Dastardly diarrhoea

Yup, that’s today’s jolly little subject. Sorry folks! But at least you know what’s coming in advance. I’m not going to spring something on you that you weren’t expecting. This blog post will do exactly what it says on the tin!

In the past week, I have noticed a definite trend towards looser bowel movements, with more farting and burping. Initially, I figured it was just that I’d eaten something that disagreed with me, or that wasn’t quite as fresh as it might have been. But in the last 36 hours, ‘loose’ became virtually liquid, with a couple of humiliating incontinent episodes, thankfully at night and in private. The burping became more sickly and accompanied by an unsettled feeling and gurgling in my stomach, while the farting became something slightly scary to anticipate, so I’ve been dashing off to the loo each time, just in case.

In the early hours of this morning, I awoke to a miserable need for another run to the toilet and an even more miserable need to change my bedding. It’s horrid. I’m only sharing this here so that other people who experience this will know they are not alone. I also find it helpful to record it as my memory is seriously lost of late and I may not remember the details… which may not be such a bad thing, given the topic!

For any normally healthy person, a case of diarrhoea, while unwanted, uncomfortable and embarrassing, is just that. It’s either caused by a bug or bad food and either way, will go of its own accord or with antibiotics. But for those of us who have had a donor stem cell transplant, there always lurks, especially in the first two years, the spectre of a third possibility… Graft versus Host Disease [GvHD].

20131203-000030.jpgGvHD can affect a number of different parts of the body (skin, gut, mouth, liver, eyes, lung, vagina, tendons) and to varying degrees of severity from mild through to fatal. My Canadian friend, Marie-Chantal, flirted very closely with death when her liver was severely compromised by GvHD.

So far I’ve been very lucky to have only mild GvHD, which doesn’t impact too much on my day-to-day life. It remains to be seen if this is simply a bug, but if not, then it is almost definitely gut GvHD. I spoke to Lynn, the transplant specialist nurse, earlier, who asked me to bring in a sample, which can be analysed in time for my clinic appointment on Thursday.

If the sample indicates that I might have gut GvHD, they may wish to do a biopsy and/or an endoscopy to confirm. Oh joy of joys! However, if GvHD is confirmed, there are effective treatments, like Entocort (Budesonide) – a steroid that only works on the guts. Back in August last year (less than three months post-transplant), when I first experienced GvHD in my mouth along with a loss of appetite, Dr Jenny suspected it might be gut GvHD and prescribed Budesonide then, which I wrote about in Striving for balance.

Today I stayed home, rested, took some Imodium and drank Ribena with the delightfully salty flavour of Dioralyte to ensure I don’t dehydrate. I’m glad to report that so far, apart from this morning’s toilet visit, all is quiet. I’ve been drinking plenty of fluids and only eaten some toast and a baked potato all day… but my stomach is still gurgling, so I wonder what tonight may bring? I’m wearing knickers and pyjama trousers to bed, just to be on the safe side.

Next day update… It’s now twelve hours since I wrote this post and all is well. No incidents of any type of bowel movement at all today – probably because I ate so little yesterday. My stomach seems pretty much back to normal and I’m eating and drinking as usual.

When the need next arises, I probably will take a sample just to be sure, but I think the drama is over for now folks. Now please move along… (pun intended!) :)