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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Ulcerative Colitis

I have to use the restroom up to once every hour, including throughout the night (20 to 30 times a day regardless of having eaten or not and with a varying amount of stool). I m literally drained. My stool is extremely watery and because everything goes right through me I often have fully formed, non-digested food in it. Using the bathroom is constant and very painful. I had a total colectomy a few years ago to deal with ulcerative colitis, but the disease had already spread to my small intestine and esophagus before the operations- rendering them useless. I now have Crohn s disease and the pain is chronic. I ve tried several medications to treat the active disease as well as medications for the pain. I know I ll never again be constipated, but I m desperate to make my restroom use as infrequent as possible- anything under once an hour would be incredible and will help alleviate a significant amount of the pain. I took Dilauded for a long time, which was specifically effective in slowing my bowels (down to ~once every 3-4 hours). However it caused far too many other problems (chronic fatigue, extreme agitation, disoriented and foggy, extreme water retention/edema, muscle spasms, low to no functionality, etc.) to continue usage with any hope for a decent and increased quality of life. It was not worth it. I m currently taking morphine sulfate (ER and IR), but the effect is minimal for slowing my bowels (back up to ~once an hour) and my quality of life is still too poor to continue taking it. I have bloody stool, edema and I m always very drowsy. Before the morphine I was taking Nucynta (150mg ER up to 3x/day with 100mg IR 2x/day). It wasn t quite enough and although it did address the pain it took too long to metabolize. I think adding a faster acting narcotic will help to address the pain more effectively. I would like to switch back to Nucynta and add Percocet. My GI said he saw no contraindications in doing so, but I need more information before I discuss this with my pain management specialist. I m having a hard time finding the proper materials to educate myself on combining these medications and I don t want to sound like a fool when I discuss this with my doctors. I also don t want to die because of a bad drug interaction. I know that sounds like a given, but the fear of that specifically is a very real fear for me. I know my doctors won t prescribe a fatal combination of medications, but again, I want to be educated before I present my thoughts and preferences for addressing my pain. Please help.
Thu, 24 May 2018
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General Surgeon 's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

The management of ulcerative colitis is multi modality approach.

Dietary measures must be at its best.
- prefer bland, vegan diet.
- avoid all dairy fat, spices, junk foods, oily.
-Life style modifications
- Deep breathing exercises and YOGA will prove a major role in control of symptoms.
- Avoidance of stress, anxiety.
- Regular sound sleep of 7-8 hours.
- Avoidance of smoking or alcohol if consuming.

Medications as per the advise of your GI specialist.

Hope I have answered your query. Let me know if I can assist you further.
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Suggest Treatment For Ulcerative Colitis

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. The management of ulcerative colitis is multi modality approach. Dietary measures must be at its best. - prefer bland, vegan diet. - avoid all dairy fat, spices, junk foods, oily. -Life style modifications - Deep breathing exercises and YOGA will prove a major role in control of symptoms. - Avoidance of stress, anxiety. - Regular sound sleep of 7-8 hours. - Avoidance of smoking or alcohol if consuming. Medications as per the advise of your GI specialist. Hope I have answered your query. Let me know if I can assist you further.