Rash on budesonide newly diagnosed with cc

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Princess
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Rash on budesonide newly diagnosed with cc

Post by Princess »

Hi I am new to the forum I was just diagnosed with collagenous colitis 3 weeks ago. My doctor put me on budesonide and after 2 weeks of taking it I started getting a rash on my elbows and thighs. I got 3 more weeks of taking it. Has anyone else ever had a rash with it?
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tex
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Re: Rash on budesonide newly diagnosed with cc

Post by tex »

Welcome to the group, sorry to read that your treatment isn't working as planned. Unfortunately, that's a rather common allergic reaction to budesonide that most doctors will claim is rare. I believe the treatment is usually discontinued in similar situations. It might be a good idea to touch base with your doctor who wrote the prescription. Here's a link to a research article that verifies that issue:

https://www.jacionline.org/article/0091 ... 3/fulltext

Again, welcome aboard, and please feel free to ask anything.

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.
Princess
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Re: Rash on budesonide newly diagnosed with cc

Post by Princess »

My doctor's office said to stop the budesonide without tapering and see a dermatologist and after I see a dermatologist call and schedule an appointment with him. I am so lost with all of this. I had d everyday for 10 months straight before they did a colonoscopy and biopsies and then called me the next week and told me I had collagenous colitis and prescribed me budesonide to take for 6 weeks. They never made me an appointment to come in and discuss it or anything. Just a nurse calling me and telling me what I had and what she was sending in and I didn't need to come back in. I'm a 39 yr old female that had never heard of this before and had very little explanation about it over the phone so I am so lost and stressed!!! Any help or advice where to begin would be great. Thank you so much!
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Re: Rash on budesonide newly diagnosed with cc

Post by tex »

We completely understand, because many of us had a similar experience with our gastroenterologist. Apparently, the primary reason for that behavior is due to gastroenterologists not understanding this disease, and not having much success in treating it. This is a complicated disease, and a comprehensive description requires book length coverage, so please bear in mind that the following description is merely a glimpse into a few of the high points regarding this disease. In a nutshell:

Medical treatments for MC typically focus on the use of anti-inflammatory medications, and either minimize, or totally avoid treatments that properly incorporate dietary changes. Medications are only temporary treatments. They only address the symptoms, not the cause of MC. To stop the inflammation from recurring with each meal, we have to avoid every food or medication antigen that causes our immune system to produce antibodies. Some physicians are beginning to learn this but many of them are still way behind on the learning curve and they incorrectly insist that diet has nothing to do with the disease. In fact it has everything to do with not only microscopic colitis, but all inflammatory bowel diseases. Claiming that food has nothing to do with digestive diseases is a lot like claiming that breathing polluted air has nothing to do with respiratory diseases like asthma, COPD, and lung cancer.

For example, we've always recommended a low fiber diet, at least when trying to recover from microscopic colitis, to achieve remission. The medical community has continued to recommend fiber, although it's clearly contraindicated for treating an IBD. Recently, medical researchers have finally published some research data which proves that fiber increases the inflammation level, and therefore the severity of the disease, for patients who have an IBD. So probably, in about 10 years, most gastroenterologists will begin to recognize that fiber should not be recommended when treating inflammatory bowel diseases.

Microscopic colitis (MC), once diagnosed, is a lifetime disease. The disease is caused by chronic inflammation. There are two ways the symptoms can be controlled.

1. Medications such as budesonide. Unfortunately, published medical research shows that 85% of patients who respond to budesonide, relapse soon after the treatment is ended. And other research shows that budesonide becomes less effective each time a treatment is stopped and restarted, so that it eventually becomes ineffective. Therefore, medications are only temporary treatments. They only address the symptoms, not the cause of MC. Although many doctors prescribed one of the Biologics after budesonide fails to provide long-term relief, published research shows that only a relatively small percentage of MC patients are actually helped by this class of drugs. The Microscopic Colitis Foundation (MCF) published a newsletter on May 1, 2022 that analyzed the possible use of these drugs for treating MC. For your convenience, here's a link where you can either read or download a copy of that newsletter:

https://www.microscopiccolitisfoundatio ... fcb80f.pdf

2. Diet changes that eliminate the foods that are causing the inflammation. This is the only way of which we're aware, to safely provide reliable, long-term control of the disease. Diet changes can be used with or without medications.

The disease is caused by chronic inflammation of the mucosal lining of the intestines, but in many cases, the inflammation can be found at any point in the digestive tract, from mouth to anus, including any and all organs in the digestive system. The initial inflammation can be caused by infection, parasites, stress, certain medications, and a few other things. Research shows that the inflammation triggers increased intestinal porosity (leaky gut), and leaky gut leads to the development of food sensitivities. Once the inflammation triggers the disease, then the disease tends to perpetuate itself, due to the food sensitivities that are created as a result of the inflammation. To stop the inflammation from recurring with each meal, we have to avoid every food, medication, and supplement that's causing our immune system to produce antibodies. MC, including collagenous colitis (CC), lymphocytic colitis (LC), and at least 10 other known types of the disease, is usually not caused by food sensitivities, but food sensitivities tend to develop after the disease begins. The molecules of which food is composed, are long chains of amino acids. Normally, proper digestion reduces those long chains of amino acids to individual amino acids, or short chains of them, so that our body can then use them as nutrition, or building materials for new cells.

Peptides are simply medium-length chains of amino acids that are the result of incomplete digestion of a food molecule. No one can completely digest gluten. And when gluten is digested, the process results in the creation of hundreds of peptides. But although no one can completely digest gluten, that usually that doesn't matter. It only matters if a person has increased intestinal permeability (commonly known as leaky gut). But research shows that gluten sensitivity can cause leaky gut and this can allow partially-digested peptides from certain foods to enter the bloodstream, which provokes an immune system response (because those peptides are obviously not supposed to be in the blood). The immune system then begins to react to certain proteins in those foods every time they are eaten, thus causing chronic inflammation . This is why some of the foods that we have been eating for most of our life can suddenly begin to cause chronic inflammation by provoking our immune system to produce antibodies against them. Because of the inability to digest gluten, leaky gut makes all of us with this condition sensitive to gluten, which means that we have to totally avoid all foods that contain wheat, rye, barley, and for most of us, also oats. About two-thirds of us are also sensitive to cow's milk, which means that we have to avoid all dairy products. Over half of us are sensitive to soy and/or chicken eggs.

Note that we react to many of the proteins in the common foods that we have eaten all our lives. Interestingly, we rarely react to the proteins in foods that we have rarely eaten prior to developing MC.

Similar to food sensitivities, certain drugs can also cause the immune system to produce antibodies that trigger MC symptoms. In some cases, just stopping the use of those drugs can bring remission of the MC symptoms. These drugs include antibiotics, NSAIDs, PPIs, SSRIs, SNRIs, statins, bisphosphonates, ACE inhibitors, beta blockers, and others. But in many cases, food sensitivities develop before the use of the drug is stopped, so the diet must also be changed in addition to avoiding the drug that causes the inflammation. But the bottom line is that if we stop the antibodies from being produced by avoiding the offending foods or drugs, then we can stop the inflammation from being produced and the symptoms will begin to fade away, as our digestive system heals. And the symptoms will stay away as long as we are very careful with our diet (and the medications we use).

The MCF has also published a newsletter with details on how to properly select a safe recovery diet. If you are interested in controlling your disease symptoms by diet changes, you might find the information in this newsletter to be helpful, for fine-tuning your diet. You can download or read a copy of that newsletter by clicking on the link below:

https://www.microscopiccolitisfoundatio ... 479987.pdf

You might find other issues of the newsletter to be helpful. Newsletters are published monthly, on or about the first of the month. You can sign up to receive the newsletters in an email, or read, or download any of the back issues, on the newsletter page of our website. For your convenience, here's a direct link to that page:

https://www.microscopiccolitisfoundatio ... etter.html

Also, there are diet guidelines posted on the discussion and support forum associated with the website at this location (in case you haven't already seen them):

viewforum.php?f=79

There is no one-size-fits-all diet that will control the disease, but contrary to the claims of the medical "experts", virtually every MC patient is sensitive to gluten. For most, it's a form of non-celiac gluten sensitivity, so that the celiac screening tests used by doctors are worthless for detecting the type of gluten sensitivity that is typically associated with MC or other IBDs. But non-celiac gluten sensitivity causes basically the same symptoms as celiac disease. Every patient has to customize their diet to fit their own specific food sensitivities. And note that stress (whether physical, chemical, or mental/psychological) has a major effect on MC. Very intense stress, or in many cases, chronic stress. can even trigger a relapse of symptoms in many cases. Therefore it's also important to find ways to minimize stress, otherwise stress can perpetuate the symptoms.

Many, many doctors have mistakenly informed many, many MC patients that they are not sensitive to gluten based on a negative celiac blood test result. The claim that a negative celiac test result means that a patient cannot be sensitive to gluten simply is not true, because doctors have no way to officially diagnose non-celiac gluten sensitivity. A positive celiac test result can confirm gluten sensitivity, but a negative celiac test result cannot rule out gluten sensitivity. Many doctors mistakenly believe that a negative celic blood test result rules out gluten sensitivity, but there is no medical justification for making that assumption, it's simply incorrect.

Not everyone loses weight because of MC, but it can cause severe weight loss for some patients. Regaining that weight is virtually impossible until the inflammation is brought under control. Once the inflammation is controlled, then healing will begin and it becomes much easier to gain weight.

Here's a quote from The Microscopic Colitis Diet Book to give you an idea of safe foods that you should be able to eat without reacting:
Summary
When choosing foods for a recovery diet, ideally, we should choose one to three safe proteins, and one to three safe vegetables, from the lists below. Except in rare cases, these foods are usually safe for most of us. Significant amounts of protein are necessary for healing, so we need to make sure that our diet contains adequate protein. Adequate protein and fat in the diet are essential for good health, but carbohydrates are optional, not essential.

Recovery can be accomplished eating only meat, because meat contains all the essential amino acids that our body needs for good health. But if we choose to go this route, we need to select a fatty meat, or at least make sure that we're ingesting enough fat, so that we avoid the risk of developing the syndrome known as protein poisoning.
We should make sure that we avoid any foods that we were allergic to, or were otherwise sensitive to, before we developed MC. And obviously, if we know that we've become sensitive to any of these foods, since the development of MC, we should continue to avoid them.

Safe Proteins
•turkey
•quail
•duck
•goose
•emu
•lamb
•cabrito (goat)
•venison
•antelope
•rabbit
•shrimp
•muscles
•clams
•prawns
•lobsters
•crabs
•octopus

Safe vegetables
•carrots
•squash
•green beans
•Brussels sprouts
•kohlrabi
•rutabagas
•turnips
•parsnips
•sweet potatoes
•yams
•cassava
•broccoli
•cabbage
•cauliflower
I hope that some of this is helpful.

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.
Princess
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Re: Rash on budesonide newly diagnosed with cc

Post by Princess »

Thank you so very much for all the information!!! I am very grateful! My GI doctor and my primary doctor have not been very helpful with any of this. I take a beta blocker and once I was diagnosed I called my primary and asked him if it was safe to take or should they switch my medicine to something else and he told me it doesn't cause any problems with my condition and to keep taking it. So maybe they should find me a different blood pressure med. If I can convince them of that. I am so thankful to you and this group. I will start trying to cut out gluten.
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Re: Rash on budesonide newly diagnosed with cc

Post by tex »

I believe the association with beta-blockers is far from being chiseled in stone. it's merely been shown to be associated with the disease because some MC patients in studies were using it when they developed MC. But that doesn't mean that it caused their disease. In other words, no cause and effect has actually been proven.

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.
Princess
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Joined: Fri Jul 14, 2023 11:48 pm

Re: Rash on budesonide newly diagnosed with cc

Post by Princess »

Oh ok. Thank you so much for all your help. I'm so thankful to finally get some info and answers. Hopefully I can figure out what will help me. Another question I have is I have read that it is usually diagnosed in women in their 60s. I am only 39? And that it usually has another autoimmune disorder with it? I'm not aware of anything else I have. Is that usually true? Sorry for all the questions and thanks again for your help.
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Re: Rash on budesonide newly diagnosed with cc

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That false claim about MC is only one of many mistakes commonly made by medical professionals because of a flaw in the system. Medical professionals claim that everything they do is based on rigidly proven science, but unfortunately, that "proven" science is flawed. When researchers are proving the basic concepts that doctors use in their work, after the data are collected, they must be analyzed before any usable conclusions can be drawn. And it is usually at this point where certain assumptions must be made before those conclusions can be drawn. And unfortunately, far too many of those assumptions have proven to be incorrect. Consequently, although the research is claimed to be proof of concept, if it's confounded by an assumption error, the conclusions are corrupted, and therefore, possibly invalid. But although that's the basic problem with flawed medical science, that wasn't the cause of the problem that you ask about. The incorrect assumption that only older women developed MC. was made by doctors.

The only way to diagnose microscopic colitis is by looking at biopsy slides taken from the epithelial layer of the lining of the colon under a microscope.normally, older patients are much more likely to have digestive system issues, that younger patients. Consequently, they're much more likely to have colonoscopy examinations. And back when MC was first defined, in the 1970s, women were much more likely to see a doctor about digestive system problems than men. Men are more inclined to just "tough it out", unless it gets so bad that they can no longer tolerate it. And even when men did have a colonoscopy, there was no reason to take biopsies. Anyway, because of the circumstances at the time, doctors were only discovering MC in older women, because those were the only patients for whom biopsies were collected during a colonoscopy. In other words, because of their habit of failing to take biopsies during colonoscopies of younger patients, and men, the situation became a self-fulfilling prophecy. The basic problem is, unlike most other diseases, you can't find MC, unless you specifically look for it. Doctors only found MC In older women, because that's the only place they looked for It.

Back in early 2000, when my MC symptoms became so bad that I couldn't tolerate them any longer, I went through all the tests at the clinic, and when the gastroenterologist performed the final test, a colonoscopy, he didn't bother to take any biopsies, so naturally, he gave me a clean bill of health, even though I was as sick as a dog (as the old timers used to say), at the time. He recommended that I see a good psychiatrist, believe it or not. That's when I decided I had better take responsibility for my own health, and I started researching the medical literature, looking for clues that might lead to a solution.

The reason for the claimed association of MC with other autoimmune diseases, is a bit more straightforward. It's true that autoimmune (AI) diseases tend to attract additional AI diseases. But that's not chiseled in stone, either. I have a very strong hunch that the basic reason why autoimmune diseases in general attract other autoimmune diseases, is because autoimmune diseases are caused by inflammation, and (in my opinion, at least) this is virtually always eventually associated with leaky gut, which leads to food sensitivities, that in turn, perpetuates the inflammation. And chronic inflammation continues to raise the risk of developing additional AI diseases. I've written an article that describes how this occurs (and why all AI diseases are very likely perpetuated by food sensitivities), that hopefully will be published in the Microscopic Colitis Foundation monthly Newsletter, but it will be way back in the queue, so It probably won't be published before late this year, or next year.

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.
Princess
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Re: Rash on budesonide newly diagnosed with cc

Post by Princess »

I'm so sorry you had to figure all this out the hard way. But I am very grateful and thankful for all the help and all you do to help people with this problem so they have answers. May God bless you for all that you do.
Princess
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Re: Rash on budesonide newly diagnosed with cc

Post by Princess »

I was reading some post and seen where some people said they have read your book and I was wondering what your book is called so I can find it and read it.
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tex
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Re: Rash on budesonide newly diagnosed with cc

Post by tex »

Actually, I've written several books, but most of the posts are very likely referring to the one called Microscopic Colitis by Wayne Persky, which is a comprehensive coverage that includes over 300 pages of discussions of the medical description of the disease, diagnostic criteria, treatments commonly used for the disease, and various insights and tips about the disease. Although there are some medical terms mentioned, because of all the medical references, they're all explained in layman's language so that anyone can understand them.

A few of the later posts may be referring to the book called The Microscopic Colitis Diet Book, but that book focuses specifically on diet, and associated issues, such as supplements, methylation issues, etc. Both of these books are available on Amazon, and you should also be able to find them at just about any other bookseller, in either digital, paperback, or hardback versions.

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.
Princess
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Joined: Fri Jul 14, 2023 11:48 pm

Re: Rash on budesonide newly diagnosed with cc

Post by Princess »

Ok thank you. I will look for them. I have one more question for you. I have seen where you have said to take magnesium and vitamin d. Is there any certain kind to look for or that you recommend? I currently haven't been taking any vitamins.
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Re: Rash on budesonide newly diagnosed with cc

Post by tex »

I've had the best luck with Doctor's Best Brand Magnesium Glycinate, and I believe many other members here use it. I also use Doctor's Best Brand Vitamin D Capsules, but there are probably many other safe brands, as long as you check the label to make sure that it's safe.

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.
Princess
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Re: Rash on budesonide newly diagnosed with cc

Post by Princess »

I have heard the fodmap diet works to get remission. Do you know if that's true?
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Re: Rash on budesonide newly diagnosed with cc

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If you analyze the FODMAP diet, you will see that it's simply a low histamine diet, recommended for IBS patients. It merely recommends avoiding foods such as:

some vegetables and fruits,
beans, lentils (legumes)
wheat,
dairy products with lactose,
high fructose corn syrup
artificial sweeteners.

And foods such as the following are recommended (these recommendations are from Johns Hopkins Medicine, for example):

Eggs and meat.
Certain cheeses such as brie, Camembert, cheddar and feta.
Almond milk.
Grains like rice, quinoa and oats.
Vegetables like eggplant, potatoes, tomatoes, cucumbers and zucchini.
Fruits such as grapes, oranges, strawberries, blueberries and pineapple.

Unfortunately, over half of us are sensitive to chicken eggs, and most of us are sensitive to some meat proteins. Cheese is loaded with casein, and about two thirds of us are sensitive to casein. Most of us are sensitive to oats, and until we reach remission, virtually all of us are sensitive to citric acid, which puts citrus fruits are off-limits.

So basically, the FODMAP diet will work for very few of us, unless it's carefully modified to fit our needs.

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.
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