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Is this constipation or what?

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Posted 8/25/2023 11:42 AM (GMT -5)
Does any Crohn’s patient on Rinvoq suffer from constipation or anal sphincter tightness? I noticed lately that when I need to have a bowel movement, I have to keep straining. A lot of times, I do cry because of the urge of having a bm but nothing comes out except when I strain harder. It’s not tenesmus. Sorry for the graphic but what comes out is not worth the straining. My rectum is very sore afterwards. I take pentasa suppository but I don’t know what causes this problem.
Posted 8/25/2023 12:41 PM (GMT -5)
Are you sure it's not tenesmus because it sounds like tenesmus? I had those kind of symptoms with rectal inflammation.
Posted 8/25/2023 2:32 PM (GMT -5)
Minnie, back in June in the crohns forum you were having problems with constipation. If you got it under control back then, I would try to remember what you did to take care of it. How is the proctitis coming along?

Try stool softeners they can be helpful.
Posted 8/25/2023 3:04 PM (GMT -5)
Sometimes what feels like constipation is actually rectal inflammation. Feels like there's something there that needs to come out. Or there really is something but it can't pass due to the inflammation. When that happens I find it really difficult not to strain, but I try hard not to. That just lead to additional problems, like hemorrhoids, on top of everything else you have to deal with.
Posted 8/25/2023 5:00 PM (GMT -5)
Minnie, are you on steroids and rinvoq? For me, when I started getting formed stool by end of May into June, they were super hard. This is always my sign that inflammation is going away since my flares are straight diarrhea. I had to start up mag citrate again just to help soften them. That worked well for me and I dont need it now that I am off prednisone. Also, using a squatty potty helps a ton for constipation. I have one in every bathroom.
Posted 8/25/2023 5:51 PM (GMT -5)
BG...Inflammation regressing, but still inflammation.

Minnie...I suggest rectal meds to deal with the inflammation.

q
Posted 8/25/2023 7:07 PM (GMT -5)
Thank you all! Well, it’s not constipation as I have several bms but I have to strain. After having a bm, I have throbbing pain in my abdomen around the belly button and it is very sore. My rectum is sore too. I took 3 antispasmodics to ease the pain. I also took pentasa suppository. I don’t know whether this is a new flare up or as my GI had told me two weeks ago that I have been flaring continuously since I failed Remicade last November and Stelara hasn’t worked.
Posted 8/26/2023 9:32 AM (GMT -5)
Heather, most likely- I know mine was still healing. My hard poops felt like a hot poker sliding through my colon. I would almost pass out on the toilet from the pain and just pray I could get through it. I preferred the diarrhea in that sense!

Minnie, same as me! Belly button area and rectum were the worst for me. It definitely sounds like you have inflammation.
Posted 8/26/2023 11:57 AM (GMT -5)
BG...My point as always is that it's still inflammation...not most likely. Either in extremely mild as in just red to full blown that's friable and bleeding...different symptoms. Many tend to look at the extremes...and when improvement is noted, it's looked upon as going away or not as much needing continued treatment.
Scary to hear about passing out while on the toilet. I've not had that experience, but ive had bms that felt like passing a watermelon...sweating and shivers and squealing like it would never end. I agree that diarrhea is much easier to deal with...i said the same to my GI. I still get the extreme butt spasming and white knuckling shivers even with my mildest flares. I try to eat foods to keep stool as soft or loose as possible.

Minnie...i do suggest you ask your GI for higher dosage rectals...can you use the enemas? If not, it would help to use the suppositories used 2x or 3x daily, as each suppository is 1g. Do you have a lot on hand?

q
Posted 8/26/2023 12:20 PM (GMT -5)
Yeah, I said most likely since Idk her scope results or inflammation markers/fecal calprotectin. My scope was great in July but I still have pain in my belly although less than before. I was actually expecting there would be inflammation in my transverse colon and it was all healed. Totally in disbelief when he told me! Still not sure why it hurts which is frustrating since Idk what to change. I have had bad constipation without flaring that has landed me in the hospital, too.
Posted 8/26/2023 4:17 PM (GMT -5)
@Joanna, yes, I prefer diarrhea to constipation. The last colonoscopy I had was July 2022 and it showed ulcers in my intestines. I haven’t had any other new scopes since I started failing both Remicade and Stelara. My disease is mainly centralized on both my terminal ileum and rectum.
@Heather. I’ll definitely try to get more pentasa suppositories. Unfortunately, though my previous perianal fistula had healed, it left a fibrotic residue when added to my new perianal fistula, this makes taking an enema a torture.
Posted 8/27/2023 12:07 PM (GMT -5)
Minnie...oooohhh, understandable re enemas re healed fistula and scarring...thanks for the clarification. If the supps can help, it would be a huge plus for you.

BG...awesome news about transvers and it being healed...something is working. What were the results for rectum and above? Even though my flares are mild, I get incredible cramping and discomfort in my stomach and colon, resulting in continual nausea. Pain location doesnt always match internal location. Are rectals totally off the list for you?

q
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