Pepto vs gluten free

Discussions on the details of treatment programs using either diet, medications, or a combination of the two, can take place here.

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tex
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Post by tex »

Either dose will work. Quite a few of us have tried the treatment and had to stop, because of side effects. If you're not allergic to it, though, (IOW, if you can stick with it), research trials showed that it has about an 85% success rate, in combination with the diet, which is a better success rate than Entocort, or any other medication.

Tex
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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 Deanna in CO »

T,

I'm not an expert like many on this board, but I can tell you about Pepto. If you've had ringing in the ears, especially from a medicine, I highly recommend you stay away from Pepto. I have known for years that aspirin makes my ears ring, and have avoided taking it because of that. But somehow I didn't connect that to taking Pepto until I started on the Pepto right after I was diagnosed. It worked - but it almost immediately made my ears ring. When I emailed my GI doc, he said the dosage was too high, and told me to go off it until the ringing resolved and then start again at a lower dose. I did, but the ringing started again right away - and this time it didn't go away even though I went off the drug. It's been almost a month, and my ears are still ringing madly. So now besides the MC and all its accompanying symptoms, I have tinnitus and have to see an ear, nose, and throat doctor.

The best advice I can give you is - don't bother. It's not worth it. Just stay GF and give the diet a chance to work.
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Post by starfire »

I've had tinnits for may years. I've never considered seeing a doctor about it because I've always heard there is nothing they can do for you. Perhaps drug induced tinnits is a different animal. Please let us know what the Dr. says.

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

I really appreciated your comment Deanna. I had tinnitus for about 6 months one time and it was so annoying. It is, definitely, the most worrisome side effect from Pepto. Like Shirley, I'd love to hear if you find a solution with the doctor.
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pepto and bloating

Post by everne »

Hello I am brand new to the mc family. I was recently diagnosed through a colonoscopy. I was also diagnosed with a gastric ulcer. I tested negative for celiacs but have tried to go gluten free. My question is has anyone else become constipated and bloating from taking pepto regularly? If so what other meds are there that do not cause these side effects. I also experience constant lightheadedness and wondered if anyone else suffers from this.

Thanks!
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Post by tex »

Hi Everne,

Welcome to the board. Constipation is not a common side effect of Pepto, though it does happen in some cases. Were you taking the Pepto to treat diarrhea, or for some other reason, (such as the gastric ulcer)? If it causes bloating and constipation even with low doses, then you are probably intolerant to one of the ingredients in Pepto. If you were taking a high dose, (such as 8 or 9 capsules per day), then the dose may be the problem.

The lightheadness could be caused by a neurological reaction to the bismuth subsalicylate in the Pepto. It can also be caused by dehydration, because of diarrhea, and it is sometimes a symptom of MC, for some of us. I had the problem occasionally, though not on a regular basis.

Side effects of drugs vary by the individual, so there's no absolute answer to your question about other drugs that don't cause constipation. That's possible with just about any drug used to treat the disease, but the risk is usually low, for most of us. If a drug causes constipation, that usually means that the dosage needs to be reduced.

There are many brands of anti-inflammatory meds based on mesalamine, but the most effective drug, (while still relatively safe), is Entocort EC.

Most of us here control our symptoms by diet changes, though those with the most severe cases sometimes have to use a combination of diet changes and medications.

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

Tex
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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 tnelson »

Welcome Everne. This is a good place to be for info about MC.

I'll let others with more experience (like Tex) speak to medications and symptoms, but since you mention going gluten free, I wanted to add my 2 cents that for me, gluten free was not enough. I had to find out my whole list of sensitive foods (testing and experimentation) and I'm still discovering what I can eat, but I am seeing improvement. At this point, I think it's pretty clear that my case is indeed diet related, though the immediate precipitating factor appears to have been Ibuprofen. The tests I used to discover my food sensitivities were Entero Lab and MRT/LEAP. It's also a matter of trial and error.

This is just my experience and yours may be different, but I learned about this testing and the possibility that MC was diet-related on this board. It took me a year to find the board, so you are ahead of the game!

--Tnelson
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Post by Christine. »

I know this thread began with Pepto and I do have some thoughts. To me, gluten free is not a huge sacrifice but when combined with d/f, s/f, e/f and all the foods that you approach with caution, it's a pain. I think about my digestion and food far more than a "normal" person. If The Pepto plan put you solidly in remission, is there a possibility that the food sensitivities other than gluten would fade away and I could relax and actually eat in a restaurant without 20 questions for the chef? The gluten is doable.

Also, 1 or 2 tablets of Pepto stop my D. Side effects aside, I feel like if i took large doses for 8 weeks I would swell up and pop with C!

Has anyone had great and somewhat permanent success?
Chris
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Post by Gabes-Apg »

Chris
Has anyone had great and somewhat permanent success?
just want to check what you mean by 'permanent success'?

remission, where there is minimal to no symptoms can most definately be attained.
You cant cure or make MC disappear. a year or so ago Polly was in remission and then within a couple of months some stressful events in her family life sent her back into a full flare.
depending on the period of symptoms and inflammation before you attain remission, and what occurs from that point forward, remission can occur for years or it can be a bit fragile.

I had scopes in August last year, and in technical terms at that point of time the MC was in remission. Since then i have had symptoms that are due to Histamine (?Mast Cell Activity) which occurs due to foods ingested, so although the MC is in remission, the digestion system is not perfect.

even though D (or C) has not been a major issue for me for many months, i would not go out and have a meal that contained ingredients that were major triggers for me (soy, gluten, raw veges)
i have worked hard (damn damn hard) to figure out my MC management plan that works for me, reduce the inflammation, heal the leaky gut issues and get the digestion functioning quite well.

As we age, our bodies ability to heal and rebuild gets harder. Ingesting ingredients that are known triggers, although they may not cause D by having them in that meal, they are causing villi damage and causing inflammation.
Gabes Ryan

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Post by tex »

Chris,

Gabes did an excellent job of describing a typical prognosis scenario for someone with this disease, though all of us react somewhat differently, and so we each have to deal with different issues, and different degrees of sensitivity.

In case you're wondering about the effectiveness of the Pepto-Bismol treatment, according to Dr. Fine's research, it's over 85% effective, (except for those who can't tolerate one or more of the ingredients in it, of course). The hitch is, (as is the case with ALL medications used to treat IBDs), soon after the treatment is discontinued, the symptoms will relapse, for most people with MC, UNLESS the GF diet is adopted when the treatment is initiated, and continued afterward. Now, these aren't his exact words, but this is basically what Dr. Fine has written about his research regarding the outcome of the Pepto treatment, and you will note that it does not mention additional food-sensitivities. I have a hunch that when he wrote it, at that point he wasn't yet aware that other food sensitivities are typically problematic with MC, but the point is, for many of us, if we can nip the disease in the bud early on, before extensive damage, (some of which may be permanent), is done, we may preempt some or all of the additional food-sensitivity issues.

IMO, it's worth a try. Dr. Fine no longer recommends the Pepto treatment as a first line of treatment, mostly because some people have adverse reactions to it, and the chance of long-term success is not good, unless the GF diet is rigidly followed, so these days, he recommends the diet alone.

If you do some research, you will find that during the past few years, (more than 10 years after Dr. Fine originally developed the treatment), a fair number of GI docs are beginning to recommend the treatment, (after Dr. Fine stopped recommending it), but they naively forget to mention that the patient must follow a GF diet. They forget to mention it, of course, because in their infinite wisdom, they "know" that diet has nothing to do with microscopic colitis. When the patient relapses, they scratch their head, act surprised, and prescribe another drug, and go through the whole routine again, and again. :lol:

Anyway, if you decide to try it, you need to take enough to provide a therapeutic dose, (not just enough to reduce your symptoms), because bismuth subsalicylate has antibiotic properties, and other therapeutic qualities, so in order to do this treatment right, you have to treat it as a drug, not simply as a remedy to mask the symptoms. Of course, once control is established, you may have to reduce the dose in order to minimize C and/or other negative consequences of the treatment. Since we all have different response rates to various drugs, you may not need the full starting dose, either, so don't feel that you need to take massive amounts, if they're not needed to attain or maintain control - just be sure to take at least enough, to keep the MC symptoms under control at all times, so that your gut can heal.

IOW, if 1 or 2 works, I would start with at least 3 or 4, and if I immediately started having C problems, I would certainly adjust the dose, but if I seemed to tolerate that dosage, I would continue to use it, unless or until symptoms indicated otherwise. After you finish the treatment, you should know within a few weeks or so, if it's going to stick. If it doesn't work, then you may have to eliminate additional foods from your diet, after all, but at least the treatment doesn't cost an arm and a leg, and it's relatively safe, (as long as you're not allergic to the Pepto-Bismol, so it won't take much of an investment to find out if it will work.

Please keep us posted, if you decide to try it. I've always been puzzled by the fact that Dr. Fine's published research showed such a high success rate for this treatment, and yet, virtually no one here has had much luck using it. :shrug: A high percentage of us seem to show intolerance symptoms to Pepto.

Tex
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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 Christine. »

Thanks Gabes and Tex. I don't think my mc is complicated by mast cell issues at the moment. (knock on wood). And as long as i am strict with diet I control the D pretty well with diet alone. But I still get rumblings, pressure and gas--not really what I was before this all began. Maybe I would be a candidate to try Pepto. I would remain on the current diet for sure during the trial. I'm going to Look up the available research ASAP. If I decide to try it I will keep you all posted. It would be great if it knocked me into a true remission.
Chris
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Post by tnelson »

Chris, If you do decide to take the Pepto, definitely let us know your progress and how things work out. I would be very interested in learning about what you did and your experience. Also, if you decide not to do Pepto, I'd be interested in what made you decide not to do it.
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Post by tnelson »

Just to add, Chris, I definitely know what you mean about how tiresome it is to have to think about digestion all the time. Rumblings that I used to pass off make me worry now. Your research will help all of us learn. Good luck!

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Post by tex »

Here's a link to an abstract of the original research article, published 14 years ago. Note that this abstract doesn't even mention any diet changes. I'm not aware that he ever published his findings, (except on his website), after he realized that diet changes needed to be made. As far as I can tell, he simply stopped recommending the Pepto treatment, and started recommending the diet, on his website. :shrug:

http://www.ncbi.nlm.nih.gov/pubmed/9428215

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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 Christine. »

I haven't yet decided whether to go the Pepto route. I checked out the abstract for the original article and looked at Dr. Fine's website. EverytHing else I found was rather vague and anecdotal. I appreciate so much the insights I get here. There is more info on mc-related issues here than everywhere else combined!

I'll keep you posted if I decide to give it a go.
Chris
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