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Fluid and gas movement sound in the terminal ileum region

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Posted 12/17/2013 5:24 PM (GMT 0)
Hello,

I've been hearing fluid and gas movement sound in the terminal ileum region (right lower abdomen). I'm also experiencing dull pain in the terminal ileum and groin region. I'm having very little appetite. I saw a big mouth blister today. However, I don't have constipation or bloody stools. As always, my stool color is either yellow or green with probably some undigested food.

Does anyone experience these symptoms? Can it be possible that I'm in a flair? It has been really difficult for me to understand my flare. My CRP level is normal. I'm trying to imagine the scenario. There is no inflammation in the intestine, probably no scar tissues as I don't have nausea or vomiting or abdominal pain. There may be some inflammation activity at the cell level in the intestine which is causing severe indigestion. This may be a sign of flair up for me.

I would appreciate any opinions.
Posted 12/17/2013 5:40 PM (GMT 0)
CRP is not an accurate indicator of inflammatory process in my experience, at least not in the timely fashion you'd want when you are having indigestion.

If you have pain in the lower right quadrant and you hear burbling sounds, then I think that is sufficient evidence to indicate a flare. Yellow and green stool is not normal. Anorexia is not normal. You don't have to have diarrhea to be having dysfunctional bowels.
Posted 12/17/2013 6:03 PM (GMT 0)
Hello Kazbern,

Thanks for your reply. I'm a little scared now, after you having said that it could be a flare.

What should I do now? Should I ask my doctor to increase my dosage? Should I undergo a lower GI endoscopy?

What did you exactly mean by, "Anorexia"? I don't have eating disorder. Actually, I'm thin and would love to add some weight.
Posted 12/17/2013 6:14 PM (GMT 0)
How do you know there is no inflammation in the intestine? CRP cannot rule that out; it's a useful marker of disease activity for some people, but not for everybody. You can only really rule out terminal ileum inflammation with a colonoscopy.

Does sound like further testing is required to find out, tbh.
Posted 12/17/2013 6:19 PM (GMT 0)
Oops, I was a bit late >_>.

Yes, have a colonoscopy, especially if you haven't had one for a while.

Anorexia refers to loss of appetite rather than a desire to be thin. If you have no appetite, then you have anorexia. Personally, that wasn't a symptom which ever affected me until late-stage Crohn's. People can lose their appetite for all sorts of reasons, both physiological and psychological. But me, I ate my way stoically through virtually everything.

Post Edited (NiceCupOfTea) : 12/17/2013 11:24:18 AM (GMT-7)

Posted 12/17/2013 6:28 PM (GMT 0)
Yeah, NCOT beat me to the anorexia definition. Anorexia Nervosa is the mental illness problem. Anorexia by itself is simply a medical term to indicate patient does not want to eat.

Your mesalamine dosage is low. Typical therapeutic dose is 3-4.5 g/day. The entocort should be treating the terminal ileum - how many days have you been on it?
Posted 12/17/2013 6:39 PM (GMT 0)
I've been taking it for three months. I don't think the medicines have made any difference. I took two sachets in the beginning for one month and then reduced to one.

To be frank. I was feeling fine only for a month or two after my discharge from the hospital. The doctor says indigestion is mainly due to the gastritis. The stomach plays a major role and intestine plays a minor role.

If they find any progress in the inflammation during endoscopy, what medicine should I ask for?

Post Edited (Usher) : 12/17/2013 11:42:12 AM (GMT-7)

Posted 12/17/2013 7:25 PM (GMT 0)
Are you still taking entocort? That could be contributing to your gastritis.

Mesalamines are the first medication usually prescribed, but if you are not seeing improvement then it is time to move on. Which mesalamine are you taking? Pentasa is probably the best one for inflammation in the terminal ileum - other types are active in the large bowel.
Posted 12/17/2013 7:40 PM (GMT 0)
Hello Kazbern,

Yes. I've been taking Mesalamine (Budenofalk and Salofalk) and all the drugs that have been prescribed to me. I sometimes have problems from gastritis too. But, I can make out the difference. If I drink tee or coffee, my stomach hurts and I have acid reflux.

I think I have been having terrible gastroparesis. It seems to me that it is almost paralysed. I did well in the first two months. I ate a lot of fiber and fat, which has probably led to gastroparesis. I've been having stomach problems for ages. I'm not denying that there can be no inflammation from CD. I'm trying to say that my gastroparesis or hypochloridia or some other illness is troubling me the most.

After having endoscopy, I'll discuss with my doctor about it again.

Post Edited (Usher) : 12/17/2013 1:25:11 PM (GMT-7)

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