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LONG question: stricture, blockage or pancreatitis ?

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Crohn's Disease
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Posted 5/8/2013 1:53 PM (GMT 0)

hi, im new again to this forum.  I haven't used it much but usually came by once in a while to creep some advice here and there and this time didn't have my same email address and couldn't remember it so made up a new username.

I have already had a partial blockage in a stricture that at the time I thought was in the ileum ? and I have had a very bad pancreatitis attack also so I dont know which it could be this time since the symptoms are pretty similar.

I went for my last colonoscopy in late January and the surgeon who did the procedure tried a  balloon dilation cause the probe wouldn't go through the connection of the big and small intestines ? Ileum? ... it didn't work. He said my Crohns was very active, he took some biopsies of the mass  and said he would make a referral to a gastroenterologist after he got the results back.  I have been waiting since.  I am not taking any meds at this time for my crohns and have taken very little in the last 27 years.  

The problem now is that I think I have a blockage or it might be an episode of pancreatitis.   The pain started on Sunday night after a snack of raw broccoli and carrots, which never bothered me before , it came in waves and spasms and got worst over the night until early morning, I really thought at one point to go to ER but felt too bad to drive myself,  finally it subsided enough for me to get a few hours of sleep, when I woke up around noon Monday I took some senna tea to maybe help things along if it was a partial blockage..  during the day  the pain was not coming in spasms or waves but more localized higher up above my bellybutton,  my upper stomach is very swollen .. The senna tea helped and I did have bowel movements in the form of diarrhea,  but now the pain and swelling is still there and  mostly if I change position of touch the area above my bellybutton.  Would the pain of a blockage in the Ileum be that high up ?  I made an appointment to see my family doctor but can only see her tomorrow.  I have started taking just soups and ensure but after having that I have cramping pain again for a little while...if it was a blockage wouldn't the pain and swelling go away after the bowel movements do you think its a blockage or pancreatitis since the pain is mostly in my upper abdomen area ?...

Posted 5/8/2013 2:26 PM (GMT 0)
Welcome back.

You have a stricture at the terminal ileum, according to your last colonoscopy. Please stop eating raw broccoli and carrots. I guess you don't want to take meds - you should follow a low residue diet so that you won't get an obstruction at this stricture.

I certainly can't answer about where your pain is vs. what could possibly be wrong. The terminal ileum is in the lower right pelvis, but the ileum itself is a couple of feet long. Adding to that confusion is the fact that pain is often "referred," meaning you'll feel it in one place but the injury is elsewhere.

I can't believe that your GI hasn't called you back since your scope in late January. I'd suggest you get motivated and take ownership of this problem. Get in for a small bowel follow through at a minimum and see what's going on.
Posted 5/8/2013 2:42 PM (GMT 0)
Are you having any vomiting? I thought that was associated with blockages. With pancreatitis, it's a simple blood test to see if your lipase and amylase levels are elevated. If you don't want to go to the ER for scans and tests, maybe just have your doctor do a blood test to quickly see if you can rule out pancreatitis.
Posted 5/8/2013 3:14 PM (GMT 0)
 Just for peace of mind, it would be a good thing to go to the ER for a CAT scan to rule-out a possible small bowel

obstruction. If you can not drive yourself, call a friend or dial 911.  Better to be safe than sorry.  Good Luck and

I agree, no raw veggies or nuts!!!

Posted 5/8/2013 6:55 PM (GMT 0)
No vomitting, i had heartburn and gastric reflux but that has passed, Now I have diarhea like 4 times already today so things are moving but the upper abdominal pain is still there, gets a little worst after I eat my soup or insure then subsides to a dull throbbing pain, i seem to have a pinpoint pain in my middle back also, and yes I agree with you gys, even with no apparent crohns symptoms, I will still stay away from raw veges.
Posted 5/8/2013 7:04 PM (GMT 0)
And by the way Im in a small town in a small province in Canada so things like going to the ER for a cat scan doesnt happen lol it can be a long 5 or 6 hour wait to see a doctor and takes weeks and more like months to get a simple blood test and then get the results back unless your admitted to the hospital then things go faster. I have a appointment at my familly doctor tomorrow maybe she can get things faster.
Posted 5/8/2013 7:06 PM (GMT 0)
Oh wow, that's so ridiculous. Pancreatitis is nothing to joke about. The pain can go through to your back. I had pancreatitis so bad for so long that they ended up putting me on a feeding tube because nothing could get my levels down.

Good luck!
Posted 5/9/2013 11:45 PM (GMT 0)
well I went to see my family doctor today and she thinks it might be a partial blockage or pancreatitis.. just like I thought..lol... she sent me straight to ER for a xray and blood tests... she is also sending another referral to the Gastroenterologist.. I feel a bit better, my upper stomach is still sore but way less and gets better every day, seems to hurt more when I walk or move around, I tried some salmon and rice tonight, I hope it doesn't clogg things again but I was hungry..
thanks everyone for your input.
its appreciated
Posted 5/10/2013 1:27 AM (GMT 0)
Well, at least the dr doesn't think you're crazy! :) That's frustrating that the blood tests don't come back right then - they would never let me leave until they had the results and if it was pancreatitis they would just hospitalize me. Maybe try broth for a few days? Liquid diets are the only way to treat pancreatitis (other than hospitalization and IVs)
Posted 5/10/2013 5:40 AM (GMT 0)
Raw veggies are a big no no for us with CD. broccoli is the worst
veggie for us. You have to really cook them very well.
Posted 5/11/2013 2:51 AM (GMT 0)
Hi sMazerolle,
How did it go at the ER? How are you doing now??
Posted 5/11/2013 7:08 PM (GMT 0)
well it went rather well, was in and out or ER in 2 hours :) and low and behold I got some of the blood test results the next day.. my family doctor says the bloodwork that came in shows everything is perfect..no issues.. not even for the Crohns inflammation markers...C reactive protein came back normal ???? so seems its not my crohns acting up.. she didn't get the tests yet for the pancreatitis or the abdominal xray.. I have another appointment with her next Thursday. My stomach is better but still sore after I eat anything.. just a light pain and nowhere near the excruciating pain of Monday night...so now Im really confused, she did mention that a pretty bad case of stomach flue is going around but I really didn't have symptoms of stomach flue,, no vomiting or diarrhea on Monday night.. just excruciating upper middle tummy pain.. diarrhea came only after I took some senna tea on Tuesday to maybe help if it was a partial blockage.. so I don't think it was a bug...
Posted 5/11/2013 9:24 PM (GMT 0)
They should be able to detect pancreatitis from amalayse and lipase in your blood work. You can have normal C. reactive protein and still be in a flare. I am currently anemic and positive for blood in my stool, but my C. reactive protein is normal. I haven't been anemic since 2007, so obviously something is flaring. I hope you continue to feel better, but if you don't, then don't let your doc pass it off as the flu.
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