Methotrexate injections and bleeding.

[Cheylann]

I had been on 15mg mtx injections for 7 months about to increase to 20mgs. However, they discovered blood in stool as well as increased size in blood cells. MTX was stopped, and I had a colonscope as well as endoscopy to find source of bleeding. Nothing sinister was found apart from a few polyps.

I suffer Psa with extremely painful tendons. The mtx was helping a bit but not 100% hence increasing to 20mgs.

Now of course I'm back to excruciating pain and yesterday had a steroid injection which has taken the intensity of pain away already.

Seeing rheumatology on 13/12 to discuss whether to go back on mtx or go onto something else.

My question is has anyone else experienced any stomach problems whilst on MTX as the nurse seems to think it isn't a side effect and if it is its very rare.

Obviously docs are still investigating the possible cause of the bleeding but until a cause is found I'm suspicious of the MTX.

Any advice and opinions are welcome.

[Haz58]

Sorry to hear this Cheylann. I've been off MTX 20mg for 12 weeks now as I got gastritis. Had endoscopy which like you only showed a polyps which they said is normal. The rheumy thinks it was possibly the MTX that caused it as nothing else had changed re my other meds I have to take etc. She said it's rare but it can happen especially as I have stomach problems anyway. I'm seeing her on 29/11 to discuss they way forward. The rheumy nurse said I'd probably have to try another DMARD though as it's protocol to try 2 DMARDS before they can try you on bios. But she said as well it'll probably mess my stomach up again so not looking forward to that!

[Cheylann in reply to Haz58]

Interesting to read you have had similar problems. Im now more sure than not the mtx caused these stomach problems.

Its just that my rheumatologist didn't seem to think the mtx injections was causing the bleeding but as I was on the 2 week cancer pathway said I should stop it until we find the cause.

Im not happy to go back on mtx or in fact on anything that causes problems in my stomach as I've had a burst stomach ulcer and lost half my stomach.

Seeing her on 13/12. I don't hold out much hope. Looks like I'm going to have to go it alone.

[Haz58 in reply to Cheylann]

Yes I had the bowel cancer test too which was clear as well. I really think in certain cases like ours they should be able to skip trying a 2nd DMARD and try something else. It's ridiculous to try us on something else that would probably cause other stomach problems. Let me know how you get on and I'll let you know what she says to me at the end of November. Xx

[Cheylann in reply to Haz58]

Another thing is I cannot believe them saying you have to try another dmard which will probably mess with your stomach again. I mean that is outrageous.Some of their policies are ridiculous. One size fits all does not work.

I would rather suffer with joint pain than risk my stomach being messed up just to tick their boxes.

[Haz58 in reply to Cheylann]

Totally agree. It's all because the next medication up from DMARDS is more expensive. I'll see what they say in a couple of weeks and let you know. X

[nomoreheels]

I've been on MTX 13.5 years & like you have have both colonoscopy & gastroscopy. I also had a recent stool test with blood so had a colonoscopy. Only polyps & an ulcer were found. Biopsies were taken of the polyps but i haven't had the result back yet.

I asked if they thought there could be a connection with MTX & they were non committal, basically didn't know. I'm not concerning myself about it at the mo, until a connection can be found I’ll continue injecting. Polyps are extremely common by 50, I don't know it that relates to you?

I hope another experience helps ease your mind a little.

[Cheylann in reply to nomoreheels]

Thank you. Yes it definitely helps reading others experiences.My rheumy was also non committal and initially said she didn't think the mtx was causing the bleeding so to carry on injecting. I was on the 2 week referral to check for cancer in bowel. Later that same day she called back and said to rather stop the MTX until the source of bleeding discovered.

So, she didn't really know but on reading all side effects, the very first one listed is bleeding then bloating etc., so I'm convinced the bleeding was mtx.

My biopsy results were all normal. No cancer.

I had a stool test 3 months after starting mtx which was normal then 4 months later after increasing to 15mgs they discover blood? Am having another one in December and if that is negative we'll then I will put the bleeding down to MTX.

I reckon your ulcer caused your blood. They bleed slowly when irritated.

[cyberbarn]

Gastrointestinal toxicity is well known in methotrexate. Were you on folic acid as well?

Here is the list of side effects.

mayoclinic.org/drugs-supple...

[Cheylann]

I know the list of side effects however the rheumatologist doesn't obviously.I was on 1 5mg folic acid a week.

Obviously, i won't be using mtx again as it's too risky.