My Gastroenterologist Says "I am CURED" :mallet:

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shewhowalksonland
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My Gastroenterologist Says "I am CURED" :mallet:

Post by shewhowalksonland »

Hi Guys,

So my Reader's Digest History is:

4 Years Chronic Abdominal pain (now goes into my back and chest)
3 years Chronic soft stool- diarrhea
Fatigue
Bloating
brusing
Mostly normal blood work (mild anemia... comes and goes)
Constant Red Blood Cells in my urine
2 years ago, Biopsies with colonoscopy positive for microscopic colitis


Been on different doses of Asocol for the last 2 years (everything from 4 tablets a day to 12 a day, currently on 6 with no results)

4 months ago I was started on 9 mg Entocort (with some relief... not pain free but was much better)

Have taken lortab, Percocet and other pain meds... but I will get to that

When Entocort didn't stop my pain my DR changed me down to 6 milligrams after a month... and now I am on 3mgs... my pain is worse then ever

I was in a bunch of pain so he re-did my colonoscopy... and said it came back clean...and I was Cured...

My question is... Is that even Possible? Dose MC go away... my understanding was after positive biopsies you just had MC... I am also really frustrated because he says I "Just have bad IBS"... Just... REALLY!!

So his new course of Treatment is Entocort 3 mg once a day, 2 Asacol twice a day and Morphine extended tabs (15mg)...

I am still in amazing pain... I see my DR tomorrow to change this Treatment plan... but other then "It's not working..." I don't really know what to say.
:cry:
Anyone else feel like they take pills ALL DAY LONG?
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Bifcus16
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Post by Bifcus16 »

That sucks. How dare he just ignore your symptoms! Of course, what it really means is he doesn't know what is causing your pain, so he just treats the symptom not the cause. :sigh:

Biopsies will only show MC if they are taken from a part of the GI where the disease is active - so if he hasn't taken them from the right spot you are magically 'cured'. That is why they are supposed to take multiple samples.

Have you tried eliminating food intolerances? I can't see any listed for you, and most of us have some. This is stuff you have got to do regardless of what the docs say.

Try to stay optimistic and we'll try to help you through it.

Lyn
shewhowalksonland
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Post by shewhowalksonland »

oopse...

i have removed wheat, corn, gluten, fake sugar and most dairy...

i also take probiotics

thanks for reading my post
Anyone else feel like they take pills ALL DAY LONG?
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adelie
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Post by adelie »

I made the "I'll try anything once" comment to my doctor when my LC started and they didn't know what it was at the time, so I've been through a pretty good list of meds. This is kinda long, but maybe it'll help someone.

Have you tried Levsin (hyoscyamine - there are many brands and you'll want to check the inactive ingredients list of each for your sensitivities)? I tend to have a lot of pain from trapped gas in the transverse colon due to 2 kinks, 2 twists and a loop (D is kind of a functional necessity for me). Any little thing (usually a bit of food not chewed so well) will send it into spasm. I used to wait until it got bad and then pop a few Levsin-SL (sub-linguals) to get it to relax so things can move along. Now, if I take one every few hours during the day, I can eliminate most of the discomfort without much in the way of side effects.

Reglan also worked for me even though it's supposed to speed things up and should make the D worse. For me, it just evened out the pace at which things moved through and kept things moving through - no getting stuck. Reglan isn't a long-term medication though. I tried the Reglan because of gastroparesis. Yea, with my GI tract, I can't seem to treat one issue without pissing off another. I'll probably give domperidone a try next since Reglan worked before and on my latest EGD, I now have a hiatal hernia and Barrett's esophagus with the beginnings of dysphagia. Domperidone doesn't cross the blood brain barrier so it doesn't have the long-term side effects after you stop taking it like Reglan does.

For some reason, Midrin really helps to even things out for me too, but I can't take it more than every few days without acquiring a tolerance. I started getting headaches about the same time the LC kicked in and had horrific reactions to the SSRI's. On bad days, the more I'd bloat, the colder my hands and feet got (sometimes turning blue). It was like all the blood was in my gut. After two midrin, everything evened out. My gut would deflate, I'd drop any fluid I was retaining in my legs and it was like an oxygen rush to my brain. My GI said I probably have an autonomic nervous system disorder in this mix. They use Midrin for POTS, but I don't have POTS. I tend to be bradycardic, not tachycardic.

Lyrica also helped with the pain, though I don't take that anymore. The midrin works well for me and I had trouble with fluid retention and nighttime leg cramps with Lyrica. Lyrica is pregabalin. GABA can help calm the nervous and digestive tracts in some people. Drug stores and vitamin shops carry GABA-related supplements. I tried some and they took the edge off without the side effects.

I've also heard the "I'm cured" from my new GI (moved this year) after my last colonoscopy. I don't know why the decision was made, but he only took biopsies of the ascending (what they could get to after 2 hours) and descending colon - none from the transverse. Well, the LC has never shown up in the ascending or descending colon, only the transverse (along with eosinophilic colitis). Lord love a duck. After 3.5 years, I still can't back off 9mg/day of Entocort without my mid-section blowing up 2-3 dress sizes in a day, so I know I'm not "cured".

Walking and Iyengar yoga help me out quite a bit too. Getting to know the early signs of things going awry is key so I can work out the kinks before they kink. There are a couple of accupressure points that can really help on those tight crampy days. Lay on your back and at points about three fingers above and three fingers below your naval, press down and breathe slow, calm, deep belly breaths. Some days, I need a pillow under my back too. It'll be sore at first until the muscles start to relax.

By far, the one thing that has helped me the most is supplementation with free-form amino acids (Jomar Labs - www.jomarlabs.com - Pure Form 21 blend) along with multi-vitamin/mineral supplements. I should caveat though that I don't seem to digest food at all, even with enzyme supplements, so the amino acids are my protein. Yea, I tried the whole Vivonex thing (and a few others) and even reacted to that. I can't seem to gain any weight, but with the supplements I feel better and my blood work looks great.

Karen
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Post by tex »

Hi Shewhowalks,

You're right, of course, there is no cure for MC, just as there is no cure for any of the other IBDs. Lyn's explanation of proper biopsy sampling protocol is right on target. Your GI doctor seems to be quite confused, unfortunately. He's in the wrong business - he should be in the entertainment business, because he obviously would make a pretty good clown. :lol:

The hematuria concerns me. If you've had more than two positive test results for red cells in your urine, the cause needs to be determined. A possible cause could be a kidney stone, a kidney infection, or an upper UTI infection, and that could obviously be the source of at least part of your chronic pain, since you describe it as "going into your back". Gallbladder disease can also cause similar symptoms, though the pain would be in a slightly different location, with gallbladder disease. Anyway, the hematuria definitely should be checked out by a urologist. Before doing that, though, I would try discontinuing the Asacol, because it can cause hematuria, and if it is in fact causing your hematuria, then you should not be taking it, obviously. I'll go into more detail, as to why you should not be taking Asacol, a little farther down in this response.

If you are intolerant of casein, removing "most" dairy is not sufficient. For those who are intolerant of casein, even trace amounts can cause the same type of intestinal inflammation as gluten, and it can take a while for the damage to heal, after all casein is withdrawn from the diet. I would suggest removing all dairy, and all soy from the diet for a couple of weeks, (in addition to continuing to avoid gluten, of course), to see if that makes a difference, since about half of us are intolerant of soy.

The bruising and anemia suggests that you are deficient of the B vitamins, especially B-12. You need to be taking supplemental B-12, B-9, and B-6, at the very least. The B-12 should be in sublingual form, to get around the malabsorption problem, and the formulations available which include a correct percentage of foliac acid, as part of the sublingual lozenge, are probably ideal for this purpose. I'm surprised that your doctor hasn't suggested that to you.

There is a possibility that the Asacol is causing your pain, and other symptoms, and if I were in your shoes, I believe that I would stop taking it, and I would locate a GI doc who would prescribe Entocort, (at 9 mg per day). If you are reacting adversely to Asacol, then you will not be able to achieve complete remission, even with a full dose of Entocort. Your pain could be coming from chronic panceatitis, for example. In fact, pancreatitis could cause all of the symptoms that you are experiencing. Again, I'm surprised that your GI doc hasn't checked out that possibility, because pancreatitis is a serious issue. Most GI docs are not aware of this, but Asacol carries a significant risk of causing chronic pancreatitis, and a lot of case studies have come to light, where that was the case. Stopping the Asacol will usually allow the pancreatitis to resolve, but not all patients are so lucky. Asacol can also cause hematuria, though, like pancreatitis, only a small percentage of patients have that experience, so most GI docs tend to just ignore the risk. You might even be reacting to the lactose in Asacol - quite a few of the members here cannot take Asacol, because of adverse reactions. That's why, IMO, Asacol and Entocort should never be prescribed together, because if one causes an adverse reaction, the other will partially mask the effects, but remission will be impossible to achieve.

Entocort can cause easy bruising, of course, but usually that's a problem only encountered with long-term use, at higher rates. The reason why I suggest the B vitamins, is because many of us, myself included, have bruising problems while reacting due to MC, and I have never taken Entocort. A week or two after beginning to use a good multivitamin, along with sublingual B-12, my bruising problem disappeared.

Please give some serious thought to discontinuing the use of Asacol - I'm not a doctor, but IMO, there's a very good chance that it could be the source of most of your current symptoms.

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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Post by Rosie »

Tex, I learn so much from reading your posts, even if they involve an issue that I feel really doesn't pertain to me. For example, in your post you mention about how common easy bruising is with MC, and that was a very noticable issue for me. I would get a bruise even if I scratched an itch for very long and always seemd to have 3 or 4 buises on my arms and legs in various stages of healing. However, when I read your post, I suddenly realized that right now I don't have a single bruise on my body, now that I've been dairy and gluten free for 3 months, and soy and yeast free for a week. :banana:

Rosie
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Post by tex »

Hi Karen,
Karen wrote:I started getting headaches about the same time the LC kicked in and had horrific reactions to the SSRI's. On bad days, the more I'd bloat, the colder my hands and feet got (sometimes turning blue). It was like all the blood was in my gut.
Those symptoms are typical for LC patients when gluten crosses the blood/brain barrier. The result is a chronic migraine problem.
Karen wrote:After two midrin, everything evened out. My gut would deflate, I'd drop any fluid I was retaining in my legs and it was like an oxygen rush to my brain. My GI said I probably have an autonomic nervous system disorder in this mix.
Midrin was originally formulated to treat migraines, which would certainly make it appropriate for this use. I got similar results from plain Tylenol, provided that I took it soon enough. If I waited too long, it had little effect. I wasn't even aware of the existence of Midrin, (and similar acetaminophen-based migraine meds), back in those days, but I sure wish that I had been.

Some GI docs seem to be exceptionally skilled at taking biopsy samples from the wrong areas of the colon. Apparently your new one belongs to that group, also. I've never figured out why they try to pick areas for sampling, (when they obviously don't know how to select the "optimum" areas), rather than just taking random scattered samples from all over the colon. The ascending colon is a preferred site for Crohn's, and the descending colon, (and distally from there), is the preferred site for UC, but MC should be searched for in any and all sections of the colon.

Thanks for the tip about Midrin. It would appear to be an optimum treatment for the migraines that come with MC.

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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"My GI says I am cured"

Post by JLH »

He should know! :graduate:

ROTFLMAO............
DISCLAIMER: I am not a doctor and don't play one on TV.

LDN July 18, 2014

Joan
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tex
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Post by tex »

Rosie,

That's good news, and it should mean that you no longer have a significant malabsorption problem.

Thanks, I learn a lot from reading your posts, also, and virtually everyone else's.

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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Post by starfire »

Tex,
You said in one post..... "If you've had more than two positive test results for red cells in your urine, the cause needs to be determined."

I'm certainly not disagreeing with you at all but I had positive test results for blood in my urine for several years and did not get a "cause" even after 2 cystoscopies. Finally the "positive tests" just went away. I never found out why I was having them. Still wonder sometimes what happened.

Love, Shirley
When the eagles are silent, the parrots begin to jabber"
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Post by tex »

Hi Shirley,

I know. I've had occasional positive test results myself, but never regularly, the way you experienced. I realize that sometimes it can be persistent, and yet the reason might never be found. Who knows why stuff like that happens? I was just parroting the advice given by the medical experts, since at the very least, certain possibilities should be ruled out - just in case.

Love,
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.
shewhowalksonland
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Post by shewhowalksonland »

Hi Everyone,

Thank you Thank You Thank YOU!!!

These topic replies really helped me ... Find my words and come to my appointment with a good list of questions.

I have had many CTs and Ultrasounds.... saw one urologist 3 years ago but he didn't feel the need to scope me due to clean CTs with contrast. I am getting a second opinion... but I honestly think I leak red and white blood cells from my large intestine and it becomes waste/ hematuria. I have heard that is possible... but only from 1 nurse and 1 acupuncturist. Doctors just look at me like I am crazy and try to treat me with antibiotics... which I refuse to take anymore without a positive culture or CBC... It makes the abdominal pain worse... obviously.

Pros:
I am going to see a second urologist for a second opinion...

I am on a better pain medication

I Changed my Family Doctor for someone used to treating chronic pain and Chronic conditions... we shall see...

My New Chiropractor (couldn't hurt... ok... I know some of you must have had bad experiences but this guy really is good and has 40 years of experience... and best of all REALLY listens) Told me how I can go to UCSF, STANFORD or UC DAVIS and not just the county hospital (we get practically free health care because my husband works for the county, but they are strict)

I am weening off Of Asacol... Thank you TEX!!! MY GI told me there were NO SIDE Effects... and even if that is true... the medication has done me no long term good.

MY GI Is back to calling MY Illness MC...(Although he says "Mild MC"... it's like a little pregnant)

Cons:
GI still wants to treat my symptoms only (pain)
...Wont Change my Entocort dose
He Does not prescribe Lyrica (But I will hit a vitamin shop and check out GABA, I looked into it and I want to give it a shot... Thanks Karen)
He Wont change any of my other meds.


But I feel like I am moving in the right Direction. I am completely saying goodbye to dairy again (I was off the Tasty tasty stuff... but my GI said I had to take Keifer and danactive or Activa... and I caved... bad me...)

Then...

Soy

Potato...

I hate to say it... but I may have to work on fruits soon too... but food at a time... Fruit is the worst part... but I think Frutose is a trigger.

Still there?? Thanks for hanging around... YOU ALL REALLY DO HELP!!!!!!!
beat_deadhorse:
Anyone else feel like they take pills ALL DAY LONG?
shewhowalksonland
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Post by shewhowalksonland »

adelie wrote:
Have you tried Levsin (hyoscyamine - there are many brands and you'll want to check the inactive ingredients list of each for your sensitivities)

Karen
I did take Levsin 3 times a day for a year and before that Phenobarb-Belladonna... I felt better in the beginning... but then it would go away...

sometimes I still take a levsin here and there for spasms I can feel... but most of my pain feels like burning or stabbing...

like road rash... sorry for the mental image :)
Anyone else feel like they take pills ALL DAY LONG?
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Post by Lucy »

I think you must've meant Midodrine as that is given for orthostatic hypotension -- an autonomic condition. You may have noticed the swelling in your feet and legs going down. That is because this medication works by forcing your fluid volume out of your extremities and into the central part of your body which, in term, helps to keep your blood pressure up. Is this what you were referring to?

I had a problem with hypotension once my autoimmune things got really bad before I was diagnosed with M.C. and treated it with diet.
Now my BP is that of a teenager, and my pulse rate is more normal as well -- it used to run in the low sixties all the time.

My mother has had orthostatic hypotension from an autonomic condition she has had for quite a while. Back when she was still able to walk, she eventually became "immune" to the benefits of Midodrine -- it was wearing off too soon, so she was switched to a medication they don't like to give unless absolutely necessary, and which causes the legs to swell. Now that she's no longer walking, she mainly just needs something in the mornings when we do several things that tend to have an effect on her vasovagal nerve, in addition to the t fact that she just got up from being supine in bed. Soo...after being off of Midodrine for a long time, especially since she wasn't able to be put back on the other med after her hospitalization, she needed something for when she first got up, so I decided to start her over on the lowest dose of Midodrine, just like I did the first time. Lo and behold, she got the same effect at that lowest dose as she'd had the first time years ago when she was put on it.
Anyway, I know exactly what you mean about Midodrine needing to be increased as time goes on in order to get the same benefit, but if you have to be switched to another med, try starting back on the Midodrine after a while and see if you can't get the same effect from the starting dose that you did in the beginning.

At any rate, I'm hoping that when you get your M.C. under control, that that won't be a problem for you. Let's hope so. I wonder how common it is to have orthostatic hypotension with M.C. or gluten sensitivity?

Just thought that I'd comment because I think you were talking about Midodrine rather than a migraine medication, weren't you?

Best wishes,
Luce
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Post by Lucy »

In place of the live culture yogurts, if you think you have a problem with dairy, you might check out the supplement section at Whole Foods where they have refrigerated probiotics, and see if you can find the Dairy Free chewable tablets. This might help replace the good bacteria that have been killed off in your gut by antibiotics and keep the bad guys out, hopefully. Remember, however, not to let them get below the required temperature to keep them alive. This is about all I could find when i went looking for a probiotic I could find. The brand, I believe, is BlueBonnet, but if not, it's probably Country Life. I get those two mixed up. Have a feeling that the only one labeled dairy free and chewable is going to be the same one, however. Some people can't take even this one, but it's worth a try if you can't take the dairy and you need it.

Yours, Luce
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