Lower-GI question

[Nymph]

Hi guys!

It's colonoscopy prep day! Whooo!!!

Now that I've got that out of my system, a question.

I have been having chronic diarrhea for some time. In the last year or so it has gotten much more frequent and is interfering with my life. Not to mention the underweight thing. Thus the colonoscopy.

It has occurred to me that it was 2012 when I first noticed episodic diarrhea. It wasn't right away when I first started Plaquenil in August of that year, but by early 2013, definitely. Then it has waxed and waned in the years since but ultimately becoming a regular part of my morning routine.

I have diarrhea most mornings. I take my Plaquenil every night. My question is, Could this be some sort of delayed-reaction side effect of Plaquenil?

Right now I'm not even entertaining the possibility that they might find something. :/

[Navigator]

It is not unusual for those with autoimmune diseases to develop others...like celiac or irritable bowel syndrome.   I have IBS and it just developed over time.  I gave up gluten dairy and sugar...with trial and error it appears that gluten is the instigator.   So while I do not have to have NONE I avoid it as much as possible.

I got this many years after being on plaquenil...so while I am only one test case it was not the drug it was a progression of the whole autoimmune thing.

[irish]

They may not find anything and it could be the plaquenil also. I noticed that you take probiotics and I am wondering if you have tried not taking them. Sometimes a person can get a probiotic induced infection in colon from probiotics. Just heard about this recently from a doctor.

I know that when I eat too much yogurt I will start to have stomach issues and have learned that I can't eat it everyday. My GI told me not to take probiotics every day either. Ask the doc to do a biopsy of your colon wall to see if there is a low grade infection brewing. Just a thought. Good luck. Irish

[Nymph]

I had the scope today. He said that everything looks good. He did a few biopsies to look for "micro-inflammation" and will let me know in about a week.

Thanks, Irish. I only take the probiotics 2-3x a week. If nothing show up I may try switching my Plaquenil to the morning to see if that makes any difference in the timing of my diarrhea. Then I would know. My mom has also had IBS forever and has to eat a very restricted diet to control it. I'm not in love with that idea but may have to look into dietary triggers beyond gluten if all else fails.

[Scooby7]

I also have what I thought was raging IBS issues.  Turns out, after a colonoscopy and an endoscopy, I have collagenous colitis.  Which is made worse by taking nsaids.  I have not found that any change in diet has changed my symptoms- I have tried alot of different things.  But, we are all different.
Staying off nsaids has definately helped.
This colitis is in the category of microscopic colitis. 
Good luck with your diagnosis.

[warmwaters]

IBS is often one of the associated delights of autoimmune problems, and specifically Sjogren's

Plaquenil can also be a trigger for some people.

One model for addressing diarrhea is FODMAP, which looks at whether you have triggers to naturally occurring sugars in food. There are different categories, which might appear in fruit, vegetables, dairy and so on. Not everyone is the same. I have the most problems with fructose (mostly in fruit), but can handle some lactose (mostly in dairy), for example.

You can also try increasing dietary fiber.  Again, not the same for everyone. But you want to be looking for soluble fiber, not insoluble (which tends to go through you). Talk with your gastro - a lot of information out there, much of it contradictory.

[Nymph]

Thanks, Scooby. That's one of the things they are looking for in pathology. The other is mast cell problems.

Warmwaters, my mom has IBS and follows FODMAP. I have resisted going that route but if nothing comes up from pathology then I'll probably test for SIBO, do the herbs, and then the FODMAP diet if necessary. I struggle with being underweight so any other dietary restriction (I am GF) is problematic.

[Deb 27]

Have you tried not taking the plaquenil for a few days to see if the diarrhea clears up? Also, what about the magnesium or other supplements? I know magnesium can give some people diarrhea. I guess it depends on how much you take but also sometimes it's a combination of a few meds that upset the stomach. That's happened to me. Just a thought for you. Good luck. I hope you get some relief soon.

[irish]

Scooby7, Just to let you know, my hubby was diagnosed with Celiac sprue years ago and was later diagnosed with ulcerative colitis. Interestingly enough, about 10 years later he was scoped again and biopsied and diagnosed with collagenous colitis instead of ulceratative colitis. The GI doc then said that the collagenous colitis, which is also known as microscopic colitis the way I understand it, had been recently identified and was found quite often in people with Celiac sprue. Have you ever tried a gluten free diet to see if your symptoms decrease? Just a thought. Irish

[Jenny]

I?m one of those who Magnesium gives me diarrhea. It took me a few months to figure it out. I know Plaquenel can do it also.  Try eleminating each for a few days. Good luck!

[Nymph]

Thanks. I have tried eliminating magnesium and the only result was that I got more migraines. I would try cutting the Plaquenil, but I think I would have to cut it for a couple of weeks to tell for sure, because there is some variation in when I have it, which is why I don't really think it's the Plaquenil. I don't want to start a flare.

[Scottietottie]

Hi 

Last year I suffered diarrhea for six months. It was awful. I had a colonoscopy that showed up nothing. A good result in one way - but I still had diarrhea and I didn't always make the bathroom!

In my case it turned out to be a pain killer I was on that was responsible. It was one of the most efffective painkillers I've ever had and apparently constipation is a more usual side effect. Obviously I can't take it any more.

I hope you get the answers you need.

Take care - Scottie

[Nymph]

Scottie, no fun! I've had this for about five years but becoming more regular in the last year. That's the thing... If I take a pill every day wouldn't I have it every day? But there are days when I don't... sometimes several in a row. And then it's back to several of those days in a row when I have trouble making it to work on time in the morning because of my demanding innards.

[SjoGirl]

Sure anything is possible. A question that a wise person once taught me to ask is it probable, and if so, how probable. You might ask your gastroenterologist or the prescribing doctor those questions about Plaquenil.