A few questions

When I was 17 and going through an incredibly stressful time I started having diarrhea after eating. Maybe 15 times in a row. A few months later I got severe stomach cramps that lasted a few hours and improved after I threw up. Happened again a month later. Diagnosis after all this was IBS. I am now 36 and have had issues off an on since. H pylori positive in 2005 and treated. Then reflux started. Pain in upper right side and lower right side and they checked gallbladder and liver but both were fine. All blood work fine. So now I am 36 having relux, sore throat, nausea (no vomiting) and the "normal" IBS symptoms come and go depending on what I eat or stress. So I say all that to ask if Crohn's can present itself starting one way and then move through the GI tract causing new symptoms? Kinda freaked out because I have had issues so long that maybe something was missed almost 20 yrs ago and now I have serious problems. My mom and sister also have stomach issues and through all their tests nothing has ever come back for them either. Thoughts?

It's not quite possible to diagnose IBD through blood and stool tests alone, but they're getting closer. There's a fairly new stool test for faecal calprotectin. A positive calprotectin result is not seen in those with IBS. Unfortunately, there's a small number of false results, so it's not 100% reliable. Blood tests test for various inflammatory markers and anaemia.

But to be honest, I don't think it sounds that likely you have Crohn's. Not impossible, just not very likely. If you do want to go ahead with endoscopic investigations, then a colonoscopy would be the next obvious step followed by an upper GI test, such as small barium follow through, MRI/CT scan or the pill cam.

It's up to you (and your doctor!). In theory, IBS is a diagnosis of exclusion: that is, all organic causes (like IBD) must be ruled out first. In reality, a lot of doctors jump to IBS (or that other perennial favourite, 'stress') as the first explanation for symptoms of diarrhoea and cramps. 'Red flags' for organic bowel disease include blood in the stools, low-grade fever, anaemia, waking up in the night to have a BM, and unintentional weight loss. Basically, a Crohn's flare-up tends to make you feel a sense of malaise, whereas IBS shouldn't do.

Does any of that ring a bell for you?

Get a Colonoscopy, you will knw a lot more after. It's an easy test. And the prep for me wasn't to bad. I was in the bathroom for about 2or 2.5 hrs the night before.