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Crohn's Disease
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Posted 11/20/2007 8:44 PM (GMT 0)

Well I just typed a whole huge post and let it sit too long and lost it---YUCKO!

I have to say: WOW, WOW, WOW, and WOW!  I have just read about 30 pages of this forum and holy cow I can't believe the wealth of information that is here!  The support, the caring, the sympathy and empathy....

As you might guess from my sign-on name, my DH was just (I think tentatively) DX'd with Crohn's.  Has colonoscopy last Thurs, doc showed us pics of colon section with 8-10 "ulcers that are inidicative of Crohn's" and put him on Pentasa 1,000mg twice a day.  Had the small bowel (that's upper GI, right?) test today--the one where you drink stuff and they watch it travel through.

Some questions:

1) if he has "ulcers indicative of Crohn's" and was put on Pentasa; doc took biopsies of ulcers; can we finally say we know what's been going on the past 8 months?

2) is there any other reason for ulcers in the colon?  don't know what section of the colon it was exactly, but MUCH of his pain is in the rectal area, inside (he says it feels like the muscles you would use to hold in a BM).

3) he has also had various "mystery pains" in his groin, hips, pelvis, scr***m (he does have a large varicocele, 20+ years) for which he takes oxycodone 5/325 (he says that rarely takes care of all the pain)

4) he was given a Celebrex script 2 days before the colonoscopy because he was taking max doses of Motrin along with the oxy (says combo of those 2 helped better); but now, wonder if he should take Celebrex due to the ?Crohn's

Not sure if my questions are concrete enough; I guess what  I am asking is whether we can really call it crohn's or should we wait for biopsy/upper GI results?  He has also been suffering from depression/panic/anxiety for which we are still working on meds.  I feel that the depression/panic/anxiety stems from not knowing what has been the problem all these months.

He has always had a "fussy" stomach, years ago was told IBS, but never had any tests for it.  He doesn't have constant D, but with the meds he is on, he should be constipated, not having D for 3-4 times in the a.m. all at once!

Well, thanks for reading all this! I just want to help my beloved!

--new crohn's wife

Posted 11/20/2007 9:12 PM (GMT 0)
Welcome to Healing Well, NCWife! Thank you for all the compliments about our community. We like to think we are the best on the 'net!

To your questions:
1) Sounds like the "lean" is towards Crohn's disease [CD]. However, before saying definitively that he does have CD, it is probably best to await the biopsy results.
2) Some medications are known to cause ulcerations in the small bowel and very upper colon but I do not know if they also effect the lower colon. NSAIDs [nonsteroidal antiinflammatory drugs] like Motrin are know to cause ulcerations in the small bowel. A quick google search found information showing cases of NSAID induced colon ulceration.
4) NSAIDs are routinely withheld in people with CD. They can cause an increase in symptoms in many people with CD. According to an article on Medpage Today "In a randomized, placebo-controlled pilot study, researchers at the Mayo Clinic here showed that patients whose inflammatory bowel disease (IBD) is in remission can use Celebrex (celecoxib) safely for short periods of time." Currently whatever your husband has going on in his gut, it is not in remission, so he should discuss his Celebrex usage with the GI and follow his advice.

Again, welcome to our forum!
Posted 11/20/2007 9:21 PM (GMT 0)
The biopsies should tell them a lot.  There are other causes of ulcers in the colon- he could have ulcerative colitis or they could even be caused by the high levels of Motrin.  Hang in there.  Hopefully in a couple of days the test results will be back and you'll know more.
Posted 11/20/2007 11:09 PM (GMT 0)
I just wanted to say welcome. I hope your husband find some answers pretty quickly. They should hopefully come back with
some conclusive answers. A small bowel follow through should show most of the GI tract. It's a good test to see inflammation
or possible obstructions. I wish you both all the best.
Posted 11/20/2007 11:57 PM (GMT 0)
Welcome,We are glade to have you and hope your husband will join as well.I know that your husband is very lucky to have such a caring wife.I would all so like to say thank you for the compliments as well.I do agree to wait on the biopsy results.I hope that you and your husband continue to post,please know that you'll are welcome any time.I hope that your husband gets to feeling better soon.
Posted 11/21/2007 1:25 AM (GMT 0)

Hi and welcome,

The first thing is wait for the biopsy, but sounds as though the Doc is leaning towards Crohn's.  Crohn's and ulcerative colitis look very similar on colonoscopy.  The only real difference is the depth of the "ulcer".  I have Crohn's in my large left intestine which is a less commom place for Crohn's and more common for Ulcerative Colitis, but after biopsy....it was ruled definitely Crohns.

I would say that definitely all of the NSAIDS that your husband is on could definitely cause complications, just not sure it would be in the large intestine without being in the stomach and small bowel first.  One thing I have learned thru all of this is that Anything is possible.  Once there is a definitive diagnosis, his GI will address all the meds that your husband takes, and would more than likely have him stop all NSAIDS.

The rectal muscle pain is common in both Crohn's and UC (ulcerative colitis).

The very most important advice I can give you is to definitely develop a relationship with his GI doc and MAKE your husband go to the GI reguarly, keep appts etc. 

Good luck, stay in touch with the forum so when can know how he is doing.

Posted 11/21/2007 5:45 AM (GMT 0)
The major differences between how CD looks via colonoscopy compared to UC is with CD the many layers of the intestinal lining may be affected (often the culprit behind fistulas which UCers don't get as a result of having UC) with UC the inflammation remains on the surface of the lining...

The other major difference is with CD there is typically skipped patterns of inflammation (healthy tissue inbetween inflammed/diseased tissue) with UC the entire area affected will be inflammed with no skipped areas.

CD can affect the entire GI tract from the mouth to the anus, UC is limited to the colon and rectom.

:)
Posted 11/21/2007 1:58 PM (GMT 0)
Hi Welcome to HW hope your H feels better soon and yes sometimes not knowing what is wrong with us can certainly cause anxiety .Good that he is getting tested and hope the Pentasa kicks in .lol gail
Posted 11/21/2007 2:17 PM (GMT 0)

Thanks so much for the warm welcome!!!  I appreciate all of your repsonses.  We will be anxiously awaiting the results of the biopsies; but I read that sometimes the biopsies can come back negative, right?  I don't know how many biopsies the doc took, how many areas of the colon were affected, etc., etc.

Hubby has an appointment Dec 6; you better believe I'll be there with him!  I have been to every Dr. appointment since all this nonsense started 8 months ago.  We have been to pcp, urologists x4 (because we thought it was something to do with the varicocele), neurologists, general surgeon (to rule out perianal abcess), GI (the one who ordered the colonoscopy), and probably a few that I forgot.

In the last 8 months he has had MRI, CT scan (2), ultrasounds of several varieties, a trip to the ER, a hospitalization for severe reaction to an SSRI (at first I thought he was having a nervous breakdown; this was the hardest thing I have done in 21 years of marriage), and probably some more tests that I forgot!

After his GI appointment, the doc called and said he saw inflammation markers and wanted his colonoscopy moved up ASAP (it was scheduled for Feb, yikes); we got 24 hours notice of the appointment being moved.

And that's where we are right now.  I really hope that we have found our answer.  It has been a very, very rough 8 months!  My DH is a SAHD of our homeschooled children (I work FT for a large teaching hospital) and this has really taken a toll.

Wow, didn't mean to drone on like that....thanks for listening!  I want to be the best support I can be for him, and sometimes it's so hard on me, trying to keep everything together!

--New Crohn's Wife

Posted 11/21/2007 2:31 PM (GMT 0)
pb4's post is accurate . . . Crohn's inflammation skips and goes deeper into the bowel wall. The biopsies won't always be definitive but they usually show enough to make the distinction. Unfortunately, the best way to tell if it is actually and definitely Crohn's is if the aptient responds to the medications. Luckily, the treatments for Crohn's and ulcerative colitis are similar enough to help most patients get better even if the exact diagnosis is still up in the air. As someone said, the main thing is to take meds, watch for dietary triggers and stay under treatment with a good gastroenterologist. Well over a million people in America have these two closely related diseases and the vast majority of them live full lives with only occasional concessions to the illness. And there are nre drug regimens being developed every year as medicine understands more and more about the whole range fo autoimmune diseases.

Posted 11/21/2007 3:28 PM (GMT 0)
New Crohn's Wife - I wanted to comment on your very last statement. You have already taken the first step to be the best support for him. Here is where you can vent, cry and scream when it gets to be too much. I am sure you will be able to keep it together, you just may have to adjust what is important to keep together and what you can let go. Do not feel guilty for doing that.

Good luck.
Posted 11/21/2007 10:30 PM (GMT 0)
Welcome!

One comment for you....you mentioned that you had been to a general surgeon to rule out a perianal abscess. Make sure he always goes to a colorectal surgeon. Let us know how his apt. goes on the 6th. Keep up the good work!
Posted 11/22/2007 1:15 AM (GMT 0)
Hi there, welcome aboard!

Sincerely,
Matthew
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