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Suggest Treatment For Ulcerative Colitis And Watery Stool

Posted on Wed, 16 Sep 2015

Question: Hi doctor, 10 days back I had colonoscopy, after procedure my doctor said my ulcerative colitis is in remission , and its not a flare, as no ulcers or inflamation is seen in report. But then why am I having loose stools, he suspected infection as my stool test had pus cells and mucus. He prescribed nizonide for 12 days, 1 tablet in night . from day one I felt good. Loose stools stopped. Today is 11nyh day and again I started having loose watery stools. This is the time when I am about to complete my course of nizonide and it started again. I had beet root curry last night. I don't know if that triggered. It's clear from reports that ulcerative colitis is in remission then why am I getting it back? Rifaximin did not suit me. So my doc gave nizonide which suited me for ,10 days and now 11th day again motions. Plz tell me what can it be.

Answered by Dr. Ajit Naniksingh Kukreja (44 minutes later)

Brief Answer:
Could be collitis

Detailed Answer:
Hi

Thanks for writing in

Your doctor is right, you probably have collitis.
Beet could be a trigger. Diet triggering symptoms can be excluded by trial and error method any diet that does not suit you needs to be excluded from the allowed list. You should make a list of allowed and not allowed and stick it on to your kitchen wall/fridge.

I would suggest you continue nizonide for another four days and get a stool culture done. In my opinion you doctor can add probiotics as well.

Why did Rifaximin not suit you, it is relatively safe drug ?

Hope this helps, Do write back in case of concern

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajit Naniksingh Kukreja (28 minutes later)

Thanks for your response doctor, whenever I had rifagut, During the course I get terrible motion 10 times a day , but after course is over , I feel better . as u said I l l continue nizonide . I am having motion since last 1 n half month. First 10 days I had rifagut it did not work , then colonoscopy came normal then nizonide worked but again stopped working. Doctor plz tell me why is my infection going and coming back again? Last 10 days I was perfect , just ond healthy motion once morning. I did not stop the course of nizonide , still it reoccured:( one more question what is colitis? Is it same as ulcerative?

Forgot to mention , I got 3 stool cultures done in past one month , and all are normal . the only thing stool test shows is pus and mucus. But cultures say no enteric bacteria found

Answered by Dr. Ajit Naniksingh Kukreja (28 minutes later)

Brief Answer:
It is infection Of GI Tract

Detailed Answer:
Hi

Thanks for your followup

It does seem to be infection of the GI tract

Usually in patients with negative culture, Probiotics and Rifaximin work wonders

May be some element of Irritable Bowel Syndrome has creep-ed in

Manage your stress levels
And follow the instructions for medicines as advised

I would give rifaximin another try maybe by changing the brand

Hope this clears your doubts
Wishing you a healthy life ahead

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ajit Naniksingh Kukreja (46 minutes later)

Thanks doctor, I will try rifaximin again. Can u prescribe dosage and how many days for rifagut? I am having buttermilk and curd a lot as natural probiotics, I am also having pomogranate juice as per internet it helps in Uc patients??

Answered by Dr. Ajit Naniksingh Kukreja (5 hours later)

Brief Answer:
Continue any household remedy that helps but do not stop medicines

Detailed Answer:
Hi XXXXXXX

Thanks for your followup query

You need to take Rifagut 400mg twice a day for minimum of two weeks then get back to me on the status

Do add a probiotic twice a day for three to four weeks apart from the diet rich in probiotics

Continue any household remedy that helps but do not stop medicines

Hope this clears your doubts
Wishing you a speedy recovery

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ajit Naniksingh Kukreja (6 hours later)

Hi doctor, I plan to start rifagut from today. Should I continue the rifagut tablets even if I experience terrible motions during the course?? Also can u prescribe any good probiotics? Can I take them during course of rifagut? Please prescribe keeping mg ulcerative colitis in mind:(( thank u

Can I take vsl#3 tablets as probiotics? Can an ulcerative colitis patient take vsl#3? If yes, plz suggest dosage, or suggest any other probiotics which I can take along with rifagut. Waiting fr your reply. Thx much doctor.

Answered by Dr. Ajit Naniksingh Kukreja (5 hours later)

Brief Answer:
Yes VSL#3 is OK

Detailed Answer:
Hi Thanks for writing in

I feel you will be able to tolerate rifagut, but do get back to me if anything untoward happens

You are on a the right track VSL#3 is one of the good probiotics available in the market you can take along with Rifagut and it is safe in UC

Take it twice a day

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ajit Naniksingh Kukreja (6 days later)

Hi doctor, as u suggested I took rifagut with vsl 3 for a week. 2 days back I got stool rou tine n culture done, results says: no mucus, pus cells : 4 to 5, no RBC, no occult blood. Stool culture says : no bacterial pathogen isolated.
I am still having 2 to 3 watery motions per day . I stopped all medicines since 2 days. No rifagut , no vsl. After I stopped medicines in mornings I got normal healthy stools , but during the day I get 2 to 3 loose stools, again next morning I get healthy stool. I don't understand what is happening. Please guide me? One query , for stool culture , I have morning sample( hard stool) and not loose stool sample. Is it why bacteria is not detecting in report?? Plz suggest what to do.

Answered by Dr. Ajit Naniksingh Kukreja (37 minutes later)

Brief Answer:
Continue VSL For 3 more weeks

Detailed Answer:
Hi XXXXXXX

The report appears normal, few pus cells are not a concern

Two to three loose stools could be due to IBS, I would suggest you continue VSL # 3 for three more weeks and then get back to me

Stool hard or loose will not matter as far as bacteria count is concerned

Manage your stress levels and continue as suggested

Hope this helps
Wishing you a healthy life ahead

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ajit Naniksingh Kukreja (50 minutes later)

Thank u doctor, so u feel I can stop rifagut now right? After having vsl 3 immediately I have 2 loose stools , that's y I thought whether I should continue or not. Doctor. This has been my query since v long. While giving sample for culture , should the stool be only loose or watery? I always have sample in early morning when my stool is semi solid or sometimes solid , but during the day I get watery stools. Please tell me is this y no bacteria is detected? Next time should I give culture sample when I feel I am having watery motion?

Answered by Dr. Ajit Naniksingh Kukreja (6 hours later)

Brief Answer:
You may change the brand

Detailed Answer:
Hi

I feel you may change the brand of the probiotic and take a chance

Yes you can stop Rifagut now

As mentioned in my earlier reply it is not necessary for stool to be liquid in form for having the bacteria in the sample and sample any hour of the day would do

Hope this clears your doubts
Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ajit Naniksingh Kukreja (5 hours later)

Thanks a lot doctor, u have been v helpful and u have cleared my doubts:) thank u so much doctor. I will get back to you within some days if my symptoms worsen. Thanks again

Answered by Dr. Ajit Naniksingh Kukreja (32 hours later)

Brief Answer:
You are always welcome

Detailed Answer:
Hi
THanks for your kind words
You are always welcome
Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ajit Naniksingh Kukreja (21 hours later)

Hi doctor, its been a week I stopped all medicines. Daily morning I am having one healthy motion and after every meal is 2 to 3 times a day having semi solid motion. Should I wait for some more days and see how my system works? Can I continue not having any medicine. As I told u one week back my report had no mucus and 4 to 5 pus cells. Rest all absent. I am scared my infection is not cured completely. Also does curd contain lactose? Curd always suited me but I am worried is it because of curd I am having semi solid motion after meals. Plz suggest

I got v loose stool completely watery , I just had some fruits : pomogranate. Doctor should I again start course of rifagut?? I don't know when I wud come out of this problem. V worried. Running out of patience:( I am sorry to bother u but I don't know what else to do.

Answered by Dr. Ajit Naniksingh Kukreja (24 hours later)

Brief Answer:
What is the frequency ?

Detailed Answer:
Hi

Please do not hesitate writing back

May I know the frequency of the stool ?
Ill formed stool needs more fiber and roughage and not antibioptcis

I am hopeful the issue will be resolved with probiotics and stress management

Do come back with the frequency and do not panic observe for few days and then we decide

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajit Naniksingh Kukreja (32 minutes later)

Hi doctor. 2 to 3 times a day very loose watery motion. But every morning I have healthy tight motion. During the day 1 hour after breakfast I have loose motion and aroung half n hr after lunch again watery motion. Then in evenings I am totally fine till next day morning. I stopped vsl too as I was not reacting wel to it. Wondering will it cause harm if I have rifagut so many times? Should I again have and see for a week?

Answered by Dr. Ajit Naniksingh Kukreja (2 hours later)

Brief Answer:
Just take a good probiotic

Detailed Answer:
It is really unfortunate that you are not confident with VSL#3

Instead take, actigut or econorm or Vibact plus twice a day

No need to repeat rifagut at this stage

Take probiotic for two weeks and get back to me
Wishing you a healthy life ahead

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajit Naniksingh Kukreja (25 hours later)

Hi doctor, I will experiment again try if vsl3 works for me , else will try any one of the above u mentioned. Just another general query . I have bendex deworming syrup to my daughter 2 years old last month. Her pediatrician suggested another dose of bendex which I have yesterday after dinner but she vomited the dinner. I don't know if she vomited bendex too. Should can I give her bendex 10 ml again may be next week? No harm right?? Regarding my condition I ll get back to you next week after observing.

Answered by Dr. Ajit Naniksingh Kukreja (27 hours later)

Brief Answer:
You may repeat it after a week no harm

Detailed Answer:
Hi

Thanks for writing in

Do try another probiotic because you have had repeated failures with VSL 3

Actually the forum does not allow replying for multiple patients in the same question

Yet there is no harm repeating Bendex after a week

Hope this helps
DO get back to me with your status

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ajit Naniksingh Kukreja (3 hours later)

Thanks much doctor

Answered by Dr. Ajit Naniksingh Kukreja (12 minutes later)

Brief Answer:
ALways there for my patients

Detailed Answer:
Hi

Get Well Soon
Regards

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Above answer was peer-reviewed by : Dr. Raju A.T