I have been on cortisone for the past 5 months for pouchitis treatment. I'm currently down to 16mg prednisone which is added to my 2mg budesonide/entocord enema every night. I am due to drop the dose to 8mg tomorrow but have started to have problems emptying myself. I feel the need to go to the toilet but when I try I have to push really hard, sometimes with nothing coming out. So far I've had no blood or increase in stool frequency or liquidity. My Doctor is on holiday so I can't ask her what to do. Could this be the start of inflamation again? I'm also on Cipro & Zinnat antibiotics.

Gee, could be, but I really don't know. This does not sound good, especially since you are already on antibiotics AND steroids (oral and topical). You can try to insert a finger and see if there is a stricture or obstruction. Is your stool very thick? Perhaps that is the problem.

Jan

Thanks for the advice Jan. Feel a bit better this morning, had lots of movements during last night but this morning have only had one movement which was really quite solid. I had already tried inserting my finger, no difference there and no pain either. Will see what happens over next 24 hours, I'm not taking oral steroids any more, just the entocord, but am adding 16mg of (injectable) prednisone to the enema....my doctor's suggestion. The plan is to try azazioprine next then as a last resort Humira. Not sure I really want to take either but would rather rule out all possibilities before resorting to a permanent ileostomy.

The antibiotics could be making your stool too thick and difficult to pass.

Jan

That has happened to me when I was on antibiotics. I felt there was an improvement - no more watery stools and achy body, but after a couple of days it seemed like all peristaltis was gone. I would then have leakage with no warning and would also have to strain so much and like you, it would amount to nothing. After I stopped the antibiotics, all was back to "normal."

I hadn't thought of that, but I've been on the antibiotics for over 6 months. It seems to be that when I eat something it activates my gut and makes it easier to empty myself, but I'm still having to push really hard. Did you find this too?

Straining, at times, is a big problem for me. I cannot figure out why since it is so inconsistent and I cannot connect it to anything. It can be very inconvenient when I have to leave the house but feel like my pouch is full and I cannot evacuate.

Could be from adhesions. When the stool is thicker, you are more likely to have kinks from adhesions causing problems. You could try increasing your juice and water intake to loosen things up.

Jan

I have been taking various antibiotics for 13 years continuously (can't get off) and have not experienced these problems. The one time I had significant emptying problems, it was due to a physical problem with the J pouch which was surgically corrected.

My stools tend to be looser with xifaxin than with cipro/flagyl. However I have never had a problem of them being too thick. I only have such issues if I take too much imodium. Even 2 mg of imodium will thicken me up right away. So the question I have is are you taking antibiotics plus imodium?

I'm not taking imodium, my doctor has suggested laxatives but I'm not convinced this is a good idea. Sometimes my stool is thick and difficult to pass but then it can be quite liquid and gassy, this is when I feel emptiest.