Does anyone have these symptoms

[whoopi]

After several surgeries over the past two years (colon, etc.) I have severe diarrhea, fatigue, mood swings (usually low moods), crying everyday.  I believe some of my moods and weight gain are caused by some of the medicine.  However, the medicine has not helped the chronic diarrhea very much.  Any suggestions?  Please help if you can.  Thanks.

[Nanny]

It would be helpful if you would post the medications that you are taking.  Perhaps then someone who has experience with these medications could give you an answer.

[whoopi]

In reference to my earlier plea, I've listed my medications below.  I appreciate any suggestions.


Coumadin 5 MG per day
My medications are as follows:

Prevacid 30 MG per day
Pentasa 250 MG – 3 capsules 4 times a day
Activella 1 mg estradiol/0.5 mg norethindrone acetate
Pravochol 40 MG per day
Levothroid 0.2 MG per day
Bisoprolol/hctz 2.5/6.25 MG per day
Nitroglycerin oint. .02% as needed
Hydrocortisone 25 MG (suppositories as needed)
Prozac 20 MG twice a day
Bentyl 20 MG 3 times a day
Pregnazone 5 MG 2 pills 4 times a day
Codeine 15 MG 1-2 pills every 4 hours
Lomotil 5 MG 1-2 pills every 4 hours
Lotrimin 1% cream as needed
Claritin 10 MG per day
Questran 3 times a day
Doxycycline 50 MG as needed for bacterial infections
Amino Acids 2 pills 3 times a day

I appreciate any suggestions.  Thanks.

[nanci]

How old are you?  I ask because your fatique and mood swings
may be pre menopausal symptoms that can start as young as 35.

[mattk]

I believe, I am not a doctor though, that the list of meds clearly shows how the mood and wieght gain would be an issue.  Is the same doctors prescribing all the meds?  If you have several doctors, please let all of them know the meds you are taking.
There are several that cause pain, blotting and mood changes.  I also take several meds, but both doctors know exactly what I take.  You are taking a lot of different meds, which may have adverse effects??!!
Good luck!
Matt

[Nanny]

Whoopi,

I entered these drugs in my drug interaction website and this is the information that it printed out.  I could not find the Lotrimin on the list.  This includes interactions with food or beverages, too.

Potential Drug Interactions
You searched for interactions of combinations of the following drugs: Activella, Bentyl, Bisoprolol, Claritin, Codeine Oral, Doxycycline, Hydrocortisone Oral, Levothroid, Lomotil, Nitroglycerin Capsules, Pentasa, Pravachol, Prednisone, Prevacid, Prozac, Questran.



(Caution: not all drug interactions are known or reported in the literature, and new drug interactions are continually being reported. This information is provided only for your education and for you to discuss with your personal healthcare provider.)

CHOLESTYRAMINE (in Questran) may interact with LEVOTHYROXINE (in Levothroid)

When these drugs are used at the same time, cholestyramine may combine with levothyroxine in the stomach and prevent it from being absorbed into the body. If this happens, then potentially less levothyroxine would be available for the body to use and blood levels could become too low. This could make levothyroxine less effective in correcting hypothyroidism (also referred to as an "underactive thyroid"). If these drugs are used together, allow at least 6 hours to pass after taking a dose of levothyroxine before using cholestyramine. Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.

This interaction is poorly documented and is considered moderate in severity.

HYDROCORTISONE (in Hydrocortisone Oral) may interact with ESTRADIOL (in Activella)

Estradiol may block the breakdown of hydrocortisone by the liver. If this happens, blood levels of hydrocortisone could be increased. This may cause an increase in both the intended effect and the side effects of hydrocortisone, including stomach irritation, facial swelling, and mood changes. If these drugs are used together, your doctor may want to monitor you closely for side effects and adjust the dose of hydrocortisone if needed. Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.

This interaction is poorly documented and is considered moderate in severity.

PRAVASTATIN SODIUM (in Pravachol) may interact with CHOLESTYRAMINE (in Questran)

When these drugs are taken at the same time, cholestyramine may combine with pravastatin in the stomach and prevent it from being absorbed into the body. If this happens, then potentially less pravastatin would be available for the body to use and blood levels could become too low. This could make pravastatin less effective. If these drugs are used together, avoid taking pravastatin within 4 hours after a dose of cholestyramine. To make this schedule easier to follow, consider taking cholestyramine before meals and then take pravastatin in the evening before bedtime. Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.

This interaction is poorly documented and is considered moderate in severity.

PREDNISONE (in PREDNISONE, Prednisone) may interact with ESTRADIOL (in Activella)

Estradiol may block the breakdown of prednisone by the liver. If this happens, blood levels of prednisone could be increased. This may cause an increase in both the intended effect and the side effects of prednisone, including stomach irritation, facial swelling, and mood changes. If these drugs are used together, your doctor may want to monitor you closely for side effects and adjust the dose of prednisone if needed. Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.

This interaction is poorly documented and is considered moderate in severity.

HYDROCORTISONE (in Hydrocortisone Oral) may interact with CHOLESTYRAMINE (in Questran)

Take hydrocortisone and these drug a separate times to prevent mixing in the stomach. Take hydrocortisone at least two hours before these drugs or six hours after these drugs. Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.

This interaction is well-documented and is considered moderate in severity.

ALCOHOL may interact with DOXYCYCLINE (in Doxycycline)

Doxycycline is broken down and removed from the body by the liver. If you are taking doxycycline and have been consuming alcohol on a regular basis for a long period of time, the drug may be broken down at a faster rate than normal. If this happens, then potentially less doxycycline would be available for the body to use and blood levels could become too low. This could make doxycycline less effective at treating an infection. On the other hand, alcohol may increase the absorption of doxycycline from the stomach. This is more likely to happen when alcohol has not been consumed on a regular basis. Although this may cause blood levels of doxycycline to be increased, it is not likely to increase the beneficial effects of the drug. You may want to ask your healthcare provider about this potential interaction if you think you are having problems.

This interaction is poorly documented and is considered minor in severity.

GRAPEFRUIT JUICE may interact with ESTRADIOL (in Activella)

Grapefruit juice may block the breakdown of estradiol by the liver. If this happens, blood levels of estradiol could be increased and this could cause an increase in side effects. Side effects that can potentially occur with the use of estradiol include headache, weight gain, and stomach irritation. More severe side effects may include an increase in blood pressure and the formation of blood clots. Because information about this potential interaction is limited, the safety of taking estradiol with grapefruit juice or nutritional supplements that contain grapefruit juice is not known. You may want to ask your healthcare provider about this potential interaction if you think you are having problems.

This interaction is poorly documented and is considered minor in severity.

That's a incredibly large amount of drugs to be taken at one time.  Perhaps you need to consult with all your physicians, with the total list, and eliminate whatever possible.

I hope this information is helpful.
Nanny

[whoopi]

Thanks so much for all of your helpful information.  All three of my doctors are aware of all the medication that has been prescribed for me.  However, the gastro. monitors the amount and which medicine I will take when.  He tries to change it around to see which medicines work best together.  So far it has not been successful.  It has definitely gotten better since a year and a half ago, but a long way from being well.  Needless to say, I'm confined to the house a lot.  

In answer to an earlier question, I'm 52 this year.

Thanks so much for everyone's input.

[kimbacat]

Hi Whoopi, since you are taking Pentasa and pred, I'm guessing you have been diagnosed with IBD.  it sounds like you are still flaring if you are still having diarrhea while also taking lomotil, codeine and questran.  talk to your gi about modifying your treatment.  the optimal dosage for mesalamine (Pentasa) is 4g, so you can still go higher on that.  ask about immunosuppressive therapy (azathioprine or 6mp), which could help you cut out a lot of your meds, including pred.  I think there have been recent studies showing that mesalamine (Pentasa and Asacol) aren't as effective in controlling IBD after you have had surgery.  how long have you been on pred (which is the likely culprit for the weight gain)?  because 40 mgs is too high of a dose to be on for any length of time.  I would strongly recommend getting a bone density (DEXA) scan to make sure your bones are still doing ok, since age, IBD and prednisone can really decrease your bone mass.  and pred definitely causes depression and other emotional problems in many people.  depression definitely goes hand in hand with bowel disease as with any chronic disease.  maybe an adjustment in the Prozac dose, or possibly a switch.  SSRI's like Prozac can worsen the diarhea (diarrhea) in some IBDers.  you also might want to try taking a really good multivitamin.  with diarrhea and the absorption problems associated with IBD, they can help.

I've had Crohn's disease for more than 25 yrs now.  I am NOT the norm for IBD and have had a pretty nasty time with it.  I've had 5+ abdominal surgeries and have a permanent ileostomy.  getting on the right medication treatments can make a world of difference and keep you from needing additional surgical intervention.  (I'm currently on Remicade and methotrexate for my Crohn's disease).  take care, I hope I was able to help.

[glutenfree]

Hi Whoopi Hopefully this will help you.
I suffered for many years with Irritable Bowel Syndrome, Acid Reflux, Diarrhea, Chronic Fatigue and more. After many doctors and prescriptions I was diagnosed with Celiac Disease. Celiac Disease is when gluten(a protein found in wheat,rye and barley) destroys the Villi of the small intestine. Once this happens you will not absorb nutrients. Recent studies show there are more than 1 million people in the US with undiagnosed Celiac Disease. Most physicians in the US feel the disease is not prevelant. CD is commonly diagnosed in Europe.
You can request the following blood tests from your gastroenterologist.
Anti-Endomysial - IgA AGA and IgA EmA
Anti- Gliadin -  IgG and IgA
Tissue Transglutaminase - tTG

I would question your doctor as to how effective these test will be considering the number and type of medications you are taking.
You can learn more about CD on my website www.glutenfreeinwny.com

Good Luck
Mike

[Concerned lady]

I agree with EVERYONE who answered you! Good info!!

You really do need to sit down with a good doc AND a good pharmacist, (for a lot longer than a 5 minute visit!!) and find out how to SAFELY get off AS MANY OF those meds as possible (if possible). I suspect that the many drug interactions plus adverse (bad) side effects are a major part of your present problems.

Have you looked into holistic health at all? (Health food stores, acupuncture, homeopathy, herbs, supplements if safe, life style changes, etc.)

Take a look at Mike's website about Celiac Disease. I checked it out, and I liked it!

I'll also post "some Gastric Reflux tips" for you, in case some of them might be helpful to you. There's a lot of "holistic", yet medically sound info in these "tips".

************************************************************

Some GASTRIC REFLUX TIPS (without acid blockers):

GER=Gastro-Esophageal Reflux. (Gastro=stomach. Esophagus=food tube.)

LPR= Laryngeal-Pharyngeal Reflux. (Larynx=voice box, containing the 2 vocal cords. Pharynx=throat, above the larynx. The larynx is above the trachea/windpipe.)

Reflux=acidic or alkaline stomach material that backs up into the esophagus (food tube), causing any of these problems: VCD/Vocal Cord Dysfunction/Laryngospasm attacks, cough, voice problems, asthma, globus (feeling of lump in throat), constant need to clear throat, worsening of sinus condition, sore throat, pre-cancerous conditions of throat &/or esophagus, etc.

SOME GER/LPR CONTROL THINGS WE DO, that we learned from the excellent book: STOMACH AILMENTS AND DIGESTIVE DISTURBANCES, by Michael T. Murray, N.D. See page 9, References, in my website: http://cantbreathesuspectvcd.com   and, also see GER/LPR info on page 5, and on LINKS page.

PLEASE READ THIS GREAT BOOK. It may possibly be bought on-line, from Michael T. Murray’s website.

Some of the following we learned from people &/or other books, &/or other good websites about voice, GER, etc.

(1) DGL (De-Glycyrrhizinated Licorice) is one of our main methods of controlling the GER/LPR. We use Enzymatic Therapy brand DGL, shortly before ALL meals (breakfast, lunch, supper). The DGL does NOT cause high blood pressure, and does NOT cause fluid retention/edema, because the bad (steroidal) part of whole/crude licorice has been removed, leaving the DGL. DGL is available at most health food stores, and at good pharmacies.
  
The DGL tablet(s) must be chewed, to mix with saliva, to be effective. If it is too dry, one could mash/crush it and mix with a little water, and then chew it up. Chew tablet(s) for about 10 seconds (at least), to thoroughly mix with saliva, shortly before EVERY meal, and if necessary, between meals (Read label directions).
  
The DGL seems to not only promote healing of throat, esophagus and stomach, but also seems to help prevent OUR reflux.(resulting in no more globus/lump in throat sensation, no more constant throat clearing, excess mucous, excess phlegm, no more NIGHT-TIME VCD/Vocal Cord Dysfunction/Laryngospams attacks, no more laryngitis, etc. for us)

We like the taste of the plain, fructose-free, DGL CHEWABLE tablets, but for those who hate the taste, try mixing the crushed tablet with a tiny bit of mashed organic banana, and then chew thoroughly, to mix with saliva. Avoid any DGL that contains mint. (Mint—in all forms, can cause gastric reflux episodes. AVOID MINT!!).

(2) We use Thayers brand of SLIPPERY ELM Throat Lozenges when we feel the need. (Soothing, coating, healing, nourishing). Slippery Elm (inner bark from a tree) also comes in teabag form, or in bulk, etc. as an herbal supplement.

(3) We drink the occasional small glass of CARROT JUICE (organic, fresh) which soothes, coats, heals the digestive tract, is nourishing, and stimulates the immune system, with beta-carotene, soothing and coating PECTIN (a type of fiber), and other good nutrients. (Carrot soup, cooked carrots are also good. Beta-carotene is heat resistant.) (Beta-carotene later is turned into Vitamin A inside us). Do not overdo. If your skin turns orange, cut back on the carrot juice. Avoid beta-carotene pills -- too potent.

(4) We tried elevating the head of the bed a few inches, by putting 6 inch to 8 inch BLOCKS, ON THE FLOOR, under the head end of the bed. This creates a slant (tilt), where the head is 6 to 8 inches higher than the feet. This helps some people, but not all people. (Check with a pediatric Gastro-enterologist, about raising the head end of a bed of a child, or a crib of an infant). Also, see (16) about a special GERD PILLOW, for adults.

(5) We try NOT TO BEND OVER too often, and we try to AVOID STRAINING (Valsalva maneuver). We AVOID LIFTING HEAVY objects. (No weight lifting!) (at least until after no more reflux symptoms for 3 months).

(a) If CONSTIPATION is causing any straining, see Ref.15,18,23,24,25 on page 9 for ideas about gently treating constipation, including eating whole grains, not white (de-natured ones), etc.  For us, exercise, increased water intake, acidophilus/bifidus, digestive enzymes, avoiding junk food, improved diet, chewing slowly (takes will power!), eating when not under stress or angry, etc., all are helpful.

(6) NO MORE TIGHT pants, belt, corset,--AVOID TIGHT CLOTHING etc.

(7) We try to not eat too much junk food. Some people avoid acidic  food, while others need to eat acidic food, if their stomach is not producing any (or enough) acid. (It is good to avoid acid, if one has an ulcer.) These gastric reflux tips methods often can help to heal ulcers. Some people need betaine hydrochloride supplements, which becomes HCl/hydrochloric acid, or, some use vinegar (acetic acid) in salads, or mixed with water, while others need to avoid eating excess acid. Each person is unique. We avoid all artificial sweeteners. Anyone with diabetes might want to look at the excellent book Reversing Diabetes, by Dr. Julian Whittaker, M.D..

Diet soda pop contains the harmful artificial sweetener Aspartame (Equal/Nutrasweet), which can cause WEIGHT GAIN, HEADACHES, UPSET STOMACH, BLURRED VISION, BLINDNESS, TWITCHING, SEIZURES, BRAIN TUMORS, HYPERACTIVITY, MOOD SWINGS, ETC., and soda pop often has strong acids, plus other harmful artificial ingredients. Plain water, gentle herb teas, certain fruit juices, brown rice-milk, etc. are healthier substitutes for soda pops.

We try to avoid all artificial ingredients, including fake fats (like Olean, Olestra, etc.), because these can destroy the digestive system, and prevent absorption of vital nutrients, such as fat-soluble vitamins (A, D, E, K) from foods. These fake fats also prevent digestion and absorption of needed fats & oils, used to repair myelin nerve cell sheaths (made of fatty material, mostly cholesterol). Hormones are also made of mostly cholesterol.

(8)  We try to drink more water, to prevent chronic dehydration. We like hard (nicely mineralized) well or spring water.
We do not drink distilled water (soft water, no minerals), because it can leach minerals out of our bones, possibly contributing  to osteoporosis. (See Ref.18,23, on page 9.) We avoid water softeners (chemicals) because they can be toxic, and because good minerals help keep us healthy. People with KIDNEY PROBLEMS &/or GLAUCOMA, etc. should ask their docs how much water is safe to drink, since too much water can be dangerous for them! (But, dehydration can cause problems also.)

(9) We use ACIDOPHILUS/BIFIDUS ( edible beneficial bacteria which keep bad YEASTS away, such as Candida Albicans, formerly called Monilia). ACIDOPHILUS/BIFIDUS also can eat or control some bad bacteria, and some viruses. The acidophilus/bifidus are also called PRO-BIOTICS and are beneficial intestinal flora (mainly for the large intestine). We keep the jars refrigerated, but not too cold. These are available at health food stores & pharmacies. (See Ref.14,15,23,24,25, on page 9).

Acidophilus/bifidus can re-populate the large intestine, with good bacteria, after antibiotics &/or steroids, etc. have killed off these good bacteria! Some of us have to continue eating the acidophilus/bifidus (daily, or from time to time), but the results seem worth the effort to us.

Yogurt and buttermilk contain similar beneficial bacteria, but are milk products, so see (11) below about milk products.

(10) We use DIGESTIVE ENZYMES. My husband likes Acid-Ease by Prevail, which contains Slippery Elm (inner bark), Marshmallow Root, Gamma-Oryzanol (from Rice Bran Oil), and the plant enzymes Amylase (digests starch), Lipase II (digests fat), and Cellulase I (digests cellulose from plant cell walls). The Acid-Ease does not contain Protease, which can be very irritating to ulcer/GER folks.

The Acid-Ease is NOT an acid blocker. It is not an antacid. It soothes, coats, nourishes, and promotes healing. Its enzymes help with leaky gut syndrome.

   I use Total Enzymes (which does have Protease, a protein digesting enzyme) by Nutri-West, a company that sells only to health practitioners (Chiropracters, Physicians, and others). One could ask their physician to order, at cost, for them, by having physician call 1-307-358-5066.

   Digestive enzymes are NOT FOR EVERYBODY.

(11)  My husband has found that AVOIDING MILK PRODUCTS helps him feel less congested, with less mucous in throat. Milk and milk products can cause gastric reflux episodes. Brown-Rice Milk (look for gluten-free) can substitute for milk (but not for babies!).

Gluten is in wheat (includes spelt & kamut), rye, oats, barley, & buckwheat. Read labels to avoid hidden gluten, in some soy sauces, gravies, grain alcohols, beer (barley malt), etc. People with Celiac Disease need to avoid all foods containing gluten. BROWN RICE (organic) is gluten-free. Corn is gluten free, but is very allergenic (allergy causing), so avoid corn. Avoid millet, at first, because there is disagreement about whether millet is safe or not, for Celiac patients.

MILK MAY CAUSE MORE ACID to be produced, IN THE STOMACH.

I occasionally eat milk products, like yogurt, cheese, whipped cream, or my ACIDOPHILUS/BIFIDUS, which is mixed with goat milk powder. So, at these times, I take LACTASE ENZYMES, to digest (break down into easily absorbed small molecules) the milk-sugar called LACTOSE. Many people (due to heredity &/or disease) have Lactose intolerance, where the small intestine does not secrete the lactase enzyme. Result is that the milk-sugar (lactose) travels further down the small intestine than it should. Then, bad bacteria eat the lactose, giving off lots of gas (a by-product of the digestion of bad bacteria), and this causes folks to get bloated, gassy, have diarrhea, and cramping. I use Lactaid brand lactase enzymes, and it works for me. Ordering direct from them can save money.

(12) Using the above methods has almost completely freed my husband of needing to use Tums, and seems to be nicely controlling his and my GER/LPR. We have never used acid blockers.

ACID BLOCKERS CAN HAVE DANGEROUS SIDE EFFECTS: Some examples are:

Acid must be present in the stomach, in order for the stomach to make a substance called Intrinsic Factor. Intrinsic factor must be present with Vitamin B 12, in the stomach, for absorption of Vitamin B 12 to happen, in the ileum (last part of the small intestine), I believe.

Acid blockers therefore prevent absorption of Vitamin B 12. Malabsorption (lack of absorption) of Vitamin B 12, causes NERVE DAMAGE (pain, numbness, pins & needles sensation, etc.) in the peripheral nerves (outside the brain & spinal cord). This is called PERIPHERAL NEUROPATHY. For details about this problem, see the Peripheral Neuropathy forum at http://www.braintalk.org

If Vitamin B 12 continues to NOT be absorbed, eventually there can be NERVE DAMAGE to the Central nervous system (brain & spinal cord).

ALSO, the minerals calcium, iron, zinc, other minerals, and important trace minerals, etc. cannot be properly absorbed, when there is no acid in the stomach (due to acid blockers, etc.).

AND, protein does not get properly digested (broken down--eventually into amino acids), in the stomach, when there is no acid in the stomach.

Doctors and pharmacists can advise about gradual(slow) tapering down (weaning) schedules (when and if safe) for the acid blockers. Some acid blockers, when stopped too quickly, can cause rebound acid secretion in the stomach, resulting in excess hydrochloric acid secretion.

ALSO, SOME FORMS OF REFLUX ARE NOT ACID REFLUX, but are ALKALINE REFLUX, (bile is alkaline). Besides refluxed stomach acid (HCl/hydrochloric acid), Pepsin (an acidic proteolytic/protein digesting, enzyme) & bile (alkaline) can irritate & damage: the esophagus, throat, vocal cords, & lungs.

(13) Do not drink ICY COLD DRINKS, and AVOID VERY HOT DRINKS. Use room temperature drinks, or slightly cool, or warm, but not ultra-hot. Extremely cold or hot liquids can irritate the stomach, which is bad for ulcers &/or gastric reflux.

(14) Ask physical therapists, chiropractors, osteopaths, etc. if they know any safe adjustments that might lessen GER/LPR, if you wish.

(15) Read (by Dr. James A. Koufman) PATIENT INFORMATION SHEET ON REFLUX by Center for Voice Disorders of Wake Forest University. Here’s a link:  http://www.bgsm.edu/voice/pt_info.html  Dr. Koufman was a pioneer in showing the connection between stomach reflux (can be acid reflux OR alkaline reflux) and breathing problems!

(16) Some have found a special (large) GERD pillow helpful for preventing GERD episodes while sleeping and while lying down. Here is a link to the Prop up pillow website:  http://www.propuppillow.com

(17) Avoid harmful chemical air pollution, which can aggravate gastric reflux. See page 5 of VCD website for more about this.

(18) Using the above methods, in addition to the SINUS SURVIVAL tips, has helped us to prevent VCD attacks, in us.

(19) Please check with your doctor, in advance, to be sure that it is OK for you to try these tips, in your particular case. Also, please get monitored by your doctor, to be sure that no more damage to the throat, esophagus, stomach, vocal cords, lungs, etc. is happening, from possible SILENT gastric reflux.

Pregnant or nursing ladies should check with their doctors, before trying any of these tips.

Avoid any herbs, foods, etc. that you may be allergic to.

Check with your doctor and pharmacist, to be sure that there would be no harmful interactions between any of your medications, diet that you may be on, and any herbs, foods, etc. mentioned in these tips.

Check with your doctor, to be sure that these tips would not interact badly with any medical condition you may have.

These tips help my husband and me (adults). Some of these tips may be OK for children, and others may not be OK for children. Check with your doctor! Babies with gastric reflux need DIFFERENT treatments, not these tips (except for raising the head end of the crib, if your doctor says it is OK to do this, etc.). Check with your doctor!

Good luck to you.

Sincerely, Concerned lady
http://cantbreathesuspectvcd.com