Chrons or ibs? Need help!! Advice on symptoms

Hi all,
So I have just joined this website as I have been reading for months and decided to ask for your advice.. Here goes...
I have been suffering with abdominal pain, night sweats, feeling sick and D for a while now! I had to go for a colonoscopy after my fecal calprotectin was raised slightly! The outcome of the colonoscopy was apthous ulcers in the terminal illiem and mild inflammation. Biopsies were taken and sent off but due to a technical issue in the lab all biopsies could not be saved - this was so annoying! My consultant put me on a 3 month course of steroids which did not work until week 6 - I finally had a "normal" bowel movement for the first time in a few years!! I was so excited but with the harder stool came a LOT of wind.. Which smells awful!! Does anyone else who has chrons suffer with bad wind? Also my tummy bubbles and pops!! My Consultant tells me this is not a characteristic of chrons diesease and now thinks this may be IBS.. He is sending me for a lactose intolerance test for the wind? I have since been sent to a dietician, I am now on a 2 week elimination diet which is making things worse and I still have the D?! I am really confused and feel helpless!! There seems to be no answer and I am no further forward with a diagnosis!

I think your consultant doesn't know what he's doing. Is he kidding that wind and stomach gurgles only happen in IBS and not Crohn's disease? As massive a pain up the arse it may be, I'd request a second colonoscopy with biopsies (hopefully the lab doesn't lose them this time). You need a diagnosis. If it is Crohn's disease, you ought to be on something other than steroids. (And not Pentasa, but that's another issue.)

I find it a bit weird that the steroids took 6 weeks to start working. They are normally extremely fast-acting, although some people do take longer to respond. However, even the slowest responder should see results after 2-3 weeks. The fact that the diarrhoea has returned makes me think the steroids didn't work for you and the hard stool was just a coincidence. If your BMs have changed, it may be a sign that your disease has changed, though I hope not.

PS: Your consultant might try to tell you that there is no point to having another colonoscopy because you've been on steroids. If so, ignore this and insist you are still having symptoms. The steroids probably won't have healed anything; in fact it's rather unlikely they will have done - they don't usually heal the mucosa.

Post Edited (NiceCupOfTea) : 5/1/2015 1:05:03 PM (GMT-6)

It is possible to have both Crohn's and IBS and affecting you at the same time...I have more gas issues as a result of my IBS, when I first got sick with Crohn's (IBS came later) for many years I did't get gassy the way I did when my GI suspected that I likely developed IBS over many years of being in a constant flare with my CD (approximately 20% of CDers also have IBS according to research stats) so IBS is real and can happen at the same time as one's Crohn's is also flaring.

Once my GI got my CD in remission, and I was still feeling unwell (but differently, kinda hard to explain exactly) he reminded me about the IBS he mentioned to me 14 years ago, he was correct, I'm seeing a dietitian (just saw her again today actually) and a therapist to deal with my anger/depression/anxiety and the dietitian did my follow up with me today because since April 6 she had me on the low FODMAP no fructose gluten free diet and the only thing that changed in the last 4 weeks is that I'm not near as constipated BUT I still have frequency and some urgency issues...they're just easy to pass and no more constipated stools either, so we're starting reintroduction of foods starting Monday, but she said looking at my journal it's clearly STRESS that is keeping my guts active more so than food, she plans to continue to make sure I don't have any other food intolerance issues (I am lactose intolerant, GI checked me for that back in 2008) but she wants to make sure I don't have/or find out if I have other intolerance issues with food...we'll find out in 3 weeks for sure if I do or not. And I very well may, but she was really concerned about my stress/anxiety/depression level due to being on the diet for as long as I have been and not much for any improvement (she says the reason my stools are no longer constipated and that they're easier --not perfect-- to pass is due to the increased fibre I've been eating (I take supplements for it too).

So you never know what could really be going on but they know that diet and stress are 2 key factors for IBS of any kind (diarrhea, constipation, and alternation between the 2) not to mention our menstrual cycles also can affect our guts (even healthy women's guts can be bothered by their menstrual cycles).

Get scoped and go from there, best of luck to you!

If you are in remission, you shouldn't have inflammation or ulceration, no. Chronic inflammation leaves a permanent imprint, but I'm not sure if you've had inflammation long enough for that to show up in biopsies: I'm not a pathologist, everything I know is gleaned from internet reading.

An MRI scan is quite a good test, but it cannot take biopsies, so you are kind of back to square one: it will only really be helpful if the inflammation has got worse - which you don't want, obviously. You need biopsies to clinch a Crohn's diagnosis and to knock the IBS nonsense on the head. Incidentally there is no reason why Crohn's and IBS can't co-exist, but it's irrelevant in your case. You have something else besides the IBS which needs investigating: the IBS is a red herring.

Unfortunately IBS is DX based on ruling out other conditions, so as NCOT mentioned if you have inflammation than naturally most GI's will just label it as IBD but there are some really good GI's that can appreciate the fact that patients can have both co-exist and although the symptoms can be very similar there are some differences so it takes a keen ear (GI) to listen to what all you're describing and a lazy GI will not make note of all symptoms (means s/he isn't really listening like they should but in all fairness it can be tough to sift through and note some key things that are indicative to either condition.

You can most definitely have IBS symptoms daily just like with IBD until IBD is in remission and IBS is under control. Not sure what other than scaring the MRI would have shown if it was crohn's, maybe ask them to elaborate on that. I think another c-scope is a good idea but just keep in mind, not all meds for IBS will likely work for each person just like with IBD, sadly even with IBS it's trial and error when it comes to meds....stress and diet are what's majorly liked to IBS issues.

Check out this link...

http://www.healthline.com/health/crohns-disease/ibs-vs-ibd#3

The presence of inflammation and ulcers indicates there is more going on than IBS. Yes, you might have IBS along with something else, but it's not the only thing happening.

However the presense of inflammation and ulcers does not necessarily mean you have Crohn's. Yes, they're highly correlated with having Crohn's, so that's a distinct possibility that needs investigation. But there are other possible causes of such findings. Taking NSAIDs (aspirin, ibuprofen, naproxen, etc) can cause those findings to be present. So can certain other medications. So can certain infectious diseases. So can other "autoimmune" conditions.

So there are several things that need to be investigated and ruled out in order to know what is really happening.

Hi all,
Thank you for all your advice & info! My consultant was not confident enough to diagnose chrons from the colonoscopy as he said there was not enough evidence from the mild inflammation and "few" apthous ulcers. I also had to do a sample before the colonoscopy which came back with raised fecal calprotectin, without biopsies returning he did not want to diagnose but he did try me for 3 months on the steroids!
This is why I then went for the MRI which came back normal - nothing was found, he said that something would have shown up on this even if I was in remission?? I also did another sample along with the MRI and this time nothing shown on this either ( I did feel a lot better during this stage) this is why I was asking if I could have been in remission at the point of MRI.. Because of this he is now leaning towards IBS.
In the mean time my GP sent me to a dietician who has put me on an elination diet, I basically eat the same 6 foods for 2 weeks .. I have now been on this for 11 days and still have loose stool and abdominal pain and wind, I do not know what I am really meant to be expecting at this stage?! Surely if this was diet related I would have noticed a change for the better?
I did take NSAID's for headaches etc but since reading this (just after my colonoscopy) I did try and lay off them!
I suppose I will never know unless I ask for a repeat colonoscopy - just seems like this has been on going for years! Wait.. It has!
It's good to read what all of you go through and the knowledge you know so thank you for the replies! X

hello! I would like to know what y'all think!

I have dealing with my symptoms for over a year. I had a capsule endoscopy few 2015 and it found ileitus. my main issues are: very random and mostly painful bowel movements, I can only describe it as contractions. I physically can not resist pushing because the pain makes me push. I get horrible constipation as well. I will go for at most 4 days with no bm. but then on the other hand, sometimes I will get diarrhea from things I eat, other times I won't. I never know how my body will be from day to day. I have very bad fatigue and insomnia, esp during the time I have my period, or when I'm supposed to have it. my periods are very random as well, I also get rectal bleeding ONLY when I'm on my period. I have very poor appetite, I eat once a day at most. when the flare up for the "month" begins I get leg/hip/butt pain that kinda feels like nerve pain but my entire leg will cramp at the same time.

I also have hypothyroidism with a goitre. I get very erratic emotional spells. one extreme to the next.