ibs vs crohns

Help! Can someone please explain to me how to tell when my D is being caused by crohns or ibs? i have this constant debate with my GI. My belief has always been tht if i hurt worse afterwards and the pain wakes me up at nite and it is a constant pain then it is crohns. On the flip side, if i have bms and feel better then it is ibs. Is this oversimplifying it? I get frustrated bc I dont feel that he hears me- i think he cares and because i havent had had to have surgeries or fistulas or perforations, i am not that bad off. And I know i am very lucky but it still sucks.. I would love to be able to eat food, workout at the gym, have some romantic time with my husband, feel comfortable in my bloated prednisione body, believe that i will get this all out of my system and be better than ever. i have amazing stress going on at home, work, with my 3yr old daughter, money, relationship issues and of course my mood swings and fears- exhaustion and supersensitivity in appearance an attitude. How does anyone else manage this? I have had numerous tests show that i have patches of mild to moderate inflammation spreadthrout the colon but he still tells me that that isnt so bad and he thinks it is ibs causing this and i just need to talk more pamine.. sigh- tried and loopy=- thanks for listening to my rambles.. any advice on how to get your dr to listen or take you seriously i very much appreciated.. :)

Hi Valorie,
I know it's frustrating not knowing what the D is caused by. I have been told I have neither IBD nor IBS because my D is somehow "outside the box" of those nice, tidy diagnoses (although in actuality, I'm sure we can agree that neither diagnosis is particularly "tidy"). Sometimes the diarrhea will wake me up at night, sometimes not. Some months I will lose 10 pounds and be a miserable, quivering heap on the floor; once in a while I feel like a normal person. Sometimes I get so dehydrated I can't stand up, other times I am thinking about signing up for an ultramarathon (or something like that).

The way I finally wrapped my head around this was thinking: most of the time, I have diarrhea. A lot. Sometimes a WHOLE lot (like 15-20 times a day). And it's not pleasant. No one disagrees with me there. And unfortunately it might just take a bunch of exhausting trial-and-error on your part to figure out what you can do to make it better for yourself. It's a terribly lonely feeling, but truly, you are not alone. The one thing your GI can do for you is to help you control the symptoms with medications. But there are many other things you can do beyond medicating that might help.

I think the key to communicating with your doc is to keep a good "log" (uh...pun intended?) of your symptoms and what you are doing to try to combat them (i.e., taking more Pamine, if that's what he recommends) and rating how "good" or "bad" your day is on a scale from 1-10. This is what I did at one point and it was helpful for me to attempt to track patterns. I never found a definitive pattern, but showing your GI that you are trying - or, better yet, letting him figure it out for himself based on what you record - might help him see exactly how debilitating the symptoms are for you.

Best of luck. Hang in there, and let us know how you're doing...