Volume of stool

[Sophfiles]

Hi all I have been diagnosed with mild Crohn’s for about 6 months now. I am 9 weeks into taking azathioprene and have recently finished my course of budesonide. I am slightly worried because I am still getting loose stools (about 6 on the stool chart) although less frequently (twice a day max) but the volume of poop is extremely large? Should I be worried or is this normal?

[Valbaty54]

Hi,

Azathioprine can take around 12 weeks to show its effect, so I would wait a little longer and see if things improve. Are you eating a lot of fibre in your diet? Maybe try having a low fibre week and see if the volume reduces. Your Gastro team should be monitoring you via blood tests while on aza so they can check inflammation levels and other things. Do you have an IBD nurse to talk to?

[Sophfiles in reply to Valbaty54]

Hi thanks for your response!

I have a dietitian and I’m currently on the low fibre diet, trying to follow it as best as I can but I do get monthly blood tests bit they don’t check the inflammation levels in them so I’m not sure? Maybe if it continues I’ll call for help but i will wait until 12 weeks of aza

Thanks 😊

[saj12]

I wouldn’t be too worried with lose stools, provided you are not seeing bleeding this is a good sign. I myself fluctuate on the scale.

Whilst I used budesonide myself, for me had little effect, this you see a pronounced change as you came off the steroid?

[Sophfiles in reply to saj12]

Ooh ok I’ve not seen blood in a while but yeah, I started budesonide a while back, ended the course and soon after I had bleeding and all sorts of other problems so I started it again with the aza at the same time to stop the symptoms, is it possible your body can get used to the medication?

Thanks 😊

[saj12 in reply to Sophfiles]

Ideally I guess prednisolone is better and far more effective than budesonide, but I do recall talking with my IBD nurse who did say that with covid, budesonide is a ‘safer’ option than prednisolone.

But whilst on budesonide if this had a positive effect for you then this is good - did you see any change as you tapered from (I assume) 9mg to zero mg?

There is an issue of steroid dependency (problem I had), lots of literature to read on the net - but as I understand more with prednisolone. With the short course you have had to date, unlikely it’s become ineffective.

Have your IBD team checked your Aza TGN levels to make sure you are in the therapeutic zone - titrating to the correct dose can take a while, once there you need to be on few months before it really grabs and starts to work.

Give things time

[saamsaamxx]

I would maybe speak to your nurse team about this! I was on azathioprine for a while when I first got diagnosed and I was still getting a lot of flare ups. I came off it for different reasons but the best person to ask is your nurse! I phone mines regularly