My LC has been controlled well by lialda (2.4 grams a day) for 4 years. A couple weeks after conception I started on a flare that is NOT getting better. My Gastro Doc told me to double my dose of lialda (already $250 a month!) and I am now taking 3 instead of 4 and I'm only going potty about 4-5 times a day rather 10 but am very uncomfortable.
I was reading about the GAPS and started cooking lots of broth and bought some fermented veggies but then read that any "die off" that occurs in the gut can cross the placenta barrier as toxins that could really harm my baby in utero and beyond.
So, any advice for me? Of course my gastro doc says to eat whatever I want cause diet makes no difference. My OBGYN knows nothing about LC so isn't really any help plus I can't get in to see her until August 5th anyway.
HELP! Newly pregnant with AWFUL flare for 3 weeks!
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Hi,
Sorry that you're having problems. If you have been using Lialda for 4 years, it's possible that it is losing its effectiveness for you. Since the active ingredient in Lialda is mesalamine, which is a derivative of salicylic acid (which makes mesalamine a first cousin to NSAIDS), it's also possible that it may be causing your immune system to produce leukotrienes, which are proinflammatory, and they can trigger D in many people who have an IMB (and yes, MC is an IBD).
You didn't mention whether or not you are avoiding any foods. If you are currently eating gluten and/or dairy products, they are almost certainly the reason for your symptoms. If you prefer to try to control your symptoms with medications rather than by diet changes, your best bet would be to speak to your doctor about a prescription for Uceris.
The massive hormonal changes that occur during (and after) pregnancy can trigger MC for some patients, while for others, the hormonal changes can bring temporary remission.
Did you order the EnteroLab tests that you mentioned in your post 4 years ago? If so, what were the test results? And of course the big question is, "If you ordered the tests, are you avoiding any or all of those food sensitivities now?
I hope that you can find a solution to get your symptoms back under control again.
Tex
Sorry that you're having problems. If you have been using Lialda for 4 years, it's possible that it is losing its effectiveness for you. Since the active ingredient in Lialda is mesalamine, which is a derivative of salicylic acid (which makes mesalamine a first cousin to NSAIDS), it's also possible that it may be causing your immune system to produce leukotrienes, which are proinflammatory, and they can trigger D in many people who have an IMB (and yes, MC is an IBD).
You didn't mention whether or not you are avoiding any foods. If you are currently eating gluten and/or dairy products, they are almost certainly the reason for your symptoms. If you prefer to try to control your symptoms with medications rather than by diet changes, your best bet would be to speak to your doctor about a prescription for Uceris.
The massive hormonal changes that occur during (and after) pregnancy can trigger MC for some patients, while for others, the hormonal changes can bring temporary remission.
Did you order the EnteroLab tests that you mentioned in your post 4 years ago? If so, what were the test results? And of course the big question is, "If you ordered the tests, are you avoiding any or all of those food sensitivities now?
I hope that you can find a solution to get your symptoms back under control again.
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.
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UkuleleLady
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Any fermented foods (yogurt, sauerkraut, probiotics) in a flare would cause me a lot more trouble and pain. You don't need them right now, and they're not going to benefit you anyway with all the BMs. My advice is to eliminate them.
I wanted to ask what Tex asked, are you gluten/dairy free? On top of that you might cross soy off your list. I would focus on eating meats, cooked simply in EVOO or baked/grilled and also well cooked vegetables. Maybe a banana a day and a sweet potato or regular potatoes for carbs if you can handle them.
Best wishes, I hope you feel better soon.
Nancy
I wanted to ask what Tex asked, are you gluten/dairy free? On top of that you might cross soy off your list. I would focus on eating meats, cooked simply in EVOO or baked/grilled and also well cooked vegetables. Maybe a banana a day and a sweet potato or regular potatoes for carbs if you can handle them.
Best wishes, I hope you feel better soon.
Nancy
If you want others to be happy, practice compassion. If you want to be happy, practice compassion. ~The Dalai Lama
I agree that starting with basics is a good idea - meat, sweet potatoes, and coconut or rice beverage with gluten-free chex with banana. Focus on meat. Eliminate gluten, dairy and soy, at least for now while you explore your problem. Make sure your vitamins are GF and SF too! Stay hydrated.
By the way, Silk coconut beverage, found in the dairy case, is high in calcium. I drink it in coffee and tea.
Good luck!
By the way, Silk coconut beverage, found in the dairy case, is high in calcium. I drink it in coffee and tea.
Good luck!
Thanks for all your responses!
Tex, I was gluten and dairy free for two years during which time I experimented with going off Lialda only to see my symptoms return rather quickly. So I kept on with Lialda and added first gluten back in. I had no worsening of my symptoms so I have been eating gluten for about 2 years. I also added back in dairy and had no surge in symptoms so have also been eating dairy for over a year.
I have now in the last week decided those two decisions may have been bad. I was heavily influenced by the gastro doc who scoffed at the idea that I could have gluten problems since I tested negative for the antibodies in the celiac blood test. He kept telling me to just eat whatever I wanted since my symptoms were so well managed. And I did.
I never took the enterolab tests as I was feeling so much better at that time 4 years ago.
Last week I went shopping and bought gluten free flours and almond milk again and I have been gluten and dairy free for about a week. I'm still taking the full dose of lialda (I had been on the half dose) and am still having D about 4 times a day. I guess I"ll just plug ahead in this way and hope the flare eventually subsides.
What is your opinion on out of balance microbiota (aka gut flora) being a precursor to this condition?
I've been eating a lot of bone broths with well-cooked meats and veggies, bananas and popsicles because they help with the nausea I have all day, whether due to the increase in lialda or simple first trimester sickness, I do not know.
Tex, I was gluten and dairy free for two years during which time I experimented with going off Lialda only to see my symptoms return rather quickly. So I kept on with Lialda and added first gluten back in. I had no worsening of my symptoms so I have been eating gluten for about 2 years. I also added back in dairy and had no surge in symptoms so have also been eating dairy for over a year.
I have now in the last week decided those two decisions may have been bad. I was heavily influenced by the gastro doc who scoffed at the idea that I could have gluten problems since I tested negative for the antibodies in the celiac blood test. He kept telling me to just eat whatever I wanted since my symptoms were so well managed. And I did.
I never took the enterolab tests as I was feeling so much better at that time 4 years ago.
Last week I went shopping and bought gluten free flours and almond milk again and I have been gluten and dairy free for about a week. I'm still taking the full dose of lialda (I had been on the half dose) and am still having D about 4 times a day. I guess I"ll just plug ahead in this way and hope the flare eventually subsides.
What is your opinion on out of balance microbiota (aka gut flora) being a precursor to this condition?
I've been eating a lot of bone broths with well-cooked meats and veggies, bananas and popsicles because they help with the nausea I have all day, whether due to the increase in lialda or simple first trimester sickness, I do not know.
With any luck at all, those diet changes should help, and your symptoms should diminish as your digestive system begins to heal. You may have to fine-tune your diet a bit more, if the Lialda plus diet changes are not sufficient to bring relief after a few more weeks. For example, you might have to eliminate soy, also. Time will tell.
Some members find that antihistamines help with the nausea. I had major nausea problems back when I was reacting also, but unfortunately I was totally unaware of any of these tricks back then, and my GI doc was just as helpful as yours — he told me the same thing, that I could eat whatever I wanted.
Good luck with your treatment, and please keep us posted on your progress.
Tex
Many, many issues can cause MC to develop, including bacterial infections. And the poor digestion that results from the inflammatory conditions that cause the disease can also cause major fluctuations in gut bacterial populations, because undigested food attracts strains of bacteria that specialize in the fermentation of partially-digested food in the gut. IOW, it seems that gut bacteria can cause MC, and MC can alter gut bacteria populations (and diet changes will also alter gut bacteria profiles).gmnjoy21 wrote:What is your opinion on out of balance microbiota (aka gut flora) being a precursor to this condition?
Some members find that antihistamines help with the nausea. I had major nausea problems back when I was reacting also, but unfortunately I was totally unaware of any of these tricks back then, and my GI doc was just as helpful as yours — he told me the same thing, that I could eat whatever I wanted.
Good luck with your treatment, and please keep us posted on your progress.
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.