• Welcome to Crohn's Forum, a support group for people with all forms of IBD. While this community is not a substitute for doctor's advice and we cannot treat or diagnose, we find being able to communicate with others who have IBD is invaluable as we navigate our struggles and celebrate our successes. We invite you to join us.

Methotrexate-induced diarrhea

I have been in remission since shortly before I went on Methotrexate 4mg injection once weekly. I am still in remission; I have no inflammation markers in any blood test. When I did have a flare-up, my symptoms were low-grade fever and fatigue. I have never had any diarrhea from Crohn's. However, within several hours of the first MTX injection, I passed loose stool for the first time in my life. My doctor brushed this off, and the diarrhea worsened as I continued with the treatment. The diarrhea was always the worst during the days and hours immediately following the injections. After about 4-5 months of the MTX and the diarrhea which accompanied it, I had enough and discontinued use of the MTX. However, the diarrhea did not go away. It has been about 5 months since I took my last MTX injection, and the diarrhea has not improved. I still have no inflammation markers, and have no symptoms of a flare-up. What can I do? Anti-inflammatories won't help, since inflammation isn't causing the problem; I believe it to be a continued side-effect of the MTX. How can I get rid of the diarrhea? My doctor has no answers except that I should go back on MTX, which caused the problem in the first place.
 
You could try and block it with immodium type of stuff. Personally if its not inflammatory, I'd still be wanting to find out what is causing it. Have you stopped the mthx? If so for how long? Has this reduced the amount? Is there anything else that could have triggered it, in terms of diet, food poisioning, gardia etc.
 
Yes, I have been off the MTX for about 5 months now. This caused no real change. I have tried immodium, but it was no where near effective enough to make a difference. My diet has been very regulated, so I can say for sure that there have been no dietary changed that could have affected this.
 
I've been off mthx for about 2 months now, I came off it due to I kept flushing beetroot on it in my face. My GI did a faecal cal-protectin test and at that stage I was feeling ok, about from going beetroot yet my results were well over 200. Since then my bloods have been in moderate neutrophilla due to a crohns flare that they discovered last week in the middle of my small bowel. I swallowed a pill cam, and thats how they found it. You talked above about your markers not indicating a current flare - which markers in particular? I just wonder as there is some interesting debate or research in what ESR and CRP, and markers like faecal ca-protectin can suggest. My GI no longer looks at ESR and vary rarely looks at CRP - he prefers the faecal test.
 
I will check with the doctor, but I have no other symptoms that I originally had (fever, exhaustion) to suggest inflammation
 
Top