New to Budesonide treatment + psyllium + hemorrhoid

[Pebbledash]

After 6+ years of trying to treat my MC with a sticking plaster—with Imodium and Pepto Bismol—I got a second opinion. This new consultant listened to my concerns: the dashed hope that the MC would heal on its own, that over-the-counter medicines would suffice, the agonizing long-haul flights, the daily bout of bathroom visits, normalizing 6 times per morning at least . . . etc

My former consultant shrugged me off, his ignorance of available treatments disturbing—and I guess I kind of bought into his line for a while since I wanted to believe that I didn’t need real medicine, that I was relatively "normal."

Truth be told I have worn myself to the ground. I need to rise again. The final straw was losing both parents, developing a hemorrhoid that won’t go, problems at work, and a fall into depression.

I am trying to turn things around. But I have basic questions.

1. I have a painful external hemorrhoid due to over-visiting the toilet, combined with long-haul flights. I have had it for 6 weeks. Anyone else had this embarrassing and surprisingly disruptive condition?

2. The hemorrhoid consultant has gone for a conservative approach rather than surgery. He put me on psyllium, which I resisted as my common sense told me that it would exacerbate my diarrhea.

Very surprisingly, it seems to have helped me quite a lot. Over a few days, significantly less bathroom visits and more formed stools.
Any views on long-term psyllium use?

3. Budesonide. My new gastroenterologist said he will put me on this for 8 weeks. There is also a stronger steroid I could take for emergencies such as long-haul flights though we are both cautious of this.

Is 8 weeks the norm for budesonide? Once I am off it, will I relapse or should it have residual effects, allowing me to turn the inflammation around?

Can one take budesonide for longer periods if needed, or take it again? Is there a limit to how many times it can be used? For example, could it be used effectively for 8 weeks once a year?

THANK YOU
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[tex]

1. I have a painful external hemorrhoid due to over-visiting the toilet, combined with long-haul flights. I have had it for 6 weeks. Anyone else had this embarrassing and surprisingly disruptive condition?

Yes. That's not unusual with MC. It may disappear when the D stops.

2. The hemorrhoid consultant has gone for a conservative approach rather than surgery. He put me on psyllium, which I resisted as my common sense told me that it would exacerbate my diarrhea.

Very surprisingly, it seems to have helped me quite a lot. Over a few days, significantly less bathroom visits and more formed stools.
Any views on long-term psyllium use?

It's OK for long-term use as long as it works OK.

3. Budesonide. My new gastroenterologist said he will put me on this for 8 weeks. There is also a stronger steroid I could take for emergencies such as long-haul flights though we are both cautious of this.

Is 8 weeks the norm for budesonide? Once I am off it, will I relapse or should it have residual effects, allowing me to turn the inflammation around?

Can one take budesonide for longer periods if needed, or take it again? Is there a limit to how many times it can be used? For example, could it be used effectively for 8 weeks once a year?

8 weeks is the labeled treatment regimen. Unless you've eliminated all food sensitivities from your diet, you'll relapse after the treatment is ended (anywhere from a few days to 8 weeks later — the residual period varies).

Yes, Budesonide is now legitimate for long-term use (at reduced dose of up to 6 mg per day). Every time you stop budesonide and re-start it's use, it will be less effective. It's best to not stop until you're relatively sure you're through with it. (Use a low dose, like 3 mg every fourth or fifth day to eliminate the stopping effect). It can be used for 8 weeks each year, but after you stop using it, it will be less effective the next time you use it (after the first time). It becomes less effective each time. This is verified by published research. That's why I say don't completely stop until you're through with it.

Tex

[Gabes-Apg]

Sorry for the loss of your parents and that you are having MC issues

1. hemorrhoid
I have had both hemorrhoid and anal fissures due to Mc issues, coconut oil is helpful - both taken orally and used on the skin as a barrier to help skin heal

2. psyllium is very safe and good option long term, the other good option is slippery elm powder (must be finely ground powder not tablets)

in line with all your questions and situation - what sort of eating plan are you following? do you take vit D3 and magnesium?
what we have seen in the near 12 years of this group sharing situations and results, all MC medication options have limited scope of success if you are not following low inflammation eating plan /lifestyle. Also if the body is low in Vit D3 and magnesium this also impacts success of medications.

[Pebbledash]

Thank you both for your very helpful answers--Tex, I hope you are feeling better.

In terms of the points you raised, Gabes:

Yes, I have been taking D3 for years since blood tests showed I was depleted. Last time I was tested, I was normal.

I have never taken Magnesium but I have seen threads about it on this forum, and wondered about it. I gather it is taken since depletion may lead to loss of bone density . . . is this the reason, or does it also treat inflammation? What daily dosage would be recommended?

In terms of my long-term diet, I do my best, but I am a Celiac, so I already am restricted and find it a challenge, on top of everything else, to maintain a GF diet (though I do).

My inflammatory levels have never gone down to "normal".

At the moment, I am amazed how helpful psyllium has been after just a few days--don't get me wrong, I am still going to the bathroom too much, but it has helped in this area, as well as bulking and calming stomach cramps. I wish I had known about it before.

I was also reading about anti-depressants on the main web site, and wondered whether to try this route before budesonide.

[Gabes-Apg]

Magnesium is very important for a multitude of reasons, one key one in regards to inflammation is that our bodies need good levels of magnesium to use Vit D3 properly.

the RDA for magnesium is 350mg elemental magnesium per day, if someone is deficient they need at least 500mg for at least 8 week to correct the deficiency. An Epsom salt bath/foot soak with 1-2 cups of Epsom salts will provide about 200mg elemental magnesium.

you may want to consider embracing other restrictions on the eating plan - most here in the early stages of healing have to be gluten free, dairy free, low fibre, bland low amount of ingredients eating plan. Avoid fruits and sugars. good serves of protein every meal, minimal processed items (ie flours, cereals, breads etc even if they are gluten free)
many have to avoid eggs, soy and other inflammatory triggers - this is all outlined in the guidelines to recovery section.

there are some MC safe type anti depressants, that will reduce symptoms - for the long term they do not treat the root cause of the inflammation etc.

[tex]

Two reasons why we advocate taking magnesium (in addition to it's critical role in creating healthy bones) is that an estimated 80 % of the general population is magnesium deficient (virtually all IBD patients are magnesium deficient because of the malabsorption problem) and magnesium deficiency causes insulin resistance and eventually type 2 diabetes. Magnesium also helps to prevent muscle spasming and helps to treat or prevent GERD, which is very common with MC.

Tex

[Pebbledash]

Thank you, both again. There is so much information across these forums, it really helps to get it from the horse's mouth!

Is there a way of getting inflammation levels checked? Is that a CRP test?

[tex]

A CRP test will indicate your general whole-body level of inflammation. Outside of noting general clinical symptoms, the only way to measure intestinal inflammation is by examining biopsies from your intestines under a microscope.

Tex

[Vanessa]

I've also added organic psyllium seed powder to my morning regime and it has really helped make things solid. But I've got 3 years of healing under my belt. I've also started taking Prescript Assist soil based probiotic. Seems to be working for me....I could not have tolerated these things in the beginning and was a little afraid to try them at first!

[Jeanie]

I just recently had a colonoscopy and found out I had 20 polyps in my colon. 14 of them were precancerous. That was really upsetting. I wondered if avoiding fiber has caused the problem. I first wondered if my UVB treatments could be a problem as I have taken them biweekly for 6 years. My first colonoscopy I had 2 polyps and 5 years later I had 1 small one. I was hoping I would be done with them however after 6 years I had developed those 20 polyps. Those same six years! I doubted it and then today I talked to a doctor friend from my church. He said that he thought that eating a lot of fiber was helpful. He had heard that a certain group of people ate a lot of fiber and had no problem with polyps. I did tell him I had a gluten problem. So now back to the drawing board. If lots of fiber is good for the colon, then what is one to do? I used to take Psyllium tablets and haven't in a long time, could that do it? I tried to avoid trouble and now a new problem!

Jean

[Gabes-Apg]

Jeanie
do you take Vit D3 and take/use magnesium?

[tex]

Jeanie,

The experience of members here shows that taking enough vitamin D to keep your blood level in the 40—80 ng/ml range will help to prevent polyps. People who used to have new polyps show up on colonoscopies every 2 or 3 years, no longer have new polyps after taking vitamin D regularly.

Tex

[Jeanie]

Tex and Gabes,

Thank you for responding. I have taken Vit D3 for a long time and at present I am taking 7000 IU daily. I also take Magnesium but recently started taking Magnesium Glycinate 400 mg daily. I also dropped taking the Shaklee OsteoMatrix tabs. That also contained 600 IU of D3 and 400 mg of Magnesium Oxide. Plus it had Zinc, Copper, Manganese in small amounts. Plus 400 mcg Vitamin K. But most of these changes were only during the last part of the six years since my previous colonoscopy. I hope I am on the right track.

What about the fiber?

Jean

[tex]

That magnesium oxide was doing you very little good. We can only absorb between 2 and 3 % of magnesium oxide The rest may act more like a laxative than a supplement, because it stays in the intestines.

I doubt that fiber makes much difference either way. There are research papers showing that it helps and there seem to be more research papers showing that it makes no difference. The studies that showed that it helps concluded that the type of fiber in vegetables was the most beneficial type of fiber, as opposed to the fiber in grain, metamucil, or psyllium, for example. But as I mentioned, the research results are mixed.

I doubt that the vitamin D you've been taking lately had time to help. The polyps were probably developing before then. Vitamin D can't destroy them if they are already growing, it can only help to prevent the formation of new ones.

Tex

[Jeanie]

Tex,
Thanks so much for your response. I do know now that Oxide was the wrong type. Wish I had know that before but I believe I am on the right track now. I still don't know why I did get 20 polyps when the previous time I only had 1 small one. But something changed in the last 6 years or is that just life!! I have avoided fiber mostly because I figured it would make the colitis worse. I did read some posts about Psyllium helping. However I'm not sure about that at all. I did take them for quite awhile but not recently for a long time. A friend was just told to take Magnesium Oxide and it seems they probably wouldn't be helped. I have been using Almond Milk for a long time but I'm wondering if I need SOME calcium. I'm just in a quandary as to what to do now. I have to take another Colonoscopy in ONE YEAR! Another thing, I had to drink a bottle of Magnesium Citrate the morning of my test. Five minutes later I suddenly felt terrible and almost passed out. I sat down and it did go away quickly but it scared me. I will ask the GI doctor about that. I didn't feel well most of the week. I could have just forgotten about the whole episode but the 20 polyps really upset me. 14 of them were precancerous.

Jean