MICROSCOPIC COLITIS: DIARRHEA, JOINT ACHES, OTHER SYMPTOMS
Did you know that microscopic colitis can cause joint aches?
The exact mechanism is not clearly known, but have you noticed that often, either in the days (or weeks) preceding a microscopic colitis flare…you have strange aching in your low back, ankles, neck, even wrists?
You may also have muscle aches, such as in the back of the upper legs and also where the top of the thigh meets the pelvic area.
Some people have even reported aching in their arm muscles.
All of these issues are most likely connected to this inflammatory bowel disease, and sometimes may occur at the same time as the diarrhea.
It’s a phenomenon called enteropathic arthralgia.
A small percentage of people with MC (lymphocytic and collagenous) experience enteropathic arthralgia.
“Enteropathic” refers to a disease process that involves the intestinal tract.
“Arthralgia” translates to joint pain. This is different from “arthritis,” because the “itis” means that something’s inflamed (the joint). “Algia” in medicine means pain.
Thank goodness that the enteropathic arthralgia in microscopic colitis is only a pain issue, rather than a degenerative issue of the joints.
The following links will take you to articles about microscopic colitis and enteropathic arthralgia.
Many of these articles contain information from gastroenterologists whom I interviewed, while the rest are based on my personal experience with this quirky but benign condition (I was diagnosed in 2010), and my extensive research.
ENTEROPATHIC ARTHRALGIA
- Time lapse between joint pain flare and diarrhea and how this process occurs
- How does MC joint pain compare to ulcerative colitis and Crohn’s?
- Detailed description of what microscopic colitis joint aches feel like
- PMS joint aches vs. those of microscopic colitis
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: ©Lorra Garrick
Elbow Pain: How to Get Your Deadlift Back
If you have elbow tendonitis, it can greatly interfere with the deadlift.
The type of elbow tendonitis that I had is called medial epichondylitis (golfer’s elbow).
Just a little gripping would aggravate it. My initial therapy (hand grips and very gradual over time increase of resistance on the close-grip hammer-grip pull-down) was working well.
Then I did some very heavy yard work and messed things up. The initial therapy then proved to be worthless.
I then decided to do the two exercises that aggravated the problem the most: farmer walks, and the deadlift.
To my distress, I discovered that a barbell deadlift (which I had been avoiding for a very long time due to this injury) of more than 50 pounds aggravated the tendon. A farmer walk with 15 pound dumbbells aggravated it as well.
You Need a Starting Point
But I decided to make that a starting point. Below is the program I used. It took approximately TEN MONTHS to get my deadlift up to 135 pounds (reps). I consider that a major milestone.
Keep in mind that my inability to initially deadlift more than 40 pounds was due to feeling a tweak in the elbow, rather than lacking the strength.
Same with the farmer walks; carrying the 15 pounders induced an unpleasant feeling in the elbow.
This sensation meant that the tendon was being aggravated.
So do not think in terms of strength. This is rehabilitation of the tendon in your elbow.
Shutterstock/solar22
Getting Your Deadlift Back After an Elbow Tendon Injury
Shutterstock/Nomad_Soul
– At first, six to seven days/week, do farmer walks.
– Deadlift twice a week (Monday and Thursday; Tuesday and Saturday; or Wednesday and Sunday).
– Use a weight for the farmer walks that you can walk around with, literally for five minutes nonstop without making you “feel” anything going on with your elbow. If you can feel anything that you shouldn’t, use a lighter weight.
– Do this three times a day for one week at the same weight.
– Every week, increase the farmer walk weight to the next possible increment. I had three sets of dumbbells at home: 10, 15 and 35 pounds.
Progressive Load of the Weights
Once I was ready to go heavier than 15 pounds, I decided to bring in sets of 3, 5 and 8 pound dumbbells.
I then took four paper grocery bags that had handles. I doubled them up, then placed a 15 pounder and 3 pounder in each (or a 10 and an 8). This way, I could farmer walk with 18 pounds.
Why not just hold the dumbbells without the paper bags?
Because this was being done at home (and daily) where I did not have access to every incrementally-weighted dumbbell at the gym.
After a week I put a 10-, 8- and 3-pounder in each bag, for a 21 pound farmer walk. The doubled bags were sturdy enough still.
I kept increasing over time, so that eventually, I had a 15- and a 10-pounder in each bag. I then put a 15-, 10- and 3-pounder in each bag.
When I was in the gym, I used their incremental dumbbells. However, once I got up to 28 pounds, I decided to par back the farmer walks to three times a week (only at the gym).
This is tedious work: walking around holding dumbbells for five minutes. But this should re-train a compromised elbow tendon to be efficient.
However, the five minute rule can be broken at around 20 pounds. Three minutes will do.
The progression with the farmer walks went a lot slower than with the deadlift.
This is due to the positioning of the hands while carrying the weights; it puts more stress on the tendon.
When I got to 40 pounds with the farmer walks, I still considered myself in rehab mode.
I was strong enough to use 50 pounders, but this would bring out the tweaky feeling in my elbow.
I then built up to farmer walks with a 45 pound plate in each hand (the style with the openings at varying points around the hole).
The plates are easier on the elbow tendon because they don’t require as much of a grip.
More on the Deadlift Rehab
– Do eight reps of the deadlift with 90-120 seconds in between sets, six sets total. This will be very tedious due to the long rests and the ridiculously light weight.
Shutterstock/Vladimir Sukhachev
Do not use a weight that makes you “feel” your elbow tendonitis. Work just below that point. Increase the weight five pounds every two weeks.
If the increase results in “feeling” the tendonitis, return to the previous weight! It took me 10 months with this approach to get from 50 pounds to 135 pounds.
The long rests will protect the tendon from over-work. Do half the sets with an underhand grip and half with an overhand. Do not mix.
– For deadlifts with pre-fixed barbells or an Olympic bar with 25 pound plates or less on it, there’s no need to touch the plates to the floor. Go down as far as you would if you were using 45 pound plates.
– When you get to 35 pound plates, it’s okay, but not necessary, to touch the floor with them.
– If you decide to make contact with the floor, DO NOT BANG THE PLATES! This will force the elbow tendons to absorb some of this!
Instead, gently touch the floor—so gently that you’re the only one who hears it. This includes at the end of each set.
– When you get to 95 pounds, increase the rest to two minutes. The set range can be six to eight.
– You are still increasing by only five pounds every two to three weeks. You’ll be tempted to make bigger increases if the weight you’re using is still very light relative to what you were lifting pre-injury.
The elbow tendonitis is the weakest link and it calls the shots, no matter how much weight your legs, back and shoulders want to lift.
– Don’t assume that once you get to, say, 120 pounds, you’ll be able to increase the incremental gains from five pounds every 2-3 weeks to 10 pounds. Stay with five.
I made a 10 pound jump and “felt it” in my elbow. So I backed down to the five pound increase (and my elbow felt fine).
– Don’t worry what people think when they see you using a light barbell, when you know that they’ve seen you in the past with a much heavier weight! This was difficult for me to digest, but I had to get used to it.
Getting your deadlift back from elbow tendonitis begins with accepting the fact that you will have to be lifting peanuts for many months.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
Lag Time Between Joint Pain & Diarrhea in Microscopic Colitis
Why can there be a time lapse between joint-pain onset of microscopic colitis and the onset of diarrhea?
It’s possible for a flare-up of microscopic colitis to consist of, initially, some joint aches (some patients may refer to it as “pain”), without the diarrhea, even though the gushing- or porridge-like diarrhea is a hallmark feature of this inflammatory bowel disease.
When a person with microscopic colitis has a flare, the joint pain and the diarrhea won’t always come at the exact same time.
The arthralgia may precede the diarrhea.
Why is this?
“Lag time may be caused by a combination of factors: diet, exercise, genetics, sleep patterns, stress, environment, ongoing medical conditions, viruses, infections, and your body’s individual inflammatory load,” explains Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
“The inflammatory load – how much inflammation the body is enduring and how much it can handle – varies from person to person.
We have built-in mechanisms that are supposed to help neutralize inflammation, but when your system becomes too overwhelmed, something has to give.”
To reduce inflammatory load, eliminate as many processed foods as possible. This means avoid eating foods from cans and boxes.
Eat as you would if there were no such thing as food factories or processing plants.
If you DO eat anything processed, opt for a minimally processed version, and make sure there are no unnatural ingredients. The more ingredients, the more processed.
The closer a food is to its natural form, the less pro-inflammatory it is: An apple is better than apple sauce is better than bottled apple juice is better than apple pie.
If you awaken one day with joint aches but no other new symptom, and you’ve already been diagnosed with microscopic colitis, and even if your last (and only flare-up) was several years ago, then consider this:
And that is the the possibility that this new-onset arthralgia is part of another flare-up of microscopic colitis and is simply lagging behind the characteristic diarrhea that will eventually be coming.
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/ Emily frost
Joint Pain in Crohn’s, Ulcerative Colitis vs. Microscopic Colitis
Is the mechanism of joint pain or aches in Crohn’s & ulcerative colitis the same as that in microscopic colitis?
“Enteropathic arthropathy” is the name for joint aches caused by inflammatory bowel disease.
The two most well-known and researched inflammatory bowel diseases are Crohn’s disease and ulcerative colitis.
One of the problems they can cause is joint pain (or aches), also known as arthralgia.
This phenomenon is called enteropathic arthropathy.
But there’s a relatively new kid on the block: microscopic colitis, an inflammatory bowel disease first described in 1976—which is recently, in terms of medical history.
There’s been a lot of research into Crohn’s and ulcerative colitis, which are far more common than MC.
I wondered if the mechanism of joint discomfort (pain, aches) in all three of these IBDs is the same (or at least, very similar).
“In both Crohn’s and ulcerative colitis, there’s a disruption of the microbiota – the microbes that live in the intestine,” begins Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
“People who suffer from Crohn’s disease can’t handle their own microbiota. They lack the enzymes to recognize that those bacteria belong down there, so the small and large intestine become inflamed.
“This may be related to increased gut permeability, which we also see in microscopic colitis patients.”
Enteropathic Arthropathy
“In addition, many people who have been diagnosed with gastrointestinal conditions – like Crohn’s or microscopic colitis – also suffer from aching joints,” continues Dr. Fine.
“We know there is a correlation between joint aches and gastrointestinal distress, but we do not yet fully understand it.
“We know they are both associated with inflammation, so perhaps it is an overload of inflammation that spills over to other parts of the body.
“It’s also possible that the patient’s chromosomes are being affected.
“Perhaps when one part of the gene starts becoming exposed, it carries over to a neighboring gene – so microscopic colitis may affect the eyes or the joints because they are near each other on the chromosome. All of this is pure speculation, of course, but it’s worth exploring.”
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/FineShine
Source: emedicine.medscape.com/article/180664-overview
Why Does Microscopic Colitis Cause Joint Pain in Some Patients?
A gastroenterologist comments on microscopic colitis and one of its associated symptoms, joint pain.
Symptom lists for microscopic colitis sometimes include “joint pain,” though the pain may feel more like an ache or dull discomfort.
This inflammatory bowel disease is infamous for its signature explosive diarrhea.
But that’s not all it causes.
A small percentage of patients experience enteropathic arthralgia.
Diarrhea + Joint Pain in Microscopic Colitis
Are these chemical messengers, or their precursor, COX 2, somehow involved in the arthralgia that’s associated with microscopic colitis?
“Aching joints can be a symptom of microscopic colitis, but not necessarily,” says Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
“Many patients with aching joints don’t have microscopic colitis, but aching joints and gut problems often go hand-in-hand.
“They’re both associated with inflammation, and many doctors speculate that cyclo-oxygenase (COX 2) or prostaglandins are involved because of the function they provide.
“Prostaglandins are chemicals that generally cause inflammation of our joints.”
Many people with MC report that a specific diet has helped manage or even eliminate symptoms.
It stands to reason that an anti-inflammatory diet would be of great value.
A pro-inflammatory diet promotes body-wide inflammation.
To minimize this, do whatever you can to eliminate processed foods.
That’s the biggest thing you can do to reduce systemic inflammation.
Processed foods often contain additives, excess sodium and unhealthy fats that contribute to inflammation and various health issues.
Instead of opting for pre-packaged meals, choose whole, fresh ingredients.
For example, if you want chicken, potatoes and broccoli for dinner, buy these items fresh and prepare them at home.
Cooking and seasoning from scratch not only enhances flavor but also ensures you’re avoiding hidden additives and preservatives found in frozen or pre-packaged versions.
This approach promotes better health and helps manage inflammation more effectively.
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: ©Lorra Garrick
Microscopic Colitis: Prostaglandin & Pelvic Cramp Connection
Here’s fascinating information on the possible connection between prostaglandins & pelvic cramping in microscopic colitis.
Can microscopic colitis cause pelvic cramps (low ab cramps or aching) even if there’s NO diarrhea going on?
I’m not referring to the lower stomach discomfort from diarrhea building up.
In fact, there may not even be any recent diarrhea or ANY at all in a flare episode, but the patient nevertheless has been diagnosed in the past with MC.
(In inflammatory bowel disease, aches and cramps can occur in the absence of clinical gut problems.)
“I haven’t seen many cases like this, but it’s possible,” says Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
“Different people may experience different symptoms, depending on their age, gender, diet, exercise patterns, overall health, family history, and a variety of other factors.
“Prostaglandins are a likely mechanism for this. Prostaglandins are chemicals that generally cause inflammation, which can irritate the stomach lining or cause other complications.”
Could pelvic cramping (in terms of location of the pain) be related to prostaglandins “running amok” and being released by the small intestines, causing spasms of their inner wall?
Dr. Fine explains: “This is conjecture, of course, but we know that prostaglandins are protective, so if they become overwhelmed or are turned off, there may be a shift in the cascade.
“We know that prostaglandins can cause contractions in the uterus, such as when PGE2 is used when a woman is in labor but isn’t contracting properly – so it is possible that the prostaglandins can cause contractions or muscle spasms elsewhere in the body.”
Fascinating!
In women, could microscopic colitis trigger prostaglandin release in the uterine muscle, thereby causing low abdominal (pelvic) cramping?
Though microscopic colitis is not a gynecological condition, I’m thinking that in terms of its associated prostaglandin release, there’s no discrimination where these chemicals are released.
“Other symptoms and conditions could become apparent with microscopic colitis,” says Dr. Fine.
“If prostaglandins are involved, they might trigger uterine contractions and/or muscle cramps.
“We know that prostaglandins can cause contractions in the uterus, when used in the medicine PGE2; so we can speculate that they might cause similar reactions in a woman who has microscopic colitis.”
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Zetar Infinity
Will Exercise Increase the Diarrhea from Microscopic Colitis??
Here’s what a gastroenterologist has to say about diarrhea, microscopic colitis and exercise.
Microscopic colitis is a benign though sometimes disruptive inflammatory bowel disease whose claim to fame is watery diarrhea — and lots of it.
The disease does not make people sick in the true sense, even though there may be brief waves of nausea right before the sudden urge of diarrhea hits. The nausea is relieved after the diarrhea is voided.
There may also be joint aches, but (at least in my personal experience with microscopic colitis) these don’t interfere with lifting weights or cardio.
“In general, exercise is good for you,” says Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
Dr. Fine explains, “It increases your endorphins and helps you maintain good health overall. It shouldn’t increase the frequency of diarrhea unless you’re dehydrated.
“Make sure you’re drinking enough water. Usually I recommend an ounce of water per kilogram [of body weight] per day, preferably filtered.”
Exercise Interrupted by Frequent Trips to the Bathroom
For some people with microscopic colitis, trips to the bathroom to void diarrhea can exceed 10, even 15 times, per day.
Even though my flare-ups of MC were never this bad, I definitely noticed that while exercising at the gym, I never once had an episode of diarrhea.
If anything, exercise reduced the frequency of diarrhea — or, to put it another way, postponed it until I got back home.
It was as though my body somehow knew that being at the gym was not a good place to suddenly have the urge to void diarrhea.
If you have microscopic colitis, even with very frequent explosive diarrhea, and are afraid to commit to a gym workout — you might want to lift this restriction.
Who knows? Maybe your body will somehow know to keep the urge subdued until you return to the comfort and privacy of your home.
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/ Oscar Carrascosa Martinez
Can Intermittent Fasting Reduce Diarrhea from Microscopic Colitis??
Find out what a G.I. doctor has to say about intermittent fasting and microscopic colitis.
Can intermittent fasting help relieve the symptom of diarrhea in microscopic colitis?
“At present, we do not know enough about microscopic colitis as a whole or about the specific effects intermittent fasting may have on it,” says Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
“However, diet can have a profound effect on the gastrointestinal tract and the body as a whole.
“If you have microscopic colitis or are concerned that you might have it, discuss it with your doctor.
“He or she can advise you on the best diet for you, given your condition, family history, fitness levels and other factors.”
What Is Intermittent Fasting?
Intermittent fasting is a dietary strategy that alternates between periods of eating and fasting.
Unlike continuous caloric restriction, which focuses on reducing overall calorie intake while still eating regularly throughout the day, intermittent fasting emphasizes the timing of food consumption.
In intermittent fasting, you cycle between periods of eating and fasting, such as eating within an 8-hour window and fasting for the remaining 16 hours of the day.
This method is popular for weight management and metabolic health.
The primary goal of intermittent fasting is to give the body extended breaks from food, potentially leading to improved insulin sensitivity, increased fat burning and other health benefits.
It’s different from caloric restriction, where you continually reduce your total daily caloric intake but still eat at frequent intervals.
Both approaches can have benefits, but intermittent fasting specifically targets the timing of eating rather than just reducing calories.
Microscopic Colitis or … Irritable Bowel Syndrome?
Shutterstock/Bannasak Krodkeaw
The only way to be diagnosed with MC is to have undergone a colonoscopy so that tissue samples can be taken from your colon and examined under a microscope.
IBS should not be given as a diagnosis until microscopic colitis has been ruled out, since the symptoms of these two conditions are very similar.
But the treatments, however, are different. That’s why a proper diagnosis is crucial for management and treatment to be effective.
Though there’s no studies supporting the application of intermittent fasting on the symptoms of microscopic colitis, it’s important that the patient determine which foods seem to trigger the diarrhea, and then work on eliminating or at least cutting back on those foods.
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Freepik.com/jcomp
Dog Keeps Scratching but no Fleas: Cause Can Be Serious
A veterinarian addresses various causes (including serious) of why your dog keeps scratching;don’t ignore this problem.
Your dog has no fleas but he keeps scratching.
What could be going on?
Where is your dog scratching?
“The first question to ask when your dog develops the itchies is, what part of his body is he scratching?” begins Dr. Jules Benson, BVSc, chief veterinary officer with NationwideDVM, a pet insurer company.
“If he’s paying particular attention to his ears, he could have an ear infection,” and this may run about $175 to treat.
“If he’s incessantly licking and chewing on his paws, legs or belly, it’s possible you’re dealing with either seasonal or food-related allergies, which are very common,” and may cost more than $400 to treat.
More Serious Causes of a Dog Continuously Scratching but no Fleas
“If it’s his whole body, it could be something simple, like dry skin, or something more serious, like sarcoptic or demodectic mange, which could range from $120 to more than $1,700 to treat,” explains Dr. Benson.
“Your veterinarian will be able to help you determine the exact cause of the itch, so bring itchy pets in for a check-up as soon as possible.”
Another possible explanation for frequent scratching in a dog that has no fleas is an allergic reaction to whatever cleaner you use on his pillow.
Dr. Benson is regularly consulted by many media outlets including ABC, NBC, FOX, The Wall Street Journal and The New York Times to provide pet health advice to pet parents nationwide.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Andrea Ravasio
Can Vaginal Atrophy Cause Brown Discharge?
Find out from a gynecologist if brown discharge from vaginal atrophy is something to worry about.
“Brown discharge caused by atrophy may be from small abrasions or scratches in dry vaginal tissues,” says Christine O’Connor, MD, FACOG, Director Adolescent Gynecology and Well Woman Care, Weinberg Center for Women’s Health, Mercy Medical Center, Baltimore, MD.
“This can be treated.”
If you have brown or tan vaginal discharge, you can’t tell simply by looking at it if it’s from vaginal abrasions, minute tears or a more concerning source.
More on Vaginal Atrophy
Declining levels of estrogen as a result of menopause cause the vaginal tissue to dry up. This can cause a very small amount of bleeding — very small — not flowing — and intercourse can bring it on.
The discharge of vaginal atrophy is usually some shade of yellow. Ask your gynecologist to extract a sample for viewing under magnification. This will help with the assessment of what may be causing the discharge.
A brown or tan discharge may be that color due to old blood, and this old blood could be from something going on in your uterus or a pathology with the cervix.
Dr. O’Connor states, “Another cause may be infections or abnormal postmenopausal bleeding. This brown discharge should be evaluated and mentioned to your doctor.”
Any new-onset discharge in postmenopause (or that which cannot be explained by menstruation during the fertile years) should be brought to the attention of your gynecologist.
Don’t just wait it out and see if it goes away on its own. Unfortunately, a time period during which the discharge has ceased does NOT rule out a malignant tumor.
Furthermore, really foul smelling discharge — often a fishy type of odor — often means an infection.
Finally, vaginal atrophy, in addition to discharge, often causes itchiness or burning in that area, as well as painful intercourse.
Additional symptoms include burning with urination and recurring urinary tract infections.
Dr. O’Connor is exceptionally skilled in minimally invasive/endoscopic and robotic surgeries.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
