Problems mainly in morning

[stolar]

I am diagnosed with microscopic colitis based on a biopsy and symptoms. I have been taking Asacol and chlordiazepoxide/clidinium every morning and at later times when needed. I have pains and diarrhea almost every morning, but symptoms during the rest of the day are unusual. Sometimes I have extreme flare ups and, in spite of taking these drugs, the symptoms last from until noon or as late as 5:00.

I need to know if anyone with colitis has problems mainly in the beginning of the day. Is there any reason sleep or wakening from sleep could exasperate the colitis?

I was on intermittent FMLA for this, and I stayed out from work for 3 days because of a flare up. They found out I worked another job in the evening and assume I am lying. In fact, I never know in the evening how I am going to feel the next day. Feeling fine before going to bed, and feeling awful the next day is the way my flare ups happen.  

I am appealing this, and I think the burden of proof is on them. But I am assuming the have a doctor who will say whatever they want him to say, and I need some evidence that my situation is possible.

Is there any such evidence?

Is there something to search for specifically, in looking for abstracts?

Is there a possible cause for my symptom?

I need help on this as soon as possible.

Thank you,

stolar

[Shonda21]

Just so you know you are not alone, it seems to be a common thing to have symptoms worse in the morning.  I have been fortunate and have only been diagnosed w/ UC for about 6 years.  It was discovered when I was pregnant w/ my daughter and since I was pregnant, there was nothing I could do for it, and thus, it continued to get worse, causing an emergency C section 5 weeks early. But thankfully she is healthy.  Since that point, I have been on a wide variety of meds that didn't work, spent a lot of time in the hospital w/ pain, nausea, vomiting, and dehydration, had multiple tests, surgeries, transfusions, and infusions.  However, my newest gastro has put me on a drug called Remicade and I have been on it for 3 years and it has made a DRASTIC difference. The treatments are IV and I get them every 8 weeks.  I went from 17 pills daily to none, aside from vitamins and occasional meds.  While the symptoms are not completely gone, they are much better to where I am confident in going out of my home and not fearing an "attack".  I am able to eat more, have actually gained weight and have a life w/ my  little girl that I hadn't had for a while.  So, there is hope though the road may still be long!  Best of luck!

[layra]

I hope you can use some of this info to help you.
I also have issues with functioning a normal daily life
my evenings too are often better. I cannot tell you the last time I did not wake up nauses! It stays and lingers for as long as it wants! I have eliminated all questionable edible products my diet is reasonably healthy. I do not eat late and yet every
EVERY morning I wake up feeling sick! My next move is to a homeopathic Dr. Good luck
Btw this affliction also affected my ability to work outside of the home. I have had to start my own employment. It is easier to work near your own bathroom and kitchen and laydown when it is all to much!
Again Good luck

[PrincessKatie]

I have Crohn's and Colitis and I pretty much cannot eat unless I have been up for at least 5-6 hours. Perhaps as the day wears on and more food is processed through your body, your body can deal with it more. If you must eat, trying eating things in the morning that are light. Eat something to provide you the nutrition you need to keep your blood sugar stable till lunch. Don't have anything with citrus, milk or coffee. These exacerbate the problem.
Sometimes if I just have to eat, I will have a piece of ham or chicken breast. It seems to do the trick. It still hurts but not as much as other things.

[PrincessKatie]

Sorry I didn't answer your questions about proving you have a disibility. I don't know much about the legal stuff so I can't be much help. I also realize you're not saying that breakfast causes it but just waking up does. Have you tried stopping eating earlier in the evening before bed? I'm sorry I'm not answering very well...I think I need to go to bed. I hope you work things out and I completely understand about not working in the morning but working at night! No one understands how half the day you can feel horrible but perk up in the evening!

[lizziecee]

Hi there - saw your post before the Dr. responded and wasn't sure I should post. He was not a lot of help, was he?

I have had Crohn's (with colitis in the lower intestine) for some 35 yrs - jeez, I could write a book on it now.

Your symptoms are very similiar to mine - severe diarrohea on wakening, and then some 2-4 hours on the loo, often with very watery stools. It seems to get a bit better during the day, but I also have frequent periods of sudden faecal incontinence, which can be very embarrassing - often have to wear incontinence pads. I do also have to get up in the night, and go to the loo with a stool movement. Can't figure out what causes it. I eat a very healthy diet, mainly protein and carbs, and very little fibre, as this exacerbates the problem.

I am now on weekly injections of 25 mg methotrexate, and for the past year, a daily dose of Cipro to keep the bacteria at bay in my intestines. I am doing fine - have gone from 95 lbs to some 120 lbs now - but I have had breast cancer recently, which really played havoc with my Crohn's meds.  

I have been able to get "Disability Living Allowance" - I live in England - which helps with transport costs to hospital, and the cleaning/hygiene problems of living with this condition.

I hope you can get your situation sorted out. Let me know if there is anything else I can help you with.
Liz.

[Kevin Pho, MD]

To answer your questions:
1) I am not aware of concrete evidence where there is a time sensitivity for the colitis.  This can vary from patient to patient.

2) You can try looking for papers or Pubmed or Google Scholar.  I am not aware of specific papers offhand.

3) Again, it may be possible for the flareups to be time-dependent.  This can vary between patients, and I am not aware of any studies proving this.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_