Cutting back on Pepto Bismal...

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Chocolate Rose
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Joined: Sat Apr 27, 2013 9:17 am
Location: WA

Cutting back on Pepto Bismal...

Post by Chocolate Rose »

I started the Pepto Bismal a week ago yesterday and had almost immediate relief. I hadn't realized that my gut was hurting until the pain went away. And, I've only had one incidence of "D" and urgency since starting the Pepto. On Thursday, I stopped taking Metformin, which my dr thinks was my trigger for CC. I've taken Metformin for the last 14 months and had "D" from day one. I'm sure quitting the met is going to be a relief to my body.
I've since had 2 somewhat normal bms (it is so weird talking about this in public :oops: ). I'm concerned about becoming constipated, so yesterday I only took 1 Pepto Bismal 4 times. So far today, I haven't taken any. I've ordered Wayne's book, but it won't be here until late this coming week. Does it make sense to stop taking Pepto Bismal, or should I keep taking it as a therapeutic? If I should keep taking it, how do I figure out how much to take? I'm confused about needing to take the Pepto to help heal the gut, but also not getting plugged up.
Thanks for any help!!
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tex
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Post by tex »

Hi Rose,

Most members who use the Pepto treatment reduce the dose after about 6 or 8 weeks, or when they notice the symptoms of constipation, whichever comes first. When taking meds to control MC, it's usually best to taper the dose slowly, rather than to stop abruptly, because stopping too quickly can trigger a rebound effect (mast cell levels suppressed by the treatment may rebuild too quickly, leading to increased inflammation).

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Chocolate Rose
Posts: 14
Joined: Sat Apr 27, 2013 9:17 am
Location: WA

Post by Chocolate Rose »

tex wrote:Hi Rose,

Most members who use the Pepto treatment reduce the dose after about 6 or 8 weeks, or when they notice the symptoms of constipation, whichever comes first. When taking meds to control MC, it's usually best to taper the dose slowly, rather than to stop abruptly, because stopping too quickly can trigger a rebound effect (mast cell levels suppressed by the treatment may rebuild too quickly, leading to increased inflammation).

Tex
This is why I'm confused. I've only been taking it for a week. It seems like it's too soon to cut back. I don't want the rebound effect but I don't want to end up constipated either. Is it possible that stopping the metformin and being on pepto for only one week would make that much of a difference?
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tex
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Post by tex »

There's a huge difference between discontinuing it altogether and cutting back. The safest thing to do would be to just reduce the dose.

That said, if you're pretty sure that the metformin was the cause of the D, then you may not need the Pepto in the first place. In many cases where MC is drug-induced, just discontinuing the use of the drug that triggered the disease often brings remission, without further intervention. The longer we react to the drug, however, the less likely that option will bring total remission.

Not everyone is that fortunate, but a few of us are.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Chocolate Rose
Posts: 14
Joined: Sat Apr 27, 2013 9:17 am
Location: WA

Post by Chocolate Rose »

tex wrote:There's a huge difference between discontinuing it altogether and cutting back. The safest thing to do would be to just reduce the dose.

That said, if you're pretty sure that the metformin was the cause of the D, then you may not need the Pepto in the first place. In many cases where MC is drug-induced, just discontinuing the use of the drug that triggered the disease often brings remission, without further intervention. The longer we react to the drug, however, the less likely that option will bring total remission.

Not everyone is that fortunate, but a few of us are.

Tex
I don't think the metformin was the actual initial cause, but it triggered an ongoing D situation and CC. I'd had a few D events over a period of a couple of years previously that were totally unexplainable. They were within 30 minutes to 1 1/2 hours after eating and it didn't seem to matter what I ate. It was always extremely urgent and uncontrollable and unexpected. The day I started the metformin, it became a D every day to every couple of days kind of thing. So, my dr is thinking that I had CC or a pre-CC situation before the metformin and the metformin pushed me over the edge.
OK, I'm going to just reduce the dose and not stress about it. Thanks again, for your help!
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tex
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Post by tex »

Rose wrote:The day I started the metformin, it became a D every day to every couple of days kind of thing. So, my dr is thinking that I had CC or a pre-CC situation before the metformin and the metformin pushed me over the edge.
Your doctor is probably right — that seems logical. That's sort of the way that mine started. I had random episodes that lasted for roughly a week or 10 days, about once every month or 2. That lasted for about a year or 2, but it began to happen more frequently, and then one day the watery D started and wouldn't stop.

Your body will tell you when it's time to lower the dose.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Chocolate Rose
Posts: 14
Joined: Sat Apr 27, 2013 9:17 am
Location: WA

Post by Chocolate Rose »

tex wrote:
Rose wrote:The day I started the metformin, it became a D every day to every couple of days kind of thing. So, my dr is thinking that I had CC or a pre-CC situation before the metformin and the metformin pushed me over the edge.
Your doctor is probably right — that seems logical. That's sort of the way that mine started. I had random episodes that lasted for roughly a week or 10 days, about once every month or 2. That lasted for about a year or 2, but it began to happen more frequently, and then one day the watery D started and wouldn't stop.

Your body will tell you when it's time to lower the dose.

Tex
Thank you! I'm looking forward to receiving your book.
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