IBS diagnosis???

I don't know if I am officially dxed as "IBS" but that's how my doc is proceeding. He keeps telling me that I may develop Crohns later (think he is trying to cover his you-know-what:))



Typically, over the last several years, I will have very acute episodes of cramping and diarrhea that typically last 3-4 hours, then get a respite for a few weeks until it happens again.



Starting with last Tuesday (coincidentally the morning of my GI appt) I have had cramps and either loose bowels, diarrhea or really gross looking white flecked stools (mucous?) every morning with the sole exception of the day after I downed 2 immodium b/c I had to go somewhere and needed this crap to stop. It has been like clockwork - about 2 hours after I wake up, it starts until I have anywhere from 1-3 BMs at which point the cramping subsides. I haven't changed anything, and I'm getting ready to start a course of Xifaxan as soon as I can get my butt to the pharmacy.



This is not typical for me. I am supposed to see my doc again in October and am supposed to keep track of my symptoms to see how they compare (pre and post-Xifaxan).



Is mucous worrisome at all? I am pretty positive that's what it is, but I am not going to examine my BMs unless absolutely necessary (i.e. doc's orders. :)) The mucous stuff started last friday. It seems to be the first BM of the morning that is all whitish looking. Not to be gross but it's all intermingled. My stool is not completely white.



Last night around dinner time, I also started to have, what I call, one of my "prickly" stomachaches. There is prickly pain all over my abdomen (mainly around my belly-button), but my abdomen is very tender in the LRQ - Like if I do something where I have to raise my right leg I actually say "ouch." I almost thought appendicitis, but it's pretty much gone this morning. And I tried the "press and release" test and the release didn't hurt as much as the press, so I figured it wasn't that. This is the third time I've had this SAME stomachache since March, when I started paying attention to everything with a little more vigilance.



By way of background I have had a c-scope (nothing), pillcam (nothing), EGD (esophagitis and gastritis). The Prometheus test predicted Crohns, for whatever that's worth.



Thanks,

May

TBH I'm not sure. When I am unmedicated, I usually have 10-20 bm's a day. But I've had CD for well over 20 yrs and most of that time I've been undiagnosed. I'd assume if a pillcam didn't pick up any inflammation or ulceration then it is more likely to be IBS. When I had my scope, there was inflammation, ulceration and the biopsy showed granulomas which is distictive of CD.

What is your blood work like? Are you CRP and ESR elevated? Are you anaemic indicating possible blood loss in your bm's? These are all questions you need to ask your GI.

I wish you the best of luck and I hope you get some answers very soon.

@Claudine: I don't know the answers to those questions, as the only bloodwork my GI did was the IBD serology. My GP did some bloodwork - on my paperwork it says "general health panel" and then a test for h-pylori is all I can decipher. I don't know that the bloodwork for inflammation markers is considered "general" but I'm guessing that anemia would be checked? I know that at my papsmear appt which was after that, my hematocrit was 11 something, but I had been taking iron as I was totally zapped energy wise. To my knowledge I have never been checked for the inflammation markers. Thanks for the well-wishes, I'm on day 3 of the Xifaxan and it seems to be working. I had no cramping and diarrhea yesterday. No BMs actually. Today I had slight cramping but it was just like "oh i gotta go" type stuff and there was some mucous, but not as much.

@njmom: Yes, I had biopsies done with the EGD and the colonoscopy. Mild Chronic Gastritis from the biopsies, and I had esophagitis which he saw, but I can't tell if he biopsied that area. The report says "Antral, biopsy" so I don't know where those samples came from, but I know there were only two. He put me on omeprazole, but then told me to not worry about it b/c i have absolutely no reflux symptoms. The only thing the c-scope pathology report says is "Multiple lymphoid nodules are present," but I asked him about that and he said that was nothing really. So test-wise, I don't know what else he could do. He doesn't seem to think there is anything better than scopes. I'm guessing he's pretty much right.

Heh, I shouldn't have made him sound so bad.  I actually am starting to like him.  I have a hard time getting comfortable with a young, not bad-looking butt doc.  :)  I was just summing things up for the sake of brevity.  I asked him specifically about the lymphoid nodules, and he said that the area where the colon and small intestine come together is an area with a lot of lymph activity, and that is what that meant.  So when I said he said it was "nothing" I just meant that he basically said it was nothing out of the ordinary.  Although if that's the case, why did the pathologist bring it up...googling it didn't bring me any satisfaction either.

And as I am absolutely anal, I have all of my reports from my tests, not just their neat little form letters. 

I just thought it was strange that he didn't appear to have biopsied the esophagus, b/c nothing on the pathology report indicates that there were samples specifically from my esophagus.  Seems like if that were an area of inflammation he would have biopsied that.  I did forget to ask him specifically if he did.  But maybe he did.

I feel like if he thought I was simply a whiny, overly-concerned woman then he wouldn't have prescribed the Xifaxan. 

That's what my un-medically educated self would seem to think as well.

When I google "crohns lymphoid nodules, " I find stuff like this online:
http://en.allexperts.com/q/Pathology-1640/colonoscopy-endoscopy.htm

I found that interesting, but it was someone with obvious Crohn's disease.

Also this:
http://pathweb.uchc.edu/eAtlas/GI/990.HTM

Less specific.

But if I just google "lymphoid nodules of colon" I get stuff like this
http://www.ncbi.nlm.nih.gov/pubmed/7771427

...Which makes it sound as if they are not a big deal. Although that article was from 1995. I don't see a whole lot of recent research turning up in my internet searches.

I posted about this on this forum and another crohn's forum a few weeks ago, and got no responses from anyone. Led me to believe it was not something anyone had heard of really.