Bloody diarrhea episodes - colitis, or a virus?

[Wallydog]

My tirz journey started in Mar 25, and in March 26 something strange happened that has now come back. Serious bloody diarrhea appeared out of nowhere, and it worried me enough to visit the ER. Not blood in the stool, but blood of the sort that makes you think serious GIT damage is going on. After some tests (MRI?) the verdict was that my colon was pretty inflamed and a virus producing colitis was the likely cause, one that would clear up by itself. 2.5L of fluids were needed, and after a couple of rough days I was on the mend. Something similar is under way again now. A little milder this time, but very concerning all the same. My hope is that my use of tirz has nothing to do with it, though the idea that I caught another virus causing this is a stretch. Has anyone else had colitis-type trouble while on the GLP1 agonists?

---- Apologies for how graphic that was, but it seemed necessary to set it apart from the diarrhea these drugs can produce as a side effect.

 

[spanky2026]

An IBS sufferer of long standing here, and then Tirz came along and it simply stopped. Colitis I do recognise, though, and there was a similar issue lately in a much milder form. The blame went on something I ate - quite literally a gaseous veggie that I already knew did not agree with me pre GLP, and it certainly did not now! A week of a torn-up gut followed, with my lower abdomen feeling rawly irritated the whole time before it finally settled down. Vegetables want to kill you - that is what I have said my whole life. Meat it is for me.

The point of all that: could it also be some food that badly irritated your gut? With everything moving slower in there now, whatever it is has longer to bounce around and make trouble.

 

[Gr33dyOctopus]

Wallydog said:

My tirz journey started in Mar 25, and in March 26 something strange happened that has now come back. Serious bloody diarrhea appeared out of nowhere, and it worried me enough to visit the ER. Not blood in the stool, but blood of the sort that makes you think serious GIT damage is going on. After some tests (MRI?) the verdict was that my colon was pretty inflamed and a virus producing colitis was the likely cause, one that would clear up by itself. 2.5L of fluids were needed, and after a couple of rough days I was on the mend. Something similar is under way again now. A little milder this time, but very concerning all the same. My hope is that my use of tirz has nothing to do with it, though the idea that I caught another virus causing this is a stretch. Has anyone else had colitis-type trouble while on the GLP1 agonists?

---- Apologies for how graphic that was, but it seemed necessary to set it apart from the diarrhea these drugs can produce as a side effect.

Holy crap buddy! That is properly scary stuff. Anything like this being tied to tirz is not something I have heard of.. but as we all know, just about anything can throw up rare outliers, so it is certainly possible...

 

[New2ton]

Wallydog said:

My tirz journey started in Mar 25, and in March 26 something strange happened that has now come back. Serious bloody diarrhea appeared out of nowhere, and it worried me enough to visit the ER. Not blood in the stool, but blood of the sort that makes you think serious GIT damage is going on. After some tests (MRI?) the verdict was that my colon was pretty inflamed and a virus producing colitis was the likely cause, one that would clear up by itself. 2.5L of fluids were needed, and after a couple of rough days I was on the mend. Something similar is under way again now. A little milder this time, but very concerning all the same. My hope is that my use of tirz has nothing to do with it, though the idea that I caught another virus causing this is a stretch. Has anyone else had colitis-type trouble while on the GLP1 agonists?

---- Apologies for how graphic that was, but it seemed necessary to set it apart from the diarrhea these drugs can produce as a side effect.

UC is something I have too, and this has not happened to me since GLPs came into the picture.

An obvious question perhaps, but has a new kit been started? And if so, was that kit tested?

Several months back I read a post from somebody with very similar symptoms that began after a new kit; if memory serves, that kit turned out to be orange cap T30.

 

[FartfulCodger]

As a side effect I have never come across this, and nothing of the sort has happened to me over the 7 months since starting Tirz.

The encouraging part is that several peptides look promising for colitis: KPV, BPC-157 and GHK-Cu. Assuming the oral forms can be obtained, they would likely work better.

 

[Troposphere]

UC here as well. GLPs have been part of my routine since mid March, and the KLOW blend since the second week of April.

Blood tests lately came back with low inflammation marker scores, though calprotectin was a touch elevated. A scope is booked in two weeks and I will report back. Merely adding my $0.02 as one more data point.

Sorry you are going through this - flare ups are no fun at all.

 

[lessthanhalf]

Guessing why viral colitis was diagnosed is difficult without every test result in front of me. Whatever the cause, though, an issue that is not settling down quickly needs fairly frequent medical review until it resolves - or, if you are unlucky, until a different cause comes to light. Were you given a follow-up plan by the doctors you saw? If not, it is time to see your local doctor, and a gastroenterologist review if that is needed. Simple things like a blood count, esr/crp and fecal calprotectin can indicate whether inflammatory markers are improving. From what you describe, no colonoscopy and biopsies took place? Most likely this simply gets better with time, but to my ear it sounds like something that ought to be under medical supervision and regular review until it does, even if only at local doctor level.

Could the tirzepatide theoretically be causing it? Extremely unlikely (my guess would be somewhere in the 1/1000 to 1/10000 range) but not impossible. Case reports of colitis from GLP drugs are not something I have seen. As a rule GLP drugs reduce ulcerative colitis inflammation, though rarer immune reactions to them, sometimes serious, can affect the skin, and there is no reason an odd immune response could not show up in the colon instead. Should it fail to settle, it will have to be counted a possible but unlikely explanation, and stopping the drug to see whether that helps is probably the only way to find out - though doing that right now, when the cause may be viral, means it clears up and you still never learn whether the tirz was to blame. Specialists in more severe drug reactions are scarce, so hopefully you never need to find one.

So you know where I am coming from: ulcerative colitis is something I have, and I have a medical background, though I no longer work as a doctor. Last year, when an unusual skin rash that might have come from ozempic appeared, I spent far too much time looking up odd immune reactions to GLP drugs.

 

[Wallydog]

lessthanhalf said:

Guessing why viral colitis was diagnosed is difficult without every test result in front of me. Whatever the cause, though, an issue that is not settling down quickly needs fairly frequent medical review until it resolves - or, if you are unlucky, until a different cause comes to light. Were you given a follow-up plan by the doctors you saw? If not, it is time to see your local doctor, and a gastroenterologist review if that is needed. Simple things like a blood count, esr/crp and fecal calprotectin can indicate whether inflammatory markers are improving. From what you describe, no colonoscopy and biopsies took place? Most likely this simply gets better with time, but to my ear it sounds like something that ought to be under medical supervision and regular review until it does, even if only at local doctor level.

Could the tirzepatide theoretically be causing it? Extremely unlikely (my guess would be somewhere in the 1/1000 to 1/10000 range) but not impossible. Case reports of colitis from GLP drugs are not something I have seen. As a rule GLP drugs reduce ulcerative colitis inflammation, though rarer immune reactions to them, sometimes serious, can affect the skin, and there is no reason an odd immune response could not show up in the colon instead. Should it fail to settle, it will have to be counted a possible but unlikely explanation, and stopping the drug to see whether that helps is probably the only way to find out - though doing that right now, when the cause may be viral, means it clears up and you still never learn whether the tirz was to blame. Specialists in more severe drug reactions are scarce, so hopefully you never need to find one.

So you know where I am coming from: ulcerative colitis is something I have, and I have a medical background, though I no longer work as a doctor. Last year, when an unusual skin rash that might have come from ozempic appeared, I spent far too much time looking up odd immune reactions to GLP drugs.

Separate from the colitis, a colonoscopy did happen in April, roughly a month after that episode. Nothing worth reporting beyond 2 polyps taken out and no biopsies. It was my birthday!

 

[lessthanhalf]

My reading of the timeline was off when I first looked at it - I had taken the initial episode to be only a few weeks back. Strange that the colonoscopy was normal and then the bleeding came back, though with less obvious microscopic inflammation in play, without biopsies nothing would have been seen. Medical followup is still what I think this needs.

 

[Wallydog]

lessthanhalf said:

My reading of the timeline was off when I first looked at it - I had taken the initial episode to be only a few weeks back. Strange that the colonoscopy was normal and then the bleeding came back, though with less obvious microscopic inflammation in play, without biopsies nothing would have been seen. Medical followup is still what I think this needs.

Well, my prostate checkup is today. Prostate cancer is the diagnosis I have been given, but it looks like the slow growing version, so for now watchful waiting it is, with PSA levels monitored every 6 months. So the urologist may be in for a surprise.

 

[Troposphere]

Update: the colonoscopy found the least inflammation I have had since the 2011 diagnosis.

Some polyps, every one of them small and benign.

Annual colonoscopies were supposed to happen since the diagnosis, and they did not. This time I was told the next one can wait 3-5 years.

Whether the credit belongs to Reta, KLOW or Mesalamine I cannot say, but I will take it.

If anyone else here has Colitis or Crohn's, please keep updating on your progress.

 

[Wallydog]

Troposphere said:

Update: the colonoscopy found the least inflammation I have had since the 2011 diagnosis.

Some polyps, every one of them small and benign.

Annual colonoscopies were supposed to happen since the diagnosis, and they did not. This time I was told the next one can wait 3-5 years.

Whether the credit belongs to Reta, KLOW or Mesalamine I cannot say, but I will take it.

If anyone else here has Colitis or Crohn's, please keep updating on your progress.

Hey -- that is brilliant news.

Mine was uneventful as well. The usual one or two polyps, nothing worth worrying about. That propofol almost justifies the prep required the night before. Almost.

 

[bamagirl26]

Troposphere said:

Update: the colonoscopy found the least inflammation I have had since the 2011 diagnosis.

Some polyps, every one of them small and benign.

Annual colonoscopies were supposed to happen since the diagnosis, and they did not. This time I was told the next one can wait 3-5 years.

Whether the credit belongs to Reta, KLOW or Mesalamine I cannot say, but I will take it.

If anyone else here has Colitis or Crohn's, please keep updating on your progress.

that is awesome!! GLP seems to have improved my digestion and my stomach too, which I did not expect- a surprising side effect.

 

[Troposphere]

Wallydog said:

Troposphere said:

Update: the colonoscopy found the least inflammation I have had since the 2011 diagnosis.

Some polyps, every one of them small and benign.

Annual colonoscopies were supposed to happen since the diagnosis, and they did not. This time I was told the next one can wait 3-5 years.

Whether the credit belongs to Reta, KLOW or Mesalamine I cannot say, but I will take it.

If anyone else here has Colitis or Crohn's, please keep updating on your progress.

Hey -- that is brilliant news.

Mine was uneventful as well. The usual one or two polyps, nothing worth worrying about. That propofol almost justifies the prep required the night before. Almost.

Good to hear yours went well too!

Wallydog said:

Troposphere said:

Update: the colonoscopy found the least inflammation I have had since the 2011 diagnosis.

Some polyps, every one of them small and benign.

Annual colonoscopies were supposed to happen since the diagnosis, and they did not. This time I was told the next one can wait 3-5 years.

Whether the credit belongs to Reta, KLOW or Mesalamine I cannot say, but I will take it.

If anyone else here has Colitis or Crohn's, please keep updating on your progress.

Hey -- that is brilliant news.

Mine was uneventful as well. The usual one or two polyps, nothing worth worrying about. That propofol almost justifies the prep required the night before. Almost.

I would agree, except that a tech always wakes me up mid-way through some incredibly vivid dream that I have no wish to leave.

 

[Wallydog]

Troposphere said:

Wallydog said:

Troposphere said:

Update: the colonoscopy found the least inflammation I have had since the 2011 diagnosis.

Some polyps, every one of them small and benign.

Annual colonoscopies were supposed to happen since the diagnosis, and they did not. This time I was told the next one can wait 3-5 years.

Whether the credit belongs to Reta, KLOW or Mesalamine I cannot say, but I will take it.

If anyone else here has Colitis or Crohn's, please keep updating on your progress.

Hey -- that is brilliant news.

Mine was uneventful as well. The usual one or two polyps, nothing worth worrying about. That propofol almost justifies the prep required the night before. Almost.

Good to hear yours went well too!

Wallydog said:

Troposphere said:

Update: the colonoscopy found the least inflammation I have had since the 2011 diagnosis.

Some polyps, every one of them small and benign.

Annual colonoscopies were supposed to happen since the diagnosis, and they did not. This time I was told the next one can wait 3-5 years.

Whether the credit belongs to Reta, KLOW or Mesalamine I cannot say, but I will take it.

If anyone else here has Colitis or Crohn's, please keep updating on your progress.

Hey -- that is brilliant news.

Mine was uneventful as well. The usual one or two polyps, nothing worth worrying about. That propofol almost justifies the prep required the night before. Almost.

I would agree, except that a tech always wakes me up mid-way through some incredibly vivid dream that I have no wish to leave.

Coming round, I am usually being wheeled along the hallway, jabbering at the nurses about some nonsense or other that strikes me as hilarious.

 

[lessthanhalf]

Every GLP drug I have tried - sema, or tirz/reta/cagri - improved my gut function, largely simply by slowing overall gi motility down. Massive weight loss, diet changes, some degree of fodmap avoidance and a repetitive restrictive diet had already improved matters a lot, yet the GLPs added further benefit on top of that. Ulcerative colitis was in remission, but gut pain and diarrhoea many times a day persisted before any of those changes; now things are somewhere close to normal, with only mild residual lower gut pain in the mornings.

 

[sweetmop]

Troposphere said:

Update: the colonoscopy found the least inflammation I have had since the 2011 diagnosis.

Some polyps, every one of them small and benign.

Annual colonoscopies were supposed to happen since the diagnosis, and they did not. This time I was told the next one can wait 3-5 years.

Whether the credit belongs to Reta, KLOW or Mesalamine I cannot say, but I will take it.

If anyone else here has Colitis or Crohn's, please keep updating on your progress.

Did that mean stopping Reta a week or two ahead of the colonoscopy? Mine is at the end of Nov and I am working out when the dose should stop beforehand. Were they told that you are on a GLP?

 

[Troposphere]

sweetmop said:

Troposphere said:

Update: the colonoscopy found the least inflammation I have had since the 2011 diagnosis.

Some polyps, every one of them small and benign.

Annual colonoscopies were supposed to happen since the diagnosis, and they did not. This time I was told the next one can wait 3-5 years.

Whether the credit belongs to Reta, KLOW or Mesalamine I cannot say, but I will take it.

If anyone else here has Colitis or Crohn's, please keep updating on your progress.

Did that mean stopping Reta a week or two ahead of the colonoscopy? Mine is at the end of Nov and I am working out when the dose should stop beforehand. Were they told that you are on a GLP?

My dose was being split every three days. Of those, two got skipped during the week leading up to the procedure.

Nobody was told I was on a GLP. How well the bowel prep went is scored across three sections of the colon and on all of them I got 3 out of 3 (perfect prep).

A Wednesday afternoon was when I booked the procedure, and all solid food stopped on Monday night. Clear liquids and the first half of the prep filled Tuesday. The remaining prep was finished on Wednesday morning.

Hope that is useful!

 

[sweetmop]

Troposphere said:

sweetmop said:

Troposphere said:

Update: the colonoscopy found the least inflammation I have had since the 2011 diagnosis.

Some polyps, every one of them small and benign.

Annual colonoscopies were supposed to happen since the diagnosis, and they did not. This time I was told the next one can wait 3-5 years.

Whether the credit belongs to Reta, KLOW or Mesalamine I cannot say, but I will take it.

If anyone else here has Colitis or Crohn's, please keep updating on your progress.

Did that mean stopping Reta a week or two ahead of the colonoscopy? Mine is at the end of Nov and I am working out when the dose should stop beforehand. Were they told that you are on a GLP?

My dose was being split every three days. Of those, two got skipped during the week leading up to the procedure.

Nobody was told I was on a GLP. How well the bowel prep went is scored across three sections of the colon and on all of them I got 3 out of 3 (perfect prep).

A Wednesday afternoon was when I booked the procedure, and all solid food stopped on Monday night. Clear liquids and the first half of the prep filled Tuesday. The remaining prep was finished on Wednesday morning.

Hope that is useful!

Yes, that really does help- my plan is roughly 10 days off Reta before mine- the day before will be all liquids plus prep for me too. Thanks again