Fine in the day- pain and cramping in evening

[FrozenGirl]

Hi everyone

So lately I have been having a weird thing going on symptom wise. It has happened a couple times now. I will be okay all day, only have to pee but no D all then. I eat as normal (low residue, safe foods) then in the evening it's like everything that should have been spaced over the day happens. First time was a horrible cramping pain with nausea but going to the washroom nothing happened until about an hour later, after which point I went a couple times. Second time fine again all day then cramps with an intense feeling of pressure. This time I had repeated small amounts of D, in cycles of pain and pressure then go the washroom okay for a bit and repeat.

I have never had this before, has anyone else? Any ideas on preventing it.

Background, got off Imuran due to chronic low WBC count, got worse (was still on Remicade) scope showed inflammation so I have been on Pred for 2 weeks(20mg) Tapered slightly to 15mg due to my complaints of side effects. Holding there until I see my GI next week.

 

[Muppetgirl]

In dealing with obstructive issues I've found I have the lions share of symptoms in the evening. I guess it is due to the build up during the day until it becomes to much to handle.

Is some sort of stricture or obstruction a possibility? The nothing happening for a while despite nausea and pain and then it all coming through is something I personally associate with obstructive problems. Not saying that's what it is BTW. Just sharing my experience. I hope you find something that helps.

 

[FrozenGirl]

I have considered it, obstruction seems unlikely to me given it seems to resolve itself in a couple hours. Can strictures cause those kind of symptoms?

 

[my little penguin]

Intussception acts like that . And goes away in a few hours.
DS had similar issues since dec - lots of workup( scope mre etc) but always normàl . It did get worse . No one could tell us why or what ..
Finally getting better but he went EEN and pred ( due to arthritis flare ) and his intestinal spasms/D etc are improving.

Hopefully you get to the bottom of it.
But ask your Gi about intuscession because that is an automatic ER visit.

 

[Lady Organic]

I have recto-sigmoid colitis which expresses like a UC and when I am sick, I usually get cycles such as what you describe. It will be most likely be in the morning for me, I can go repeated times up to 4 or 5 times in a row within an hour :cramp, urgency, D , relief... cramps, urgency, D relief, etc.. and then I will be good all day. That is when my disease activity is at low-medium. If you were given 20mg, it means your activity is low. as my disease activity escalates, the episodes just come more often during the rest of the day.

 

[2thFairy]

I no longer have active disease, but can tell you what stress (regular daily stress, not excessive stress) does to my digestive system on a daily basis. Now that I have a stoma, it is really easy to see (literally) what is going on at different times of the day. If I am under pressure at work, my stoma will sometimes shut down and there will be no activity at all until I am on my drive home and starting to relax. No output all day and then suddenly a full bag within 15 minutes.

It's just something to consider. All levels of daily stress affect the digestive tract.

 

[UnXmas]

I no longer have active disease, but can tell you what stress (regular daily stress, not excessive stress) does to my digestive system on a daily basis. Now that I have a stoma, it is really easy to see (literally) what is going on at different times of the day. If I am under pressure at work, my stoma will sometimes shut down and there will be no activity at all until I am on my drive home and starting to relax. No output all day and then suddenly a full bag within 15 minutes.

It's just something to consider. All levels of daily stress affect the digestive tract.

My ileostomy works in a similar way, except I can't attribute it to any stress. I don't work, so I'm at home during the day, but my ileostomy doesn't do anything until the evening. Then I empty it once or twice, then again when I wake in the morning because it's been active while I'm sleeping. Then back to nothing all day long.

 

[FrozenGirl]

MLP: hmm I have never considered that but it does look like a possibility. I will mention it to my GI.

Lady Organic: usually I am a morning symptoms most followed by some not as bad symptoms during the day and evening, which is why I am confused. I'm not sure 20mg indicates a low disease activity as much as the fact that I hate pred and pretty much refuse to go on more if it's not a life threatening scenario.

2th Fairy and UnXmas: interesting that your symptoms temporarily get better under stress, usually I find if I am panicked over something (big test, talking to my manager, etc) my symptoms get worse, primarily Urgency and D wise.

Thanks for the help everyone. I am hoping my GI has some ideas and it isn't just a oh, just one of those things nothing you can do. While the daytime freedom is nice the pain is not worth it.

 

[2thFairy]

I'm not sure 20mg indicates a low disease activity as much as the fact that I hate pred and pretty much refuse to go on more if it's not a life threatening scenario.

I agree. A dose of 20 mg prednisone does not indicate severity of disease. Some people are quickly affected by smaller doses than others and don't need more to get full effects.

 

[UnXmas]

2th Fairy and UnXmas: interesting that your symptoms temporarily get better under stress, usually I find if I am panicked over something (big test, talking to my manager, etc) my symptoms get worse, primarily Urgency and D wise.

Just to clarify, mine don't get better under stress, my digestive system just follows a 24 hour cycle.

 

[FrozenGirl]

Ah UnXmas, makes sense. Yeah my symptoms tend to always be worse in the morning, no matter what. Interestingly when I started having symptoms they would be entirly in the morning, and then fine. Then it progressed to what is is now, worse in mornibg, but symptoms all the time.

Also 20mg of pred does not put me into remission, never has. 40 probably would but the side effects are just so bad and tapering is so hard I live with 20 which gets my symptoms to livable.