Anyone develop Constipation while on Uceris or Budesonide?

[lsedels]

And if so, how did you deal with it without causing a relapse of the diarrhea?

Thanks in advance.

[suzieq]

Hi Larry,

I had a whole lot of trouble with constipation after taking Budesonide. I was on Budesonide for about 6 months and tapered off around Christmas 2013 when the constipation hit and it hit hard. My Dr. was no help at all. In February and still being painfully constipated, I posted about my trouble, and got a lot of helpful suggestions.

I tried fish oil supplements, flax seed supplements, increased my water intake, increased exercise, small portions of salad, fruits and I can't remember everything I tried and I even gave myself enemas and at first nothing seemed to help. It took until about the end of March when the constipated gradually got better. I truly believe that I took Budesonide too long and that it took over 3 months to get out of my system and I will never take it again. I still deal with constipation occasionally.

I follow a gf, cf, ef, sf diet. My MC is in remission and I hope my luck with it continues.

I hope this helps.

Susanne

.

[Sheila]

Entocort was prescribed originally as 9 mg (3 capsules) each day. After a few days I was terribly constipated and cut back to 3 MG a day. I had no further constipation and no WD. Entocort worked beautifully for me

Sheila W

[Gabes-Apg]

I cant comment on the medication/steroid link
previous discussions by others is start reducing the dose.

For a long time doctors and GI suggestion for Constipation was Fibre. It is now acknowledged that Fibre bulks up the stool and can make the Constipation issues worse.

The best outcome not matter what the cause is to assist motility, without bulking up the stool and avoid causing/increasing inflammation in the gut.
The suggestions below, most of these can take 48 hours to work, so it is best to start with small dose, take them daily, dont stop when the BM happens, keep taking them until you get regular BM's with minimal issues for a few weeks, then taper off slowly.
If the C starts again, increase the daily dose of motility aids back up

- Lactulose
- increase water intake
- start taking magnesium orally, spread the dose over the day (all at once will have intense laxative effect)
- pear juice or apple juice - both are anti-inflammatory and will help motility
- increase oil intake, either coconut oil, rice bran oil
- small peeled apple, chew well, eat slowly
- small amount of lemon juice (5-8ml) with cup of warm water

It can take a few weeks of magnesium supplementation to aid motility. The muscles of the bowel need the magnesium to contract properly to move the poop through, so if the motility issue is linked to magnesium deficiency then it may take 6-8 weeks

Hope this helps

[carolm]

Larry, constipation on Entocort (especially with abdominal cramping) is a sign that it's time to reduce the dosage. Not only did I experience this but so did many others here. Once we reduced dosage the cramping and constipation reduced. When it occurred again it was time to reduce the dosage again. But I'd say it's a fairly common thing among Entocort users.

take care,
Carol

[lsedels]

Thank you everyone for your help - I really appreciate it. There has been no cramping, just no BMs for a few days after weeks of 10-15 diarrhea BMs a day. My guess is the Dr. will reduce the dosage (or take her off it completely) when she sees him on Monday. Many of the dietary ways to deal with constipation I am aware of ... prunes, fiber (although I did see one of you said fiber isn't really that good for constipation), etc. I guess the reason I asked is I want her to incorporate enough of these things back into her diet to facilitate normal BMs without having "too much" of these things that will make her go ... and then end up driving her back into a relapse. In other words, how much is too much?

She did have one prune today and a small amount of salad at dinner (for the first time since she took ill) and this evening, she had a nice sized normal bm.

Thanks again for your help!

[carolm]

Hi Larry, I'm glad your mother is doing better and actually has an appetite. Fiber is a very tricky thing and early on most of us avoided it as much as possible. Your Mom will want to avoid peelings, like apple peels, so if she eats apples it's best to peel them first. Most lettuces can be very hard on an inflamed gut, especially iceberg (I've heard it compared to sandpaper). I've read that romaine is the easiest to digest. Personally if I needed fiber I went for the soluble fibers like cooked carrots, peeled apples, sweet potatoes and baked potatoes. I think prunes should be okay. You get the idea. More than likely if the D returns it will be due to increased inflammation. While she's on Entocort is a good time to focus on establishing a diet that is free of the foods she is sensitive to. That's the only way to keep from relapsing once the Entocort is gone.

If you are keeping a "food and poop log" you could track how much fiber she's eating daily and which foods seem to help her feel her best. I've learned a lot from my food diary. Even my GI doc likes to look at it. Its a good way to see patterns both good and bad. I highly recommend it.

Best wishes,
Carol

PS- Larry, early on when I was in my big flare that prompted my diagnosis I also ate low fat, low or no sugar, and avoided caffeine and acidic foods. I still eat simply. Lean grilled steak with roasted potatoes, a lean roast with carrots, grilled chicken with guacamole, etc. Right now I'm cooking chicken and noodles in my slow cooker. The noodles are a gluten free, rice based fettuccine. No one would ever suspect they are gluten free.

[lsedels]

Hi Larry, I'm glad your mother is doing better and actually has an appetite. Fiber is a very tricky thing and early on most of us avoided it as much as possible. Your Mom will want to avoid peelings, like apple peels, so if she eats apples it's best to peel them first. Most lettuces can be very hard on an inflamed gut, especially iceberg (I've heard it compared to sandpaper). I've read that romaine is the easiest to digest. Personally if I needed fiber I went for the soluble fibers like cooked carrots, peeled apples, sweet potatoes and baked potatoes. I think prunes should be okay. You get the idea. More than likely if the D returns it will be due to increased inflammation. While she's on Entocort is a good time to focus on establishing a diet that is free of the foods she is sensitive to. That's the only way to keep from relapsing once the Entocort is gone.

If you are keeping a "food and poop log" you could track how much fiber she's eating daily and which foods seem to help her feel her best. I've learned a lot from my food diary. Even my GI doc likes to look at it. Its a good way to see patterns both good and bad. I highly recommend it.

Best wishes,
Carol

PS- Larry, early on when I was in my big flare that prompted my diagnosis I also ate low fat, low or no sugar, and avoided caffeine and acidic foods. I still eat simply. Lean grilled steak with roasted potatoes, a lean roast with carrots, grilled chicken with guacamole, etc. Right now I'm cooking chicken and noodles in my slow cooker. The noodles are a gluten free, rice based fettuccine. No one would ever suspect they are gluten free.

Thanks, this is very helpful.

The challenge I have right now is she's still on the Uceris, so if she is one of the people who will relapse, we won't know it until she comes off the drug. The other challenge is her age. This is all so daunting and confusing to her and also, she wants to eat what she wants to eat. I hate to say it, but it may actually take her getting sick again (only if the Dr. won't allow her to stay on the drug of course) for her to really want to conform to a strict diet. I hope not, because I don't want to go through it again. I'll pass on your recommendations to her. Thank you.

[carolm]

My heart goes out to you and her, Larry. My late father had several autoimmune diseases and was on methotrexate, which comes with it's own issues. He was 80 when I first talked to him about going gluten free. Dad was sharp in every way, and cooking for himself but I think the changes seemed overwhelming for him too. And this was a man who had just finished rebuilding a 1908 REO, which would challenge most of us.... but instead cooking gluten free had stumped him.

There may be some reasonable substitutions that can be made to your Mom's diet where it may not seem as restrictive-- like eliminating bread and wheat products, but using the gluten free noodles and more rice (if she can tolerate rice). I purchased a cookbook (the Kindle edition) called Paleo Comfort Foods. There is a turkey sausage with sage gravy recipe in there that my family asks for. And my chicken and noodles? add some sage and rosemary and I can't keep other people out of it. The cookbook has a fried chicken coating that is made from almond flour that is very good (works for fish too). I've gotten much better with seasonings. I use my slow cooker a lot too. If I want ice cream I buy the So Delicious brand made from coconut milk, in chocolate. So there are changes but it's not impossible, but it didn't happen overnight either. And you are correct-- the motivation has to be there.

I'm truly sorry this is happening to your Mom, especially in her 90's. Honestly, if there is a point in our lives when we should get to have things our way, it ought to be in our 90's! Here's hoping and praying for her continued progress.

Carol

[lsedels]

My heart goes out to you and her, Larry. My late father had several autoimmune diseases and was on methotrexate, which comes with it's own issues. He was 80 when I first talked to him about going gluten free. Dad was sharp in every way, and cooking for himself but I think the changes seemed overwhelming for him too. And this was a man who had just finished rebuilding a 1908 REO, which would challenge most of us.... but instead cooking gluten free had stumped him.

There may be some reasonable substitutions that can be made to your Mom's diet where it may not seem as restrictive-- like eliminating bread and wheat products, but using the gluten free noodles and more rice (if she can tolerate rice). I purchased a cookbook (the Kindle edition) called Paleo Comfort Foods. There is a turkey sausage with sage gravy recipe in there that my family asks for. And my chicken and noodles? add some sage and rosemary and I can't keep other people out of it. The cookbook has a fried chicken coating that is made from almond flour that is very good (works for fish too). I've gotten much better with seasonings. I use my slow cooker a lot too. If I want ice cream I buy the So Delicious brand made from coconut milk, in chocolate. So there are changes but it's not impossible, but it didn't happen overnight either. And you are correct-- the motivation has to be there.

I'm truly sorry this is happening to your Mom, especially in her 90's. Honestly, if there is a point in our lives when we should get to have things our way, it ought to be in our 90's! Here's hoping and praying for her continued progress.

Carol

Thank you Carol. My Mom has taken an interest in GF to a limited extent. I've already bought her GF pasta and she has been eating that and rice and white potatos and I've been making her grilled fish, chicken, lamb chops and steak. She has bought the GF bread (although it's frozen) and has been eating that but we tossed the GF english muffins (can't say I disagree, they were awful).

But for example, I took her to a restaurant with a GF menu and she won't order from it because she claims the fish came out too dry (she asked for it well done!) and she will eat bread, brocoli (not cooked well but crisp) and a brownie for dessert ... sometimes she eats salad. She LOVES ice cream and that has been tough on her. I've bought her the So Delicious Coconut milk. Vanilla was tasteless, but Mocha Almond Fudge she likes (although it has nuts in it) - I also bought her the chocolate covered Coconut Milk bars. But she feels that you get too little for the money you spend and doesn't want to buy them. I told her she's not going to have a choice but I don't think she's fully bought into it. She also bought granola bars that are GF, but they have fiber and nuts in them.

Monday we have an appt with the gastro. We will see what he has to say. Right now, everything is kind of "masked" because she is still on the Uceris and hasn't agree yet to the Enterolab test.

Thank you again for your suggestions.

[carolm]

Larry, I'm impressed. You two are doing well trying new things! I agree-- gluten free bread should be called something else because it has very little resemblance to wheat breads. I haven't found one or made one that I really liked. I will say the Rice bread makes a great dressing at Thanksgiving time. It's dense and it soaks up the broth, butter, and herbs. But otherwise..... I've abandoned all hope of having bread again.

I agree with your Mom that you don't get much for the money you spend when you buy GF foods already made. There are recipes to make ice cream with coconut milk, probably on this site in Dee's kitchen. Regarding milk, I use almond milk and it's so much better than rice milk (which is watery). The vanilla sweetened Almond milk is like melted vanilla ice cream. The first time I had it on Rice Chex with a couple of strawberry slices I fairly sure I swooned. Most of the time I buy the vanilla almond milk UNsweetened just because it's good for me to limit my sugar.

If your Mom can tolerate soy her options will be much greater than mine. For her sake I hope that's true. It would be simpler for her because so many convenience foods contain soy.

Gabes was right, your Mom is lucky to have you traveling this journey with her. I'd say most of us would have loved to have someone researching and advocating for us. Hang in there. You are making this difficult road much easier for her.

Carol

[lsedels]

Larry, I'm impressed. You two are doing well trying new things! I agree-- gluten free bread should be called something else because it has very little resemblance to wheat breads. I haven't found one or made one that I really liked. I will say the Rice bread makes a great dressing at Thanksgiving time. It's dense and it soaks up the broth, butter, and herbs. But otherwise..... I've abandoned all hope of having bread again.

I agree with your Mom that you don't get much for the money you spend when you buy GF foods already made. There are recipes to make ice cream with coconut milk, probably on this site in Dee's kitchen. Regarding milk, I use almond milk and it's so much better than rice milk (which is watery). The vanilla sweetened Almond milk is like melted vanilla ice cream. The first time I had it on Rice Chex with a couple of strawberry slices I fairly sure I swooned. Most of the time I buy the vanilla almond milk UNsweetened just because it's good for me to limit my sugar.

If your Mom can tolerate soy her options will be much greater than mine. For her sake I hope that's true. It would be simpler for her because so many convenience foods contain soy.

Gabes was right, your Mom is lucky to have you traveling this journey with her. I'd say most of us would have loved to have someone researching and advocating for us. Hang in there. You are making this difficult road much easier for her.

Carol

Thanks, I am trying. FYI, she already uses the Almond Milk ... specifically the Vanilla one that you mention. She doesn't like the breakfast cereals ... and I absolutely cannot convince her to try ham, bacon, sausage. Someone (it might have been you) suggested potatos for constipation and she doesn't grasp that potatos may be tolerable for the person who suggested it, but may not be for her. She reads things literally and just can't remember (at 91) that this is a very individual disease that she (and the Dr) won't know much more about until she either finds out either through experimentation or the Enterolab. We see the Dr. tomorrow, so we'll see what he has to say.

Thanks again.

[maestraz]

Larry,
In terms of gluten-free bread products, the best I've found by far is Canyon Bakehouse. They are available at Whole Foods or online at their website. I always toast GF breads/rolls. I don't care much for them otherwise. I keep them frozen and just take out what I'm going to use.

[lsedels]

Larry,
In terms of gluten-free bread products, the best I've found by far is Canyon Bakehouse. They are available at Whole Foods or online at their website. I always toast GF breads/rolls. I don't care much for them otherwise. I keep them frozen and just take out what I'm going to use.

We have been to Whole Foods - I'll look next time for Canyon Bakehouse. Thank you!

[maestraz]

At my local Whole Foods, Canyon Bakehouse goods are in a GF freezer near the produce dept., not in the frozen food aisle.