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Crohn's Disease Forum » General IBD Discussion » Is Adderall Masking A Flare? What symptoms constitute a flare?


06-24-2013, 12:47 PM   #1
BB3000
 
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Is Adderall Masking My Symptoms?

I've been in what I think--as does my doctor--is remission for 7+ months and recently I've been noticing an uptick in specific symptoms that I associate with the only 2 flares I've ever had since I was diagnosed back in October.

Both times I flared, I had abdominal pain, diarrhea, blood in stool, watery stool, food was going through me in an instant. Each time, the flare was preceded by those heavy gurgles in my bowels, and a little blood in one stool that caught my attention.

For the last couple weeks I've noticed blood in my stool on several occasions, a couple stools that were predominantly black, food has been sitting differently in my stomach (hard to describe, but you know it when you feel it, if that makes sense to anyone else.) I have not had any abdominal pain though, no diarrhea, no nausea or vomiting, and after I eat meals (aside from breakfast) it's only a little gas that comes out the other end... and as my wife can attest, that part is TOTALLY NORMAL.

I called my doctor and he said to "monitor it" but nothing I described was a particular cause of worry to him. My worry is that what's happening in my colon is causing more inflammation and ulcerations, but since I take Adderall (a diuretic, which means I'm done pooping by 11am every day) the flare symptoms are going unnoticed.

Do no symptoms mean no flare/no damage being done?


ps. Am taking Lialda and Rawassa (sp?) suppositories as treatment. NOT on an immune suppressant.

Last edited by BB3000; 06-26-2013 at 11:00 AM. Reason: Focus of discussion has changed
06-24-2013, 12:56 PM   #2
Clash
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You can be completely asymptomatic and still have damage going. Symptoms can vary from flare to flare as well so I would keep monitoring and keep the GI informed of ongoing symptoms.
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06-24-2013, 12:59 PM   #3
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My worry is that with no symptoms, if I'm doing damage to my insides every day, is just a matter of waiting until my next colonoscopy? I mean, quality of life for me is totally unaffected right now... and even though that doesn't stop my suspicions, I'm not going to schedule appointments and mess up my work week when I feel totally fine.
06-24-2013, 03:35 PM   #4
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Oh ok I thought you were concerned that you may be in a flare just not experiencing the flare symptoms you had experienced in the past.

With or without symptoms there can be inflammation present if you are untreated or under treated for active inflammation. Blood work and fecal calprotectin stool test are simple ways to keep up with whether there is inflammation going on. Some people don't have their inflammation show up in blood work and is a good reason to also do fecal calprotectin. But a colonoscopy is needed to visualize full mucosal healing and that is why CD'ers are scheduled for regular colonoscopies.
06-24-2013, 03:37 PM   #5
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If there's blood in your stool with no obvious other cause (hemorrhoids, fissures, etc.) then I would definitely consider it to be a flare. If you aren't aware of anything that might be causing bleeding, it needs to be evaluated either way to make sure.

Bleeding IS a symptom, so I wouldn't say you're not experiencing symptoms. Have you been bleeding regularly throughout your period of remission?
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06-24-2013, 03:43 PM   #6
CrohnsChicago
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you can have no symptoms, but still quietly have damage being done in your system.

No two people experience flares exactly. Also each flare can present itself differently from the flares before. But if you have bleeding, you can guarantee something is not right and needs to be evaluated by a doctor. Bleeding is never normal or healthy.

I would consider a second opinion. I honestly can't believe some doctors would say to monitor blood and allow you to go un-evaluated or untreated. That's just ridiculous.

If you cannot get in to see someone very soon I suggest popping into an ER to have someone examine you and your symptoms.
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06-24-2013, 08:19 PM   #7
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[QUOTE=CrohnsChicago;669816]you can have no symptoms, but still quietly have damage being done in your system. )QUOTE

How true. Have had what I call mild Crohn's for 27 years. At time of diagnosis had small bowel resection. Nothing much going on since then (a couple of minor flares that were short term treated with prednisone). Recently knew things were progressing; short story is that I ended up with small bowel obstruction and emergency surgery. Surgeon said it "worse than I thought it would be. It was bad. Really bad." Am recovering and looking for new medication regime; gastroenterologist wants to try Humira.

DO check out what you think are "minor" or "nonspecific" symptoms. Save yourself some intestine!
06-26-2013, 10:15 AM   #8
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How true. Have had what I call mild Crohn's for 27 years. At time of diagnosis had small bowel resection. Nothing much going on since then (a couple of minor flares that were short term treated with prednisone). Recently knew things were progressing; short story is that I ended up with small bowel obstruction and emergency surgery. Surgeon said it "worse than I thought it would be. It was bad. Really bad." Am recovering and looking for new medication regime; gastroenterologist wants to try Humira.

DO check out what you think are "minor" or "nonspecific" symptoms. Save yourself some intestine!
I have "mild Crohn's" and I'm determined to try anything short of an immune suppressant for the time being because my wife and I are trying to have kids, and beyond worrying what kinds of effects one of those drugs would have on that department, I don't like the idea of suppressing my immune system with an infant around, both in terms of passing sickness onto the child, and being exposed to about 1000x more germs, and thus being sick a whole lot more.

My guess is, if what I'm experiencing--minimal symptoms, no lifestyle change--is doing damage to my intestines, then the next step would be something like 6mp or whatever similar drug is recommended. The point is, for at least the next couple years, I don't want to overreact, yet I don't want to ignore a serious problem.

When I describe my stool to my doctor (and his practice is considered one of the best in NYC, so I am not particularly interested in a second opinion), and he tells me that's not something I should be overly concerned about, I want to believe him.

I have had tiny specks of red in my stool on approximately 7-8 occasions over the past 7+ months, and black stool on 2 occasions. 4 of these instances have come in the last month. I am getting the gurgles more frequently. That's it for symptoms. I understand that longterm I'd prefer not to have any of this, but over a (relatively) short timeframe, I don't know if this is something I can live with, but I want to tend toward not overreacting.
06-26-2013, 10:24 AM   #9
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The severity of disease can only be determined at the time tests are done - this really has no impact on the future severity of your Crohn's. Because it was mild before doesn't mean it can't take a turn for the worse at any time. It also doesn't mean it can't go into a stable remission for the rest of your life. There's no way to predict these things, but staying on top of treatment does of course reduce the risks and severity of any future flares.

I understand wanting to avoid stronger medications, but in all honesty, the medications you're on haven't been proven to be very effective in treating Crohn's. I suggest you talk to your doctor about what medications they think would be best for you to take while trying to start a family.

If you chose to believe your GI, that is your choice. Personally, though, I would not trust a doctor who told me bleeding was normal and didn't take action to correct the problem.

I hope things go well for you!
06-26-2013, 10:28 AM   #10
CrohnsChicago
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You are correct. There are other options before Humira. I currently take 6-MP. The point we were all trying to make is that you need to be evaluated. It really does sound like a small flare or irritation of sorts and Bleeding is never a normal symptom of anything as far as I am concerned and should not be left to continue.

Could simply be a hemorrhoid. But it could also be a fissure, or bleeding ulcer or something else you shouldn't take lightly. Addressing the problem early on prevents any worsening of a situation or potential complications. I don't call that being worried or being overreactive. I call that being pro-active about a person's health and making sure that you don't make things any worse than they need to be. After all you want to make sure you are in the best physical condition to care for your future family.

You seem to respect your doctor's opinion and have no interest in a second opinion. I hope that things look up for you and if they do not you should push your doctor for more evaluation of your symptoms.

Wishing you the best

I have "mild Crohn's" and I'm determined to try anything short of an immune suppressant for the time being because my wife and I are trying to have kids, and beyond worrying what kinds of effects one of those drugs would have on that department, I don't like the idea of suppressing my immune system with an infant around, both in terms of passing sickness onto the child, and being exposed to about 1000x more germs, and thus being sick a whole lot more.

My guess is, if what I'm experiencing--minimal symptoms, no lifestyle change--is doing damage to my intestines, then the next step would be something like 6mp or whatever similar drug is recommended. The point is, for at least the next couple years, I don't want to overreact, yet I don't want to ignore a serious problem.

When I describe my stool to my doctor (and his practice is considered one of the best in NYC, so I am not particularly interested in a second opinion), and he tells me that's not something I should be overly concerned about, I want to believe him.

I have had tiny specks of red in my stool on approximately 7-8 occasions over the past 7+ months, and black stool on 2 occasions. 4 of these instances have come in the last month. I am getting the gurgles more frequently. That's it for symptoms. I understand that longterm I'd prefer not to have any of this, but over a (relatively) short timeframe, I don't know if this is something I can live with, but I want to tend toward not overreacting.
06-26-2013, 10:53 AM   #11
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It's not a hemorrhoid, of this I am sure. (Side note: 5-hour flight with a bad hemorrhoid is the physical manifestation of the 7th circle in Dante's Inferno.)

The medications I've taken have worked wonders, and they took me so far from where I was pre-diagnosis. I know they are still working (to an extent, at least) because the symptoms I was experiencing before I started on them have not returned at all. I guess what nobody has addressed, and perhaps what I haven't emphasized enough, is my worry that Adderall is masking symptoms because I have pooped 1-2 times a day every morning without fail for the last 15 years, it's always been loose, and it's always been urgent. It's a powerful diuretic, and seems to overpower everything (diet, Crohn's, other meds, hangovers, etc.) and keeps me regular. I was diagnosed about 9 months ago, and after I went on Lialda and the suppositories, I'm back to the 'normal' pooping.

Is there anyone with experience on Adderall (or a similar ADD drug) that has had similar worries?
06-26-2013, 10:59 AM   #12
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I will change the title of your thread to reflect your primary focus on Aderall masking crohn's symptoms.
12-01-2014, 06:12 AM   #13
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sorry to revive an old thread, but I'd just like to say that this was a friend's experience with adderall and a recent flare he had after doing well on the SCD diet and no meds for about 6 months. It was obvious when he started to take adderall later in the evening so that his symptoms would stop for a bit and he would be able to sleep. That didn't last for too long as he then tossed the rest of his medication soon after.

He would advise caution to anyone with IBD.
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