Sutab Review For Crohn's Patient and Colonoscopy Update

This past week (August 25th, 2021) I had a colonoscopy to monitor my Crohn's. My last colonoscopy was back in August 2018 and my gastroenterologist wants me to go in every 3 years for an update which I covered here. 

One thing that was different this time around was the type of bowel prep I took. The last time I had my colonscopy I had Suprep Bowel Prep Kit (which includes a very gross tasting bowel prep-12 ounces to be exact). My thinking when I had this bowel prep was "hopefully I don't have to do this for another 7-8 years). This time around I was prescribed Sutab. Given I saw Sutab was approved by the FDA for bowel prep I thought I would try this given I am not a fan of the Mirlax and Gatorade. Honestly, I can say I still have that yucky taste in my mouth even though I last had it 3 years ago! 

The nice thing about Sutab is it is just pills and water (that's it!). Having to do bowel preps before I thought this would be an improvement over the previous method. My gastroenterologist allowed me to take Zofran (his prescription was for 3 pills) and I decided to take one pill before each prep (I took the first one an hour before my first Sutab pills). The way Subtab works is you take it twice (the evening before your procedure and then early in the morning of the day of the procedure). 

I started taking the Sutab pills a little after 6 P.M. and then around 9 P.M. there felt like there was a storm in my stomach. It wasn't until around 10 P.M. that I had my first bowel movement. After that I would say I was in and out the bathroom a few hours then able to sleep until 2 A.M. when I took the next dosage of Sutab. With each Sutab you take 12 pills (these pills are easy to digest too) and then drink 32 ounces of water. I found that I was actually drinking more water even after taking the pills because I was thirsty. Even though I was in the bathroom a dozen times during the night I felt as if it was easier than the previous bowel prep. I also did not feel nauseated as some people online have reported (I credit the Zofran) with helping that). 

Around 2 A.M. I woke up (and watched Frasier on T.V. to pass the time) and popped in one Zofran pill 10 minutes before I started my second batch of Subtab pills. I dumped the pills out on the table (the closest I will ever be to becoming a drug addict!) and took them one by one. For the second round I probably consumed all the pills over 20-30 minutes (as compared to the hour and half for the first found). 

I would say this time around my rear didn't feel as raw as it did the last time I had a colonoscopy. The morning of the coloscopy I took a hot shower which did provide some relief to the pain I was feeling in my rear. One thing that really did help me as it did 3 years ago was having adult diapers. I ordered Depends years ago and rarely have used them since I don't have any flare ups from Crohn's. I did notice the night before the colonoscopy I had involuntary bowel movements. To me the adult diaper is somewhat like wearing a bulletproof vest for your rear in a sense. Since I am fairly conservative I used two adult diapers for protection. One thing I did different during the day is I had Pedialyte which I think didn't make me feel as dehydrated. 

I weighed myself after I took all the bowel prep and weighed 170 lbs and this morning weighed 166 lbs (after I was all cleaned out). After the procedure me and my mother stopped by a local diner placed and I had a CLT (cheese lettuce tomato sandwich, French fries, and hash browns with some pecan fudge pie and ice cream). The last time I had ate was around Monday night at 10 P.M. 

Compared to the last colonoscopy I was more sleepy and dazed post the colonoscopy even though last time I stayed up from 4 A.M.-8 A.M. to watch TV. My colonoscopy was schedule for 10 A.M. this time around but you typically check in, go back and get comfy on a bed and a nurse will ask you questions, and then they finally wheel you back. My glasses were on but I was taken back to the doctor around 10:20 A.M. and then put to sleep and I woke up groggy and had some food went home and took a nap.

In the days after the colonoscopy I probably felt more tired then usual (however I think my body was just trying to catch up on the sleep). In the report prepared I noticed on the report that I had a anal stricture which concerns me a little bit if there is anything I need to do to fix. However, it looks like the rest of the colon was okay (inflamed a little bit from the Crohn's as expected). My gastroenterologist told me this was nothing to worry about since it was just caused from the previous inflammation from the Crohn's and nothing new. Also honestly I don't feel any pain near my rear and just have felt a little constipated. 

All in all I am glad I took the Sutab bowel prep and would do it again. The only thing I would change would be maybe starting the prep at 3 P.M. and the second round at 10 P.M. to allow for better sleep the night before. Given the pills take 3-4 hours to get through your GI track I would haven't to been worried staying up thinking when I will have a bowel movement. I am just happy that I am still in remission and don't have issues and had a clean bill of health. 

Current Status and Upcoming Colonoscopy

Well it actually has been almost one year since my last post! I really can't believe I haven't blogged in that period of time. The main reason for not blogging is I haven't felt a need to (which is a good thing given I have been in good overall health). My game plan is within the next year to blog more often and focus more on research (new treatments available for Crohn's disease). 

Overall my health has been very good in the past year. I still rarely have any type of loose bowel movements and rarely in pain. Every now and then I might have some cramping that comes and goes for a couple of days but hey if that is all I have I would say I am winning the battle with Crohn's. As usual the biggest factors seem to be stress, sleep, and what I eat. There have been times were I feel some cramping and then I sleep for 9 hours and feel like a million bucks the day after. 

Recently I have been stressed because I took the second part of the Enrolled Agent exam (for non tax people it covers business income taxes). I had been studying months for the exam but within the past couple of weeks really tried to work hard. Every morning I would wake up and study around 7 A.M. until around 8 A.M. and then use that time to get ready for work. During lunch I would close my office door and get in about an hour, and then after work study for a few more hours. The pressure of both studying and working I could feel the burden. The last few weeks I have felt more of a cramp in my lower intestine. What is interesting is after the exam my cramping went away completely! 

My colonoscopy is scheduled for this coming Wednesday (August 25, 2021). On Monday I have to go in to get a COVID test (I got my 3rd booster vaccine at a local Walgreens by me last week). The only main side effect was a slight sore arm. I was able to get the third vaccine since I take an anti-TNF drug (Humira) and I had to sign a self attestation form that my immune system was compromised. My view was given the minimal side effects of the vaccine and given I have already had two vaccines it is somewhat like  My last colonoscopy which I blogged about here was in July 2018. The big difference from this time is I will be take Sutab prep pills (they were approved in late 2020 by the FDA)  instead of taking the usual Gatorade and Miralax combination. Actually the last time I had my colonoscopy was better than the previous colonoscopy but I can still have the after taste in my mouth. I read some reviews online of Sutab and some people complained that they had to vomit. Well one way around this is I had my GI prescribe Zofran to get around this. I will probably write a follow up on my experience after the procedure. I am curious to see how the procedure goes and move importantly to make sure I am still okay in terms. 

Fecal Transplant Greatly Improving Alzheimer's and Other Diseases and Illnesses?

As many of you who read this blog know I back in 2013 suffered from c difficile and ended up going through many rounds of different drugs without anything working. Luckily back then I was doing research and had discovered (on my own) that fecal transplants starting to gain acceptance and being performed around the country. At the time the success rate of fecal transplants for c difificle was 90%. To be honest since I had the fecal transplant I really haven't had any issues in terms of major flare ups (the only time I was in the hospital for Crohn's was when I was initially diagnosed.

Other uses for fecal transplant may include autism, alcoholism, obesity, multiple sclerosis, Parkinson's, rheumatoid arthritis, acne, insomnia, major depression, diabetes, cancer, peanut allergies, chronic fatigue syndrome and even anorexia, 

A recent case study showed that a 82 year old man who had c difficile and Alzheimer's was treated with a fecal transplant (he received from his wife). Just 2 months after the fecal transplant there were improvements that were noticed for Alzheimer's. First the patient had a sharpened state of mental acuity and mood improved. Between 4-6 months there were further improvements to memory and mood. Initially the Mental Mini Score Exam (a metric used to determine dementia) was only 20 (which indicates mild dementia). Only two months after the fecal transplant the number increased to 26. At 6 months the score increased to 29 (the maximum score is 30). The author who published the case study is now running a double blind placebo controlled clinical trial to see if having a fecal transplant (orally) would have any effect on Alzheimer's patients. Although, this is only one reported case it would be interesting if fecal transplants could help individuals with Alzheimer's and dementia. Also given that there really aren't any drugs on the market that reverse the underlying condition of Alzheimer's (my understanding from when my grandmother had dementia was the drugs keep things stable but over time the disease takes over). Roughly over 44 million people around the world have Alzheimer's. If a fecal transplant or a fecal transplant was required once a year and it could truly improve the symptoms of the disease it would be a game changer for not only patients but their caregivers and most likely save the healthcare system worldwide tens of billions of dollars a year.

Within the next few years there will be more researchers and doctors studying fecal transplants to see how effective they are at treating various illness and diseases. The hard part too is that often times researchers stumble into these findings like with the Alzheimer's case study (since the patient had both c difficle and Alzheimer's). My view is that even if fecal transplants could help 10%-20% of people with all these illnesses and diseases (inflammatory bowel disease, cancer, Alzheimer's, etc.) fecal transplant would be something of a wonder drug that would greatly improve the quality of life of tens of millions of people around the world, improve their well being, happiness, and also make them more productive, and they are their families wouldn't be faced with the same psychological and financial burdens. The psychological aspect for Alzheimer's can be burdensome to caretakers (who are usually family members) and often times family members will take turns with other siblings to look after loved ones. 

Some questions will have to be answered in terms of what method is most effective to deliver the fecal transplant: by colonoscopy, enema, pills, naso tube, etc. the frequency of the treatment and the dosage. These questions would take time and clinical trials to figure out. Also and most important is the safety of the procedure. Generally fecal transplants are fairly safe however with COVID going on there will have to be safety protocols in place to ensure COVID isn't transmitted to patients. The other thing too is that fecal transplants are extremely safe (yes one person did die (the patient also had a rare blood condition too) but that was because the transplant was contaminated-it had been stored in a freezer for several months and developed e-coli). Remember Dr. Thomas Borody and his clinic in Australia have performed over 30,000 fecal transplants for over 25 years and to my knowledge haven't had many adverse effects. 

Crohn's and Coronavirus: What I Am Doing

With the coronavirus recently coming to the United States and infecting many different people the question is what are Crohn's patients to do. I contact my regular doctor and GI and both had similar advice in terms of avoiding large places/crowds, washing hands, and the usual common sense advice. Although I am not a medical professional I thought I would share what my game plane is to perhaps help other individuals.

The first thing I did last early last week was to stock up on water, toilet paper, and antibacterial soap. My views is that I could possibly be self quarantine for some period of time so I want to make sure I have the essentials. I have been washing my hands multiple times a day and avoid touching any public surface, I use the end of my key to press elevator buttons and use the end of the key to hit the automatic door opener just to reduce the risk. Also I have been avoiding going out as much as possible to also reduce my risk. However, at some point I will have to go out again to get groceries/get gas/etc.

Work wise I want to try to work from home later this week. I have a laptop that I can do work things but currently only have access to e-mail. Our company has a VPN (virtual private network) that I have used before but currently my VPN hasn't been working so I need to have that fixed before I can work from home. Honestly, I would be okay working from home considering I could do the same type of work from home. In some ways it would be a little less stressful (many times people will come in and ask for something).

My view is that my behavior of self isolating and self quarantining this week should reduce my risk of catching coronavirus. Also I have been on the lookout for anyone who might be coughing. I went out to dinner last night with my parents and noticed a woman sitting roughly 20 feet away from me and she had a dry cough but she only coughed a few times in a 20 minute period (so it may have been something else).

I currently take Humira which does lower my immune system however as I write this there is only 1 documented case of inflammatory bowel disease in the United States and there really isn't good data regarding what the outcomes are. Once the data is actually out there I would be curious to see if Crohn's patients would get sicker than just regular individuals. Also I would say other than Crohn's I am relatively healthy 33 year old male, who doesn't smoke, who doesn't have any cardiovascular issues, no diabetes, no cancer, no heart issues, and real other health issues.

My advice to other Crohn's patients is make sure you have enough supplies to last you a while, avoid going out as much as possible, wash your hands on a regular basis, if you do go out stay at least 6 feet away from other people, and just remember that this will eventually pass (even though it doesn't feel like it now) I know this too shall pass.

Thanksgiving, Upper Respiratory Infection, and Antibiotic

Well as usual I haven't been blogging for a while (since I have been feeling pretty well too). Back on November 17, 2019 I started to feel signs of a slight cold (coughing, stuffed up, etc but no sore throat). Typically I would go to the doctor right away to find a fix, however in this case I waited a number of days and went to the doctor this past week and saw him. I proactively took a probiotic a few days before I saw him since I had a feeling I would be prescribed an antibiotic (Augmentin). It took a couple of days before the antibiotic kicked in (I felt the same for a couple of days and then on the 3rd or 4th day I was feeling almost back to normal). Last weekend I was pretty much sleeping most of the weekend and watching TV (it actually felt good to this).

Today is Thanksgiving and I am looking forward to eating some delicious food and desserts. This morning I woke up with some minor cramping (this is actually better than 3 years ago when I woke up in the morning and felt as if I had a block of cement in my stomach but then when back to bed for a few hours and felt a lot better).

All in all I have been feeling well and glad I get to spend time with family. It has been an interesting journey since 8 years ago around this time I was laying in a hospital bed (the hospital actually did have a turkey as an option for Thanksgiving). I can still an interesting time in my life: on one hand I was getting the help I needed but on the other scary since it really wasn't known what I had. My father at the time believed I had c difficle-from what he had read online (I would eventually have that too) and would challenge my gastro doctor. I can still remember my gastro doc coming in every day checking in on me in the hospital and then telling me my colon was pretty rotten and on a scale of 1-10 of severity my colon was an 11. In hindsight I was lucky I didn't need surgery at the time and my GI was able to get me under control pretty quickly.

Tinea Versicolor and Vacation

(note this is a general photo of tinea versicolor)

So for about a month I had a rash/marks on my stomach/abdomen area. I didn't think this was too concerning as I didn't feel any pain nor did it hurt. At any rate I went to my dermatologist (it took about a month or so ago to get an appointment with him). After getting into the doctor's office I was seen quickly by someone who asked me basic questions about why I was seeing the doctor and then waited another 30 minutes to see the doctor.

The doctor came in and I took off my shirt and showed him the marks and right away he mentioned it was tinea versicolor which was fairly common and just an overgrowth of yeast on the skin (he was even able to provide me a brochure that discussed more about it). The disease is just when there I live in a fairly humid city and noticed the marks tended to get worse when it was hot or when I worked out. My doctor has mentioned that people also can get it in the winter since they wear multiple layers and still sweat. The doctor ordered a shampoo from a specialty pharmacy that will be shipped to me next week once I return from vacation. 

Also I will be on vacation this week so the marks/rash should be more calm and the weather I am currently vacationing will be much cooler than my hometown. In addition to this, I am hoping to rest and relax while on vacation and take in some of the local sights. It is always good to get a break after working so hard for most of the year.

Overall, my Crohn's still remains under control. I seem to have a little more cramping then usual but as I write this post I don't have any cramping and feel well rested. Hopefully this vacation and weather will be what I need to relax and calm down my tinea versicolor.

Minor Cramping This Past Week and Minor Dizziness

So last weekend I splurged a little bit food wise. On Saturday night I went out to this burger place that I had not been to before and ordered a Kobe beef cheeseburger with some Parmesan fries (it was very delicious. About an hour or so after that I went to this dessert place and ordered a small brownie sundae (it had hot fudge on it too). Although the food was amazing and my stomach was quite expanded I was in the bathroom most of the night (very few loose bowel movements though).

For the past week I had some cramping in my stomach (more like distant cramping). Also this week at work I had a bunch of meetings and probably didn't the best sleep either which usually compounds the cramping issue. Last night I feel asleep around 10:30 P.M. and felt refreshed when I woke up. I most likely will be sleeping as much as possible this weekend to make up for some of the lost sleep during the week. As I write this right now I feel virtually no pain. I had been taking hot baths and using a cold ice pack during the week to mitigate some of the pain. The only other odd thing health wise that happened this week was I felt dizzy on Wednesday after work and had to lay down as I felt as if I was moving even though I was in the shower, walking, or laying down. I wrote a post on my vertigo issues last year and that experience.

This past week is a reminder to really appreciate every day I can live in remission with Crohn's and be thankful for what I have. Historically I have found eating light food, sleeping well, and not stressing out too much have been the keys to success. I know I will have up and downs with Crohn's but I am of the opinion that we should all constantly strive to feel better and have a better quality of life with this awful disease.