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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Constipation And Diarrhea Inspite Of Taking Ondansetron For Colitis?

My 75 year old mother has been suffering from chronic diarrhea off and on for the past 10 years. She had a colonoscopy 9 years ago which didn’t reveal any problems. In 2013 she had another colonoscopy and was diagnosed with colitis. She was prescribed Lialda for 6 months. A month after taking Lialda, she still had severe problems, and the doctor added Prednisone. The doctors never re-tested her to see if that helped with the colitis, and she still suffers from chronic diarrhea that is not constant, but comes and goes. When it hits her, it is sever and she won’t even leave the house. At one point, the doctor prescribed another medication (unfortunately she doesn’t recall the name) but it was going to cost her $500 for 30 pills (that’s after Medicare covered the first $1,500) and she simply couldn’t afford it and never filled the prescription. She continued taking the Lialda and completed the 6-month prescription, to no avail. She’s now taking Ondansetron, at first 2 pills daily. While that helped for a while, she starting suffering from constipation and the doctor had her cut back to 1 pill daily, which is where she’s at now, but still suffers from the diarrhea. She is also taking a drug called Lomotil, although she doesn’t take them on a regular schedule. She was advised to take them “as needed” so she will take them when she has an episode, but can’t say if these are helping. There’s no blood/pus/mucus in her stool, and also not completely liquid. She takes 3 blood pressure medications (Metropolal, Norvasc, Losartan). The doctors eliminated the Metropolal and Losartan at different times to see if that helped, with no success. At no time did the doctor recommend stopping the Norvasc. The only other medication she takes is low dose aspirin. I asked her if she was drinking a lot of fluids (as this was recommended in numerous medical references online) and she said her doctor prescribed the opposite, to cut down fluids to about 50% of normal consumption (I’m concerned about dehydration). The doctor’s reasoning for this was because too many fluids will lower sodium levels (she’s had some problems with low sodium and in fact was admitted to the hospital twice for this). The doctors are at a loss at to what to try next, and I would like to help her. Any advice or recommendations, including the names of reputable specialists in the Tyler, Texas area, would be greatly appreciated.
Wed, 15 Mar 2023
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General & Family Physician 's  Response
Hi,

Chronic diarrhea and constipation can have various underlying causes, including colitis, irritable bowel syndrome, inflammatory bowel disease, infections, medications, and other medical conditions. In your mother's case, it seems that she has been diagnosed with colitis, and has been prescribed several medications to manage her symptoms, with limited success.

It's important to note that ondansetron is an anti-nausea medication and is not typically used to treat colitis. It may have been prescribed to alleviate the nausea or vomiting that your mother may be experiencing. Additionally, Lomotil is an anti-diarrheal medication that may provide temporary relief, but should not be relied on as a long-term solution for chronic diarrhea.

Regarding the issue of constipation, the reduced dosage of ondansetron may have contributed to this symptom. In general, it's important to maintain a balance of fluids and electrolytes to prevent dehydration, especially if your mother has a history of low sodium levels. You may want to discuss with your mother's doctor whether increasing fluid intake or incorporating electrolyte replacement drinks could be beneficial for her.

It's also important for your mother to follow up with her doctor to discuss alternative treatment options or to seek a referral to a specialist if necessary. Gastroenterologists are medical doctors who specialize in the digestive system and can help diagnose and manage conditions such as colitis.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Priyanka, General & Family Physician
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What Causes Constipation And Diarrhea Inspite Of Taking Ondansetron For Colitis?

Hi, Chronic diarrhea and constipation can have various underlying causes, including colitis, irritable bowel syndrome, inflammatory bowel disease, infections, medications, and other medical conditions. In your mother s case, it seems that she has been diagnosed with colitis, and has been prescribed several medications to manage her symptoms, with limited success. It s important to note that ondansetron is an anti-nausea medication and is not typically used to treat colitis. It may have been prescribed to alleviate the nausea or vomiting that your mother may be experiencing. Additionally, Lomotil is an anti-diarrheal medication that may provide temporary relief, but should not be relied on as a long-term solution for chronic diarrhea. Regarding the issue of constipation, the reduced dosage of ondansetron may have contributed to this symptom. In general, it s important to maintain a balance of fluids and electrolytes to prevent dehydration, especially if your mother has a history of low sodium levels. You may want to discuss with your mother s doctor whether increasing fluid intake or incorporating electrolyte replacement drinks could be beneficial for her. It s also important for your mother to follow up with her doctor to discuss alternative treatment options or to seek a referral to a specialist if necessary. Gastroenterologists are medical doctors who specialize in the digestive system and can help diagnose and manage conditions such as colitis. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Priyanka, General & Family Physician