 1:52 PM (GMT -5)
I use Digest More by Renew Life. But do your research as ones to try first.

q
Posted 4/11/2020 3:16 PM (GMT -5)
okay thank you!
Posted 4/12/2020 2:52 AM (GMT -5)
I have tried Rifaximin in the past and it worked like a charm to get rid of awful smelling gas and loose stool. Shame my new GE seems to think it is useless.
Posted 4/12/2020 11:59 AM (GMT -5)
Did you try it during a flare up?
Posted 4/12/2020 5:44 PM (GMT -5)
The foul smell seems like a clue that some unwanted bacterial condition has cropped up, which can happen with Prednisone intake. Could be the reason your former gastro RXed Rifaximin. Thinking back to a 1990s severe flare when I had to take Pred starting at 40 mg. daily for 8 days then tapering weekly, I had a lot of stomach rumbling with gas, not so in intestines. Hopefully members here can help you to sort this out and advise on probiotics. Florastor helped me quickly with gut gas pain I got from Clindamycin a while back. / Old Hat (39 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 4/12/2020 8:59 PM (GMT -5)
@oldhat The gas has been there since the flare started I took prednisone a few months after but the foul smelly gas is after the prednisone. Do you think then the antibiotic is my only option?
Posted 4/13/2020 12:18 AM (GMT -5)
It seems like Straydog, Quincy, & Paduk think that Rifaximin would help if your problem with gas is coming from a bacterial imbalance. (Which Pred could induce or aggravate-- that's why gastros try to keep IBDers off it more & more in the last 15 yrs: it can cause side effects just about anywhere in one's body with lengthy or repeat use.) Try to get hold of Paduk again to ask for specifics-- per above post ! / Old Hat (39 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 4/13/2020 3:16 AM (GMT -5)

deee19 said...
Did you try it during a flare up?


TBH I can't remember, it was years ago. I remember having those symptoms and blood tests being normal and calprotectin was not used back then.
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