Crohns or IBS?

Hi guys,

Have just gotten out of hospital for yet another bad flare up of IBS.. was dx approx 6 years ago with IBS despite that they couldn't see my entire gut with the colonoscopy.. When they inflated my bowel I was in IMMENSE pain despite being heavily sedated and that is why I was diagnosed with IBS. I get flare ups which start with a bout of diarrhoea (my usual symptom is constipation with occasional runs) and progresses to huge pain which lands me in hospital on morphine and exploratory abdominal surgery :-(. always the same process. except lately I am now getting mouth ulcers and rawness and/or itching around my anus before it starts and during. One of the doctors this hosp admission wants me to see a gastro doctor to have another colonoscopy (they won't do it as an emergency) to rule out Crohns. Spoke to my GP about it today during my discharge check up and she laughed and said that the two conditions are SO dramatically different that I would have been diagnosed with Crohns right at the very start had it been that and that I would be very very ill with dramatic weight loss and other things... I am slightly anaemic with no explanation. before a flare up I have noticed I lose a kg or two during the first few days but usually don't weight otherwise. What is the opinion of those that have these conditions? Is it possible to have Crohns so far up the gut they can't see it? Is colonoscopy the only diagnostic test? From what i have read my symptoms fit.. right down to the mouth ulcers and the itchy anus.. of course the pain and alternating runs and constipation match IBS though.. HELP. I am SO OVER THIS! I'm so confused and just want to get better.. I hate not even being able to pick my very small 3 year old up because of the pain :-( I also get very tired and usually need a nana nap during the day. Have been like that for years.

Post Edited (Leebie3) : 3/27/2012 7:30:37 AM (GMT-6)

Urgh, I feel so annoyed at your GP. She is clueless about Crohn's. (Not surprising though; my GP doesn't know a lot about it, as I suspect most GPs don't.) Crohn's does not always present itself for the first time in a drastic way, with dramatic weight loss, hospital admissions, surgery etc.; in fact, it's just as common, if not more so, to have a slow-burning start with symptoms/flare-ups slowly getting worse over a period of time. That was certainly true of me. I had symptoms far less debilitating than yours, but luckily I saw a decent locum doctor who ordered the relevant tests and a few months later, I was diagnosed with Crohn's.

For what it's worth, your symptoms bring up a few red flags for me; the extreme pain, the mouth ulcers, the rawness/itching, the fatigue, and finally the slight anaemia. None of those by themselves, or even altogether, definitively point to Crohn's, but if I was a doctor, at the very least I would be running all the diagnostic tests for IBD.

I would find a different GP and see if you can get a referral to a gastroenterologist. They'll know what tests to run. A colonoscopy checks for disease in the colon and terminal ileum (last part of the small intestine); biopsies are also taken to check for microscopic evidence of disease. However, there's also blood tests (inflammation), stool samples (infection, occult or 'hidden' blood), small bowel tests such as barium follow-through, and CT/MRI scans.

Good luck. I hope you can get this treated.

thanks guys.. They did a CT scan while I was in hospital and said there was nothing really there and that my blood tests were fine so I have no idea what's going on.. :-s Is there anything over the counter that I can try that helps? I'm allergic to buscopan.

CT scans and bloodwork should be pretty reliable tools to detect inflammation, but they are not infallible. You can also do stool samples to check for inflammatory markers, and swallow a pillcam to look for inflammation in the small bowel that is not significant enough to show up on a CT scan. There are also abdominal MRIs with contrast that might show iflammation in the small bowel. But yes, you need to see a GI.

Do you need to get a referral from your GP because of some insurance issue? If not, start asking around and see if you can get the name of a GI who treats a lot of people with Crohn's and UC. There are some GIs out there who don't, and you don't want them.

Best wishes.

I have Chrons and mine was diagnosed by doing an Upper GI because my disease back then was in my terminal ileum.Maybe you should ask Dr

 

    Hi there.

    Those are rather *Drastic* symptoms for IBS, I think. Hopefully this Gastero can figure out what is wrong. I hope all goes well for you!

    Sincerely,

      Matthew

 

Barium swallow with small bowel follow through.

I suffered for YEARS before getting diagnosed with colitis (nonspecific) and sometimes it takes getting scoped and or having the tests at the right time. All the stuff people mentioned here are tests you should get done. Also some blood work for inflammation. Hang in there! We all know how you feel.

Once I found the right GP my life with Chrons got easier. I was misdiagnosed sent to a gyn and he removed an ovary.After the surgery I felt just as sick and was in hospital several times with obstructions but they thought I had a bladder infection.I didnt know I had Chrons back then and have never been as sick in my life .On one of my hospital visits an intern at the hospital mentioned fistula to me and I looked into it got myself some new Drs and had my first bowel resection for fistual from bowel to bladder.Lesson learned for me know your disease and get a good GP because thats where the good care begins.I have had two more resections since then because of obstruction and now have a colostomy because of anal absesses and fistulas.

ps: he also gave me some steroid cream for the old sore, bleeding bottom without asking to have a look :-D i was quite worried he'd wanna look at my bum lol