Metamucil, Bentyl recommended during flare

I’ve had UC for years and it’s fairly well managed with mesalamine. I experience flares a few times a year, usually lasting several days. Those involve cramping and diarrhea to the point where I’m going so often, there’s not much other than mucus at times. I’m always told to stick to a low residue diet. I’ve taken Bentyl in the past during flares. I’m not sure how much this helped. I had to switch GI doctors fairly recently and he seemed a bit hesitant about the Bentyl, but still prescribed it. When I called today about my current flare, the PA recommended I take the Bentyl and Metamucil. That is a new one for me. I’ve always thought of Metamucil as being used for constipation. I wouldn’t have thought adding fiber would be a good idea during a flare. I suppose I understand the idea: try to bulk up your stool. I see contradictory thoughts online. Any thoughts? I’m also concerned about the Bentyl, as I haven’t used it in a long time and I read too much about that online too. I take probiotics, so I was thinking about upping those during the flare and getting fiber from cooked vegetables, canned fruit, etc. Normally, I wouldn’t be as concerned, but I’m supposed to go out of town this weekend and I really don’t want to make things worse. At the same time, if I don’t get some relief, the weekend isn’t going to be much fun.

Metamucil is soluble fibre, which is gentler than insoluble fibre. You really don't want to be taking the latter during a flare up, but soluble fibre should not harm you. However, it's also unlikely to do anything for your current flare up. An increase in mesalamine or adding in rectal meds would probably be more beneficial. Steroid foams/enemas are another possibility.

I spoke with the doctor directly and he advised against the Metamucil. He did say the Bentyl would be good in my case. He also prescribed a mesalamine suppository, which I’ve never used, but since I take mesalamine daily, I can’t imagine that will be a problem. I just hope I can get some relief before I have to make a decision on the out of town trip tomorrow. Does Tylenol do anything for general discomfort? I assume the Bentyl is the best bet.

Hi...what is the location extent of your UC?
if youre having diarrhea during flares, I think you're undertreated rectally.

The Bentyl will help spasming, cramping etc.
It will definitely give help with comfort...it is a necessary med for me because I get a lot of nausea.

Metamucil is both soluble and insoluble...however, you can try other fibre that is purely soluble and clear.

I do, however, suggest you ask your GI for mesalamine retentions enemas of 4g dosage.

Let us know how you're doing.

q

I'm curious when was your last colonoscopy? I suggest you know exactly what's going on in your colon re UC. You are undertreated...Bentyl doesnt treat inflammation, and if you flare as you state...I assume you have continual simmering inflammation...which is not a good thing. I've never heard of anyone having only a several day flare. But I assume you're talking symptoms and not actual knowledge of inflammation. Some UCers' inflammation doesn't match symptoms and could have us thinking all is good when it isn't.
I'm suggesting a more focused knowledge.

Keep us updated,
q

Your flares only last a few days? You are very, VERY lucky! That's quite unusual. Tylenol does absolutely nothing for me but you could try it. Bentyl also does nothing for me, but if it helps you, I wouldn't hesitate to try it. I would definitely try the suppository and if those don't work, you could try mesalamine enemas.

I think most people have to increase their current med dosage, add in something like rectal meds, take a steroid like prednisone or budesonide, or switch to a different medication. I know my flares don't just resolve on their own. It's hard for me to function very well while flaring. It still sucks you have it at all, don't get me wrong.

My initial flare lasted a year. When I was on steroids it abated enough that I could live a somewhat normal life. But every time I stopped the steroids I would start bleeding again. And long term steroid use is really bad for overall health and most importantly your bones.

As far as biologic side effects I have absolutely none after 5 years on entyvio. I think most of us on here who are on various biologics don’t have side effects. They do list tons of very worrisome side effects on their labels — but have you ever read all the possible side effects on an antibiotic or any other medication? They all come with risks. Even mesalamine. Not to say going to a Biologic isn’t a serious decision.

Hope you start feeling better soon!