Rituximab and gastro-intestinal problems

[crowneagle]

Colitis Associated With Rituximab in 21 Patients at a Tertiary Center

"Rituximab has been associated with numerous adverse gastrointestinal effects including diarrhea and bowel perforation, and recent reports have associated rituximab with the development of de novo inflammatory bowel disease (IBD)."

https://www.cghjournal.org/article/S...291-5/fulltext


For the past few years, I've had repeated incidents of pancreatitis and colitis. After careful observations, I believe Rituximab is contributing to my problems. I have to be extremely careful in avoiding foods that aggravate my gastro system. Oddly, I would feel increased problems after partaking too much in my favorite peanut butter. I needed to know why. I soon found out that peanut butter has little to no anti-inflammatory omega-3 fatty acids and a lot of pro-inflammatory omega-6 fatty acids. The ratio of omega-6 to omega-3 fatty acids for peanut butter is 1720:1. Nothing like trying to kill myself. Even 20:1 would be bad. My new regimen is a 4:1 ratio. Peanut butter is only one example. I'm investigating additional triggers, such as my statin drug and cooking oils.

The Omega 3 to 6 Fat Ratio of Common Nuts

https://vegfaqs.com/omega-3-to-6-fat-ratio-nuts/

I'm currently being evaluated by my gastro doctor. I'm in good hands. I've already had a colonoscopy and CT scan and an endoscopic ultrasound is on the agenda. He's not ruling out RTX as the primary cause. My colon was filled with ulcers and fecal calprotectin levels were 10 times higher than normal. I never even heard of a calprotectin test before last month. Going without RTX is not an option. It's the only treatment that's kept me alive. But, maybe adjusting my dose might be in the cards. If you suffer from gastro issues, are you on RTX? Researchers are looking into it. Supposedly, we might need those CD20+ positive B cells after all. They might prevent T cells from flooding into out gastro system and causing havoc or in my case, ____ Cry Havoc!

[Alysia]

Hi Tom,
Thanks for the info. Sorry for your gastro mess, I know too well about it. Definitely rtx contributes to it. I have had gastro issues since I was a kid but rtx made it more dramatic and I have developed also mycroscopic colitis due to it. I know a weggie on facebook who had it too and if I remmember correctly also @me2 ?
After each rtx IV I had 2 weeks of watery crazy crazy diarrhea.
I no longer on rtx because my Igg and Igm has dropped below the normal.
I am on Leflunomide, Arava 10 mg daily which works for me better them rtx. No joints pains. I suggest you check it.
Take care.