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Crohns and IBS?

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Crohn's Disease
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Posted 5/1/2015 2:08 AM (GMT 0)
Hi guys!
So every since my csection in November, my guts have been all over the place!
For two months after the delivery, I would eat and then run to the bathroom within 15 minutes, which was not normal for me.
Before pregnancy, I would have my bad days, but for the most part, my main symptom was an active 5 year old perianal fistula that goes from skin to rectum.
I'm not sure, but I think all that postpartum diarrhea was because of antibiotics they gave me after my surgery, but who really knows?
Then in January, I started getting constipated! For maybe the 3rd time in 15 years! The stools were not hard, nor were they very big, so I don't know why I was so plugged up. I eventually started bleeding and there was a whole week where I bled enough to turn the bowl red.
I had a blood test, but it was fine and a GI appointment, but he wanted to wait until after I finished breastfeeding to do any procedures.
There was one scary day in March where my fistula closed up, got super tender, and then burst.
But nowadays, my guts are so unpredictable. I could go days of mild diarrhea with no pain and then I'll do days of constipation where it feels like the stool is in my rectum ready to go, but the muscles lack the strength to push anything out. All that comes out for awhile is owl pellets and then finally loose stools. I may bleed a little but nothing like in January. I usually have some degree of rectal pain from mild to moderate.
I saw my GI on Wednesday and he's thinking I might have IBS as well as Crohns, but wants to do a colonoscopy to confirm.
What's he looking for? Rather, what are the indicators for IBS in a colonoscopy?
He said that he might tell me to eat benefiber if I do have it, but that seems ridiculous to me, who normally can barely eat apples or oatmeal.
For those who have Crohns and IBS, what are your guts like? Does this sound familiar at all?
Should I start eating oatmeal???
I'm only on remicade right now, but I used to take 6mp which I hate.
Thanks!
Posted 5/1/2015 2:36 AM (GMT 0)
I hate to break it to you but it's not likely going to be as easy as just eating oatmeal when you have IBS...I too have Crohn's colitis (CD is affecting the colon) my GI suspected that I developed IBS as well about 14 years ago (based on symptoms, not C-scope because my C-scope back then revealed that my CD was still flaring (it did for 23 years until last year when Humira finally put it in remission) and yet I still felt/feel lousy so that confirmed his suspicion that I definitely have IBS as well and my IBS is mainly C but alternates (usually with menstrual cycle) with D as well but the C is more prominent yet even with constipation I still have frequency issues--I'm a mess!!!!

So GI told me that stress and diet were the 2 key components for IBS and that I had to get it under control, he referred me to a dietitian (she happens to have CD herself and is one of his patients too) and therapy. So far the Dietitian has put me on low FODMAP no fructose diet so we can figure out what might be my trigger foods/intolerant foods for my IBS (she also plans to get me on a diet to aid with my CD the next time I flare) I've been on this diet since April 6 (seeing the dietitian tomorrow with food and BM journal) and the only thing the diet as done is ease up the constipation but I still have frequency and gassy issues so I'm kinda pissed actually since my diet seems to really suck (she has me avoiding gluten and wheat too, though I've been tested many times over the years for Celiacs and I don't have Celiacs).

So I'm trying to stay positive and hopeful but will probably lay into her a bit tomorrow about how unhappy me and my guts are with this fairly restrictive diet that I've been following to a "T" and still the only good thing is I'm not as constipated but sometimes/often enough still IMO I do still struggle to pass many of my stools, I haven't had too many hard round ball stools but on occasion I have while on this diet so that and the frequency is really making me frustrated...she better have a good resolution for me tomorrow or I might just blow my lid.

According to research it's estimated that approximately 20% of CDers also develop IBS as well so we're not alone.

I mean obviously the C-scope is good to have to see if all your inflammation is gone but whether it is or not won't change the fact that you still have IBS issues while flaring with CD if your scope shows inflammation since you can have both be active at the same time. However if your crohn's is in remission then that should prove you definitely have IBS issues.
Posted 5/1/2015 2:44 AM (GMT 0)
I have Crohn's which I think is still in remission, and yes, I have had IBS my whole life. The colonoscopy is to make sure you do not have any active Crohn's disease, and if all looks fine, then the doc will lean toward IBS. IBS is more of a motility dysregulation but it doesn't cause inflammation and disease. Fiber supplements like metamucil or benefiber helps to add bulk to stools and it helps with both constipation and diarrhea. If you decide to try it, go slow, because it will cause gas and bloating until your body gets used to it and drink lots of water. I take fiber pills and solace (stool softener) daily. I tend more toward constipation, meaning pain and I get backed up but the stool is always soft....kind of confusing. I do think you should have the colonoscopy, especially with your fistula acting up. Have you had blood work for inflammation markers? That may help too.
Posted 5/1/2015 3:16 AM (GMT 0)
Without a colonoscopy he has no way of knowing that it isn't a Crohn's flare up. For some people blood tests don't always tell the story. You for sure need some tests to see what is going on, and active fistula sure isn't IBS. I wouldn't take that diagnosis until they have ruled out your Crohn's being the culprit.
Posted 5/1/2015 4:10 AM (GMT 0)
I was flaring at the time my GI suspected I also developed IBS about 14 years ago so it is possible that a good GI can pick up on the subtle signs of IBS even while flaring with crohn's. Again though, once my crohn's went into remission is was much easier for him to confirm what he had suspected but still, he did suspect it back while I was flaring with my CD.

I do agree though that it's a good idea to get scoped.
Posted 5/1/2015 1:08 PM (GMT 0)
I have Crohn's in the colon and honestly, I don't see how someone with that can NOT have spasms when flaring, but I loathe the IBS term as it kept me from being taken seriously for 25 years. Of course my bowels are "irritable" when their inflamed, but I consider that a part of having Crohn's.

Your symptoms, to me, sound like your inflammation is narrowing your intestines, which would explain the need to go but not much comes or it's narrow and soft. You can get adhesions after abdominal surgery which can cause problems too. I know I flared immediately after both a delivery and a miscarriage, which I think was triggered by the hormonal changes.
Posted 5/1/2015 2:08 PM (GMT 0)
Thanks everybody!
pb4 - The thing is, I don't think I'm flaring, partly because I hate that term, but also because I feel fine. I just don't ever want to be constipated! Constipation is what started my crohns journey way back when I was a kid. Constipation and a fissure that wouldn't heal and a 40lb weight loss.
Gumby - I hope it's not IBS. I have watched my mother suffer from constipation my whole life and I don't want to live like that. I'm really wishing that this is all just a bizarre postpartum symptom. Thank you for the fiber tips, but the idea of me purposefully ingesting fiber just seems nuts to me! Blood tests in February came back normal but I was still breastfeeding at the time.
jen77 - well the fistula has been around for what feels like forever and always tends to act up in the summertime. For example, I had a small abscess occur in august 2012 and the GI made me get a prometheus test to check for antibodies, but I was fine. Doc wanted to do that again, but I said no way. I had to fight my insurance company for 6 months before they agreed to pay for that darn test!
pb4- haven't had a scope since fall 2012 so I guess I'm due for one. The last one came back clear except for where the fistula was in the rectum, plus a big noncancerous thing that they lanced out. Grandma and great grandpa both had colon cancer so I'll never turn down a scope!
Jasanne- Narrowing of my intestines is an idea that lingers in the back of my mind very much. I had diarrhea/ileal inflammation as a kid, then fistulizing disease of the rectum in my 20s, and so wouldn't it be approapriate that I have stricturing crohns in my 30s? :P I hope it's just hormonal changes, but part of me wants to see some kind of evidence of what's going on with me internally, even in if it's bad.
Thanks again everybody!
Posted 5/1/2015 9:16 PM (GMT 0)
Well, our bodies tend to change over time, we can develop food intolerance issues that can easily be masked when you have something like IBD (or even IBS) it took a while but I found out I became lactose intolerant but it was easily masked by my CD and my IBS but I have an excellent GI and he tested me for lactose and that's how I was able to find out because just eliminating dairy didn't help because the CD masked the lactose intolerance very easily.

Best of luck to finding out what's going on, it's frustrating and scary I know...I'd rather have the runs than be constipated cuz at least with the runs you get stuff out, the constipation is so painful and super scary (I had a recto-vaginal fistula last year that the Humira seems to have cleared up, getting confirmed May 11).
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