POZ Community Forums
Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: krh on August 06, 2010, 01:41:30 pm
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Hi all:
I know this topic has been discussed before, but I thought I might get some fresh opinions from others with the same issue. I know it's not a great topic but I'm at wits end.
I've been hiv+ for 7 years and started Atripla within 2 months of seroconverting. My numbers are great and I've always been undetectable (600 TC, VL <50). When I first became hiv+ I had a very bad infection with intestinal parasites which was cured from antibiotics. Since then, my GI tract has not been great.
I have had loose stools (smelly, small, flatulence, sometime just diarrhea , and just not nice) ever since then. I've been tested for parasites and the test comes up negative and sometimes positive.. I've been on several bouts of antibiotics but even on the antibiotics nothing changes.
I was also on prevacid for GERD and stopped that thinking it might be the culprit, but after stopping it changed nothing. (I'm not on any other medication)
I have no other issues except some sleep problems sometimes.
I'm just sick of having to go to the bathroom 2-4 times a day and it sucks on my love life (I'm gay).
So I had two questions for others with a similar experience.
1. Changing from ATRiPLA to ISENTRESS/TRUVADA might make a difference? It would probably help with sleep issues, but GI?
2. Any dietary recommendations that would help firm up my stools or cause me to go less?
I'm trying to avoid taking other drugs such as diarrhea meds etc which stop me up for days.
Any ideas.. Thanks.
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Some people just have bad GI issues from the virus itself -- I've always had a big problem regardless of the countless med regimen changes I've undertaken. I've had to take rather large amounts of loperamide daily for at least 13 years. I also take Psyllium seed husks capsules, as well as a prescription pancreatic enzyme called Pancrecarb. Pancrecarb is actually good because instead of just treating the symptom (like loperamide) it treats the cause of malabsorption in the intestines, and also decreases bloating and gas.
Anyway, that's what works for me. I take 2-3 lopermide twice daily (so that's like a total of OTC Imodium of 8p-12 mgs for reference), 1 psyllium capsules twice daily, and Pancrecarb MT-16 2-3 twice daily. Basically I take as much, or more, pills for GI issues as I do for HIV.
Oh, and I also use lactose free milk just in case. I still have other dairy, as I refuse to give up gourmet cheeses, but actually cheese doesn't seem to bother me like regular milk. When I have ice cream I keep it to about four spoonfuls as a serving, but that's fine because it keeps me from being fat.
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Wow. Sorry about your troubles..
If I take one immodium it blocks me up for days. I couldnt imagine taking one more than one twice a day.
The main problem is that the stools are soft and small, with alot of gas, especially in the morning (gross I know).
I was researching about apple pectin how it may harden the stool and making it easier to pass.
Anyone else?
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I would try yogurt with acidophilus or just find some acidophilus pills. Being on a lot of antibiotics kills the body of the good bacteria which could and usually causes GI issues. The acidophilus replaces the good stuff that is killed off.
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Krh,
Wrist makes a good point. Probiotics can be very effective in controlling "D". See this from Harvard Med:
http://www.health.harvard.edu/fhg/updates/update0905c.shtml
Also, eat a lot of fiber (daily we should be getting about 25g of fiber daily.
Good Luck,
v
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Ever get tested for celiac sprue? Having a gastric illness can permanently change your intestines and bring about illness' that weren't there before.
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I actually eat quite a bit of yogurt and tries pro/prebiotic supplements.
I've tried stopping it also to see if that might be culprit.
Never got tested for celiac sprue
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Hey krh,
Supplementing with calcium, probiotics, slippery elm and inulin fiber can firm things up.
Taking meds on a full stomach is helpful, but you are taking Efavirenz, so this would increase the risk of CNS side effects.
Have you consulted a dietitian? You might have some allergies, and there are diets that can help clear things up.
Supplementing with probiotics can be particularly helpful if you have been taking antibiotics.
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What does the HIV doc offer as a treatment?
I guess if your numbers are stable you could try a different combination. There is Intelence or Isentress if you don't want to go the protease route.
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Taking a dump 2-4 times a day isn't necessarily "abnormal". I found just eating oatmeal for breakfast really helped firm things up. Not the instant kind, but good old fashioned oatmeal. I make a pot and then microwave it each morning.
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Well.. I just got my numbers back. TCELL is 660 and VL undetectable for the past 7 years.
I've tried supplements for the diarrhea and nothing seems to work.
The DR is going to try switching my meds from ATRIPLA which I've been on for about 6 years now to
ISENTRESS/TRUVADA. He wants to start there and then go and do other tests if it persists.
I'll let you know if anything changes for those in a similar situation.
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I was on Atripla for almost a year and hung up the towel because of the CNS issues. I made the switch to Truvada/Issentress this week. OMG what an amazing difference. If anything, I'm leaning more towards constipation, but I think it's still too early to call because I've also changed my diet this week as I actually have more of an appetite than I seemed to have had the rest of the year.
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Maybe you have a parasite that is not being tested for in your lab.
I live in the tropics and suffered from chronic diarrhea or 4 years!
Thankfully I work at home and have 3 toilets in the house.
Finally I went to a better lab and they determined which parasite I had causing the problems.
The anti-parasite meds are not fun but they worked.
On the up side after that many years of diarrhea, I turned from a bottom to a top.
My husband may not be that happy about it...
Hoover
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Any doctor worth his pay will test for parasites FIRST before moving to other remedies -- it's the first thing to rule out. Why would you live for four years like this, and why would your doctor think that this is appropriate?
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I've had stool tests several times and my diet is pretty plain.
This was another way to see what is going on. I'm headed for another colonoscopy also. Everything has come back normal so meds change was the next step.
Also, I've had a couple of opinions and they all correlate the same.
Anyway, I'll let you know my progress.
The only big issue was the cns effects and diarrhea with Atripla but I really like once a day dosing so I stuck with it for a long time. I don't think I ever missed a dose more than 6 hours in many years.
The isentress is 2x a day which I'm not excited about.
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hey buddy hang out there : )
I just started a treatment which is considered tough, and specially giving diarrhea as side effect. Kaletra + Combivir. but still have nothing
Even though might sound as a cliche but the alimentation + sport is the key.
Fibers and fruits are the best for this. nuts *specially pistachios, almonds, cashews then dried plums, dates, figs are piece of heaven. mint/pepper mint hot teas are very good also. specially yogurts with selected ferments will help also
Running 3-4 times per week also indicated.
so keep it up and good luck!
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Hi All:
Just an update. After being on Atripla for several years I switched to Isentress and Truvade. The only issue I have is that I have to go from once a day to 2x a day. As someone who is a bitg anal about being compliant I really enjoyed the once a day.
I do not have any side effects after 2 weeks. I am getting up earlier in the morning and feel a bit better than Atripla. I was going for a master program while on Atripla and boy, it was tough in the mornings where I had to be competitive early. Wish I had been on the Isetnress combo then!.
As for the diarrhea. It is still there. However, it is definitely not as bad. Before with Atripla, I had very urget need to go and it would be pretty explosive/smelly, and I'd have to go several times a day.
Now, it is about 50% better. Still not perfect but better.
If this is of any help to people I'd say talk it over with your doc.
I'll update my post with numbers after being on this combo for 6 weeks (although my numbers are pretty great now) so hopefully there won't be a change.
Thanks all for the words of support.
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Good to hear things have improved.
Probiotiocs as others have mentioned, and fiber can really help with loose stools/diarrhea.
Some people take glutamine, I think the dosage is 3000 mg 3 times per day.
This link has more info:
http://www.umm.edu/altmed/articles/diarrhea-000050.htm
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I have had great success by using Calcium w/ vit D and pro biotics...increase your whole grain intake and fiber this will help fix it right up.