Sorry to be gross, 5-6 rounds of D this morning. Saw 4 whole lialda pills, taken about 2 1/2
Hours earlier. It has really unnerved me. Has this happened to anyone else. Been working hard on GF DF Sf diet for about 10 days. Waiting on IGa test results befor enterolab testing.
Thanks!
Pills in toilet
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Hi,
Yes, that's fairly common with MC, especially for people taking one of the various mesalamine-based medications. All of the mesalamine-based tablets (or ingredients in a capsule) are designed with an enteric coating that prevents them from becoming active (disintegrating) until they reach a location in the GI tract where the pH is above approximately 6.5. In a normal gut, that allows them to begin the activation process after they pass the point where the common bile duct enters the duodenum (in the first segment of the small intestine). Since disintegration/activation is a time-dependent process, this normally allows them to become fully activated by the time that they reach the lower third of the small intestine (the ileum), so that they can treat the ileum and the colon.
Lialda appears to take this one step further, by utilizing a pH of approximately 6.8, and that allows them to proceed a bit farther down the GI tract before activation is completed. This makes it better suited for treating UC, since UC typically presents at the distal end of the GI tract (at the rectum), and spreads backward into the colon, as the disease progresses.
IMO, that makes Lialda somewhat less useful for treating MC, since MC typically involves significant inflammation in the ileum and colon, and often upstream from the ileum, as well.
Anyway, to get back to the problem at hand, during an MC flare, we most definitely do not have normal bowel function. Instead, we typically have rapid transit (as you described) and any medications with disintegration-resistant enteric coatings are not likely to be able to become completely activated. In fact, some of them appear to exit completely intact, as you have noted. IOW, for people who have normal bowel function (IOW, those who don't need any medication) the pills work just fine, but for anyone who has severe diarrhea, they are not very effective.
This is one of the reasons why budesonide (Entocort) is typically much more effective, because the medication is delivered in the form of tiny enteric-coated "pods" or granules, encased in a capsule (that is not enteric-coated). Even with the enteric coating, the small particles dissolve much more rapidly in the small intestine, so that the active ingredient becomes available soon enough to provide some benefit as it passes through the ileum and the colon.
Eventually, as the effects of the diet changes begin to help slow down the motility, you will be able to absorb more of the tablets, and after that, improvements should come at a faster pace.
In the meantime, it may be best to not look.
Hard to do, I know, because virtually all MCers are "bowel watchers", by habit. It's another satellite symptom of MC.
IOW, as Jeff Foxworthy might say (if he told jokes about MC):
If you find yourself staring into the toilet bowel every time after you use it,
You might have MC.
Tex
Yes, that's fairly common with MC, especially for people taking one of the various mesalamine-based medications. All of the mesalamine-based tablets (or ingredients in a capsule) are designed with an enteric coating that prevents them from becoming active (disintegrating) until they reach a location in the GI tract where the pH is above approximately 6.5. In a normal gut, that allows them to begin the activation process after they pass the point where the common bile duct enters the duodenum (in the first segment of the small intestine). Since disintegration/activation is a time-dependent process, this normally allows them to become fully activated by the time that they reach the lower third of the small intestine (the ileum), so that they can treat the ileum and the colon.
Lialda appears to take this one step further, by utilizing a pH of approximately 6.8, and that allows them to proceed a bit farther down the GI tract before activation is completed. This makes it better suited for treating UC, since UC typically presents at the distal end of the GI tract (at the rectum), and spreads backward into the colon, as the disease progresses.
IMO, that makes Lialda somewhat less useful for treating MC, since MC typically involves significant inflammation in the ileum and colon, and often upstream from the ileum, as well.
Anyway, to get back to the problem at hand, during an MC flare, we most definitely do not have normal bowel function. Instead, we typically have rapid transit (as you described) and any medications with disintegration-resistant enteric coatings are not likely to be able to become completely activated. In fact, some of them appear to exit completely intact, as you have noted. IOW, for people who have normal bowel function (IOW, those who don't need any medication) the pills work just fine, but for anyone who has severe diarrhea, they are not very effective.
This is one of the reasons why budesonide (Entocort) is typically much more effective, because the medication is delivered in the form of tiny enteric-coated "pods" or granules, encased in a capsule (that is not enteric-coated). Even with the enteric coating, the small particles dissolve much more rapidly in the small intestine, so that the active ingredient becomes available soon enough to provide some benefit as it passes through the ileum and the colon.
Eventually, as the effects of the diet changes begin to help slow down the motility, you will be able to absorb more of the tablets, and after that, improvements should come at a faster pace.
In the meantime, it may be best to not look.
Hard to do, I know, because virtually all MCers are "bowel watchers", by habit. It's another satellite symptom of MC. IOW, as Jeff Foxworthy might say (if he told jokes about MC):
If you find yourself staring into the toilet bowel every time after you use it,
You might have MC.
Tex
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.
Yes, there is a daily critique of performance.......I can't imagine NOT taking a quick peek.Deb
"Do not follow where the path may lead. Go instead, where there is no path, and leave a trail.
-Ralph Waldo Emerson
2007 CC
2013 thyroid cancer- total thyroidectomy
2013 Hashimoto's - numbers always "normal"
2017 Lyme's Disease
"Do not follow where the path may lead. Go instead, where there is no path, and leave a trail.
-Ralph Waldo Emerson
2007 CC
2013 thyroid cancer- total thyroidectomy
2013 Hashimoto's - numbers always "normal"
2017 Lyme's Disease
Yup... I too am a poop peeper. Lol . It's now the highlight of my morning to produce a
PPP (picture perfect poop). Life is full of wonderful surprises!
PPP (picture perfect poop). Life is full of wonderful surprises!
Diabetic DX June 2012
Diverticulosis/ MC DX Feb.2014
I am thankful for my struggle because without it I wouldn't have stumbled across my strength.
What are you willing to let go of so you can live the life you know you deserve?
Diverticulosis/ MC DX Feb.2014
I am thankful for my struggle because without it I wouldn't have stumbled across my strength.
What are you willing to let go of so you can live the life you know you deserve?