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Author Topic: Terrible diarrhoea  (Read 4273 times)

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Offline BM

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Terrible diarrhoea
« on: December 28, 2008, 01:26:28 PM »
I have been experiencing terrible diarrhoea for weeks, which is barely touched by loperamide tablets. This is no doubt due to the Norvir in my regimen. Can anyone suggest something that might help? I'm due to see my doctor on Wednesday.

Offline Miss Philicia

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Re: Terrible diarrhoea
« Reply #1 on: December 28, 2008, 02:52:09 PM »
Actually if you just went on meds, but have been infected for 4 years with a high viral load, your diarrhea may be more from the effect of HIV on your digestive tract.

Can you be more specific as to the frequency of these undesirable bowel movements, and what they're like (i.e. 3 times a day consisting of mostly watery stools, etc.) -- you'll have to really describe all of this in detail to your doctor.  If you really want him to act I'd recommend making a "bowel diary" and giving him a copy and tell him you want it included in your records.  I've always found, as someone who has had this issue for over a decade, that it forces the doctor to get aggressive in treating it.  Your doctor should also immediately screen you by taking a stool sample -- if he/she doesn't do so please insist on it, as this could also be from some sort of parasite and you need to eliminate that possibility first, before moving to something stronger than loperamide.  By the way, when you try to use lopermide how many mg's are you taking on a daily schedule?
"Iíve slept with enough men to know that Iím not gay"

Offline Roie

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Re: Terrible diarrhoea
« Reply #2 on: December 28, 2008, 04:13:26 PM »
I have been taking half a teaspoon of Indian cinnamon powder 4 times a day.
I usually stir it in with my coffee, I find that the cinnamon helps to keep my stomach problems in check.


Cruise on down the High Way

"When people who are not ready jump in, things can go horribly wrong. For most of us, there is always time to take a deep breath, consider one's options and make a careful, sound decision based on clinical fact, not emotion."
MtD

Offline BM

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Re: Terrible diarrhoea
« Reply #3 on: December 28, 2008, 05:23:13 PM »
The dirrhoea is usually preceded by lots of "churning" and "moving" in my stomach. Sometimes there's cramp-like pain. When I go to the toilet, the diarrhoea is quite explosive and I can be there for up to 15 minutes as I get 'waves' of bowel motions. I usually take 4mg of loperamide after the first motion and 2mg after each subsequent motion, up to a maximum of 12mg a day (as per the packet instructions). The diarrhoea is very watery, and the lopermide serves only to make it slightly lumpy (sorry if you're eating while reading this!). I have episodes 5-6 times a day (mainly the episodes happen quite close together, but it can be erratic). I am spending a fortune on rehydration salts. The skin around 'that area' is getting quite sore and cracked with constant wiping, even with moistened toilet sheets.

Offline Miss Philicia

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Re: Terrible diarrhoea
« Reply #4 on: December 28, 2008, 05:31:22 PM »
I think I would have called my doctor and insisted on seeing him earlier.  Totally sounds like it could be a parasite.  But you're seeing him on Wednesday so all is good (well, not until you see him of course).

I don't think it's Norvir at all -- used as a booster at 100mg/twice a day there's not really that effect like in larger doses.  I'd be hesitant to halt the Norvir so I hope you've not done so during all of this, seeing how you've not fully suppressed your viral load yet.
"Iíve slept with enough men to know that Iím not gay"

Offline BM

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Re: Terrible diarrhoea
« Reply #5 on: December 28, 2008, 05:37:34 PM »
I haven't messed around with my drugs - I'm too scared to! My PI regimen is 400mg Reyataz + 100mg Norvir, once a day with food. I can only imagine what higher doses of Norvir must be like to live with!

Offline newt

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Re: Terrible diarrhoea
« Reply #6 on: December 28, 2008, 06:14:47 PM »
This a real bummer, so to speak..

What Miss P said -- plus your doc should test for infections/parasites as a matter of course

But if that don't work you can whack up the Imodium. It's impossible to take to much. Also insoluble fiibre and Ispaghula (psyllium husk or seeds -- available as Fybogel or Isogel) do wonders for some people

Plus, taking Viread with food, v important

Oddly also you might try bulk forming laxatives (odd I know but works sometimes)

Some people are highly sensitive to Norvir, you might speak with seriousness to your doc about doing this every other day as a last, last resort, and about octreotide (a morphine based anti-diarhhoeal) short term.

Hope it clears up

- matt
"The object is to be a well patient, not a good patient"

Offline Miss Philicia

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Re: Terrible diarrhoea
« Reply #7 on: December 28, 2008, 06:28:48 PM »
Yeah, if it's not a parasite you can even ask for tincture of opium.  I have a friend that's taken it daily for eons and his bowel issues are so intense it's the only thing that works.

fyi, "BM" I've gone up to 20 mg of loperamide per day for long periods of time with no problem.  I currently take 12, and supplement it with Pancrecarb which is a (prescription) digestive enzyme that I've found helps with intestinal absorption issues, which alleviates a lot of bloating/cramps/flatulence and seems to consequently decrease my diarrhea.  I've been on Pancrecarb for the past 3 years and it's improved my life immeasurably. 

I've always had worse bowel issues than what I've seen others have on this web forum.  I've dealt with it for over a decade, and it more than doubles the number of pills I take each day.  I take a total of 12 pills per day for it (versus just 7 daily for HIV).  Fortunately I'm at the point where it's controlled so I could care less how many pills I take to achieve this feat :)
"Iíve slept with enough men to know that Iím not gay"

Offline BM

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Re: Terrible diarrhoea
« Reply #8 on: December 28, 2008, 06:41:51 PM »
Thanks everyone for your suggestions and advice! I do take my Viread with food.

Brian

Offline Roie

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Re: Terrible diarrhoea
« Reply #9 on: December 29, 2008, 07:12:15 AM »
Seriously, try the cinnamon. It really works. (Must be Indian cinnamon.)

In medicine it acts like other volatile oils and once had a reputation as a cure for colds. It has also been used to treat diarrhoea and other problems of the digestive system. Cinnamon is high in antioxidant activity. The essential oil of cinnamon also has antimicrobial properties, which can aid in the preservation of certain foods.
Cinnamon has been reported to have remarkable pharmacological effects in the treatment of type II diabetes and insulin resistance. However, the plant material used in the study was mostly from cassia and only few of them are truly from Cinnamomum zeylanicum (see cassia's medicinal uses for more information about its health benefits). Recent advancement in phytochemistry has shown that it is a cinnamtannin B1 isolated from C. zeylanicum which is of therapeutic effect on type II diabetes, with the exception of the postmenopausal patients studied on C. cassia. Cinnamon has traditionally been used to treat toothache and fight bad breath and its regular use is believed to stave off common cold and aid digestion.
Cruise on down the High Way

"When people who are not ready jump in, things can go horribly wrong. For most of us, there is always time to take a deep breath, consider one's options and make a careful, sound decision based on clinical fact, not emotion."
MtD

Offline Miss Philicia

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Re: Terrible diarrhoea
« Reply #10 on: December 29, 2008, 09:06:20 AM »
With all due respect, Roie -- if he has a parasite then cinnamon isn't going to do anything. 

Furthermore, what information do you have about the interaction of cinnamon with each and every HIV medication on the US market?  If you don't have this information then it's most likely purdent not to make this recommendation for those fellow board members in such a position, and perhaps reserve it for those patients not on meds.
"Iíve slept with enough men to know that Iím not gay"

Offline BM

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Re: Terrible diarrhoea
« Reply #11 on: December 31, 2008, 07:31:02 AM »
The doctor took some samples - one to check for parasites and one to check for bacteria. I've been given some calcium tablets and vancomycin in case it's clostridium difficile-related diarrhoea (I had clindamycin a month ago, which increases the probability of C. diff). My stomach is so distended I look pregnant!

Offline AndyArrow

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Re: Terrible diarrhoea
« Reply #12 on: December 31, 2008, 07:46:40 PM »
I hope things settle down for you.  I'm glad the doc gave you some calcium, sometime it can really make a difference.  When I was on an older regimin with more Norvir it helped me a lot.

Some people also find that rice helps them.

Also, if you are also experiencing stomach problems (cramps/bloating) you might as the doctor about Reglan. Its mainly prescribed for nausea but it aids in moving food through the stomach so it might help also.  I take it 4x a day.

Good Luck,
AA
It is not the arrival that matters.  It is the journey along the way. -- Michel Montaigne

Offline northernguy

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Re: Terrible diarrhoea
« Reply #13 on: January 02, 2009, 08:19:54 PM »
The doctor took some samples - one to check for parasites and one to check for bacteria. I've been given some calcium tablets and vancomycin in case it's clostridium difficile-related diarrhoea (I had clindamycin a month ago, which increases the probability of C. diff). My stomach is so distended I look pregnant!

Did the problems get worse when you were on clindamycin?  My doctor told me that antibiotic is very brutal on the stomach.
Apr 28/06 cd4 600 vl 10,600 cd% 25
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Feb 17/10 Started Atripla
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Offline aztecan

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Re: Terrible diarrhoea
« Reply #14 on: January 02, 2009, 11:40:49 PM »
Hey BM,

If its C. Diff. I hope you get it cleared up quickly. Remember to keep your water intake up because you lose a lot with diarrhea.

Clindamycin can be tough on the tummy. If you turn out not to have parasites, I would ask your doc about taking some of the Pancrecarb Philicia spoke of, or even to try eating yogurt regularly or drinking kefer. The latter two will help replenish missing necessary organisms to your system.

Ask your doc about it.

HUGS,

Mark

"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline Tempeboy

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Re: Terrible diarrhoea
« Reply #15 on: January 03, 2009, 03:44:05 AM »
Hey BM,

Sounds awful. 

Some other things to consider might include your recent course of antibiotics.  This can deplete your natural gut flora - worsening the diarrhoea.  You could try a cultured yoghurt or even probiotic supplements - capsules that that contain and/or promote the growth of good gut flora.  Usually available over the counter.

I have heard of a number of people who take their loperamide at least half an hour before they take their PI's - can make a big difference.

Could there be anything in your diet irritating your gut?  Could you consult a dietitian? There is an old but effective rehydration formula that could help with diarrhoea related fatigue - http://positivelife.org.au/talkabout/2007/dec-jan/another-way-keep-rehydrated

And don't forget soft toilet paper, and sorbolene cream your bottom gets irritated.

Great resource for you to check out - http://positivelife.org.au/factsheet/17
Roughly roundabout somewhere in the eighteenth or nineteenth century, Sodomite begat Homosexual out of moral, medical and legal models, bequeathing him Identity, who inbred with Nuclear Family and Industrialism to spawn Homophobia.

Dean Kiley

Offline BM

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Re: Terrible diarrhoea
« Reply #16 on: January 06, 2009, 06:10:14 AM »
I originally had Clindamycin for a throat infection. I only lasted 2 days on it as it made me violently sick and gave me explosive diarrhoea. The diarrhoea sample I originally gave for analysis wasn't tested for C. diff, for reasons best known to the lab scientists. The sample I gave on Wednesday is being tested specifically for C. diff (and parasites).

The combination of Vancomycin/Calcium Carbonate seems to be helping and my stomach's nearing normal size again (although I think some of it might be fat related to Christmas excesses!). I will run all the suggestions here past my doc next time I see him.

Thanks everyone!

Brian

Offline pozhealthy

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Re: Terrible diarrhoea
« Reply #17 on: January 14, 2009, 09:21:54 PM »
you need to see a doctor. binding whatever may be in you with loperamide and other stuff is not the answer until you know for sure its not bacterial,viral,parasite or whatever.  You are potentially making things worse. Sometime diarrhea is your body's defense mechanism to purge things from your system.

I have terrible problems with this area but got some good relief from 6-8mg loperamide and Lotronex--but only after all the tests came back negative for things like c-diff and whatnot.  Loperamide is luckily cheap (get the generic brand) and amazingly my copay for the lotronex is one thing i can afford.
I still seem to have one week in the month that i have problems---i just call it my "male period"--sorry ladies if i offended anyone.
get to your doctor!
 anyway on a lighter note i found your screen name to be rather appropriate to the topic.....:)




Offline pozhealthy

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Re: Terrible diarrhoea
« Reply #18 on: January 14, 2009, 09:25:45 PM »
oh yeah, be sure to eat lots of yogurt. it replaces the good bacteria in your GI tract if you were on antibiotics. (which kill good and bad bacteria) Just be sure that if you need the antibiotic that its not one that will bind to the calcium in the yogurt which will essentially pull the antibiotic out and into the toilet.  Look for the "avoid dairy products" warning on the bottle.

Offline pozhealthy

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Re: Terrible diarrhoea
« Reply #19 on: January 14, 2009, 09:33:02 PM »
one last thing----it might be something as common as lactose intolerance. At a certain age many people seem to lose the ability to digest the sugar in milk products ( milk, yogurt, cheese, ice cream, hot dogs---they put nonfat dry milk in everything cuz its a cheap filler so you gotta read the lables on everything!)
i re read your original post and thought back to about 16 years ago........i had a lot of the same symptoms.
the milk products sorta fement in your gut and can cause some amazing rumbling and churning and ungodly smelling gas and diarrhea.
i don't think there is really a medical test for this like a lab test.
here is what my doctor had me do
on empty stomach drink a glass of milk and see what happens--- i had all the nasty things described above.
repeat test a few days later but take a lactaid pill ( its generic version now and i get target brand) and see if things are ok and no problems with gas and diarrhea.
try it and see what happens.
good luck

Offline MexicoGringo

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Re: Terrible diarrhoea
« Reply #20 on: January 19, 2009, 12:30:17 AM »
I just recently took clindamycin for a spider bite infection, and I think that's my problem now...  I am torn up...     I am going to the doctor tomorrow..

Offline BM

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Re: Terrible diarrhoea
« Reply #21 on: January 19, 2009, 12:40:46 PM »
See if your doctor will put you on vancomycin 125mg, 4 times a day. My diarrhoea problems have disappeared since I finished the course. People have written lots of good advice on here for dealing with symptoms in the short term, so it might help speed things up if you can take a sample to your doctor in a sterile container.

Good luck!
« Last Edit: January 19, 2009, 12:47:56 PM by BM »

Offline pos2007

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Re: Terrible diarrhoea
« Reply #22 on: January 21, 2009, 11:10:00 PM »
avoid  any  food  with  MSg  in  it (  Mono Sodium  Glutemate)   It   can   do  the  same  thing  to  you .  You  won't  believe  what  all  it  is  in.   The  rolling  guts,    then  the  explosive  diahrea  makes  me  think   this  is  a  large  part  of  it.   I've  been   there  so  I  know.   Loperamide  won't   do a complete  fix  if  the  MSG  is  the  trigger.  A  lot  of  people are  allergic  to  MSg   and  the  meds  and  low  immunity  make  it  much  worse.    If  you   break  out  in  sweat   with  your  diahrea,   that  is also  a sign  of MSG  allergy.
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