UC or IBS-How do you know?

I'm starting to question whether or not my UC is in remission and I dealing with IBS at this point--

My reasons for thinking it's in remission are---

I've been on Entyvio since August which allowed me to end 3 years of Prednisone back in October.  I have not seen blood since September and I have gained 30 lbs and returned to my normal weight.  My energy level is pretty good on most days too. Blood tests confirm inflammation levels do not show active disease.

But I still have doubts because---

I still have frequency and urgency problems..prob having 6 bms per day and consistency can vary from pretty normal (except stools can be somewhat flat) to loose. 

So how do you know if it is UC or IBS?  Is there any definitive way to determine which one is active?

 

I think that IBS is a crock and that you are not in remission from UC but I'm sure a doctor would agree with your diagnosis.

This is a really difficult question to answer, and one I still struggle with also. Are your days always 6 or so poops? I find ibs more fluctuating. Good days/bad days. When it's been inflammation it seems more consistently bad, or bad and getting worse.

That's quite a while between scopes, is there any way you can get one booked sooner? Where I live, if things are getting worse or changing the GI will often want to scope it out and see if it matches what your symptoms are doing especially if symptoms are changing. I think discussing with your GI would be a good idea, see what his possible explanation for your current issues might be. It might simply be playing around with your meds a bit to get things back on track but your GI should know if it's IBD or IBS or both that are causing new symptoms or changes in symptoms.

Given IBS isn't a real diagnosis, I have to think that those of us who are in remission but still have issues just have sub-clinical UC problems. Could be everyone with IBS has subclinical UC problems. If you're still struggling I would recommend trying some lifestyle and diet changes and see if they help.

My doctor thought that my UC was in remission and that I was dealing with IBS now. So I had a scope done a little over a month ago. It confirmed that my UC is still active, however, he believes I'm still dealing with some IBS. I am about two weeks post my first Entyvio infusion and have been on Lexapro for anxiety related to the disease. I don't know which one is helping, but I'm feeling better now than I've felt in a very long time. I'm having 4-5 bm's a day (some even solid!). That is down from 10-15 a couple of weeks ago.

Exactly Red!! I find it insulting as well....I'm in remission with my CD have pics to prove it and thankfully my doc isn't one that is close-minded and he suspected I had developed IBS long ago while flaring with my CD, he's a lead researcher for crohn's and colitis and has excellent credentials and since I know how I'm still feeling even with being in remission I believe him when he says it's my IBS that we have to deal with now.

To clarify, I did not mean that people with an IBS diagnosis don't have real symptoms. They clearly do. It's just that IBS as a formal diagnosis seems like a bit of a cop out to me when doctors tell someone with IBD that their symptoms are IBS. For people who also have IBD (or cleliac perhaps) it is not unreasonable to think the IBD and IBS are strongly related. Hence my point that what is called IBS might just be subclinical IBD or an additional symptom of IBD.

Gary and FSLondon, you should really re-read what you've written.

Are you both serious? You mine as well say that the only time anyone can have any issues with the way their intestinal tract works is if they either have IBD or Cancer because no other possible GI tract issue could be the culprit other than those 2 diseases. You really think people just can't have a dysfunctioning GI tract unless they have an IBD (or Cancer) only??? Do you realize how saying that it has to do with IBD and nothing else (like IBS) is real and how thinking and saying that makes you sound?


By Mayo Clinic Staff;

It's not known exactly what causes irritable bowel syndrome, but a variety of factors play a role. The walls of the intestines are lined with layers of muscle that contract and relax in a coordinated rhythm as they move food from your stomach through your intestinal tract to your rectum. If you have irritable bowel syndrome, the contractions may be stronger and last longer than normal, causing gas, bloating and diarrhea. Or the opposite may occur, with weak intestinal contractions slowing food passage and leading to hard, dry stools.

Abnormalities in your gastrointestinal nervous system also may play a role, causing you to experience greater than normal discomfort when your abdomen stretches from gas or stool. Poorly coordinated signals between the brain and the intestines can make your body overreact to the changes that normally occur in the digestive process. This overreaction can cause pain, diarrhea or constipation.

Triggers vary from person to person

Stimuli that don't bother other people can trigger symptoms in people with IBS — but not all people with the condition react to the same stimuli. Common triggers include:

Foods. The role of food allergy or intolerance in irritable bowel syndrome is not yet clearly understood, but many people have more severe symptoms when they eat certain things. A wide range of foods has been implicated — chocolate, spices, fats, fruits, beans, cabbage, cauliflower, broccoli, milk, carbonated beverages and alcohol to name a few.
Stress. Most people with IBS find that their signs and symptoms are worse or more frequent during periods of increased stress, such as finals week or the first weeks on a new job. But while stress may aggravate symptoms, it doesn't cause them.
Hormones. Because women are twice as likely to have IBS, researchers believe that hormonal changes play a role in this condition. Many women find that signs and symptoms are worse during or around their menstrual periods.
Other illnesses. Sometimes another illness, such as an acute episode of infectious diarrhea (gastroenteritis) or too many bacteria in the intestines (bacterial overgrowth), can trigger IBS.

Where on earth did we say that? Did you read the link I posted?

And from your link Gary...."Patients suspected to have irritable bowel syndrome should undergo biopsies of the colon. This is absolutely necessary to exclude the possibility that they could have one of several forms of microscopic colitis." Yes, my GI does biopsies and they came back clean therefore confirming his original DX as also having IBS. Don't just pick out the odd thing here in there written in the link, IBS is it's own entity as of now still and until research on IBS all come to this conclusion I too will continue to believe it. And please explain why the Humira has cleared up all my inflammation that I had ongoing for over 2 decades but not on the microscopic level to completely get rid of symptoms, but yet for others it does (I'm referring to those that have IBD only and get into full remission with their Humira) because not everyone that has IBD also has IBS so why on earth would my CD be cleared up by the Humira but I still have ongoing GI issues when for others the Humira clears their IBD up and they don't??



Even your article says..."BLOOD TESTS SHOULD ALSO BE DONE BEFORE ASSUMING A DIAGNOSIS OF IBS" a diagnosis of IBS meaning that IBS is in fact real and the article is simply pointing out that it's possible if a patient has microscopic colitis that needs to be ruled out BEFORE a patient is DIAGNOSED WITH IBS because IBS is a real condition as well. The article you posted does not say IBS isn't a real DX.


Article Source: http://EzineArticles.com/455365

Gary, I've understood what you meant about being misDX, that's completely different than saying a condition doesn't exist, very very different (which is why I came across defensive) I know people get mixDX that's not the point you were making, the point you were making was that IBS isn't real...it is, whether you want to believe it or not, it is. That likely will never change. You have the right to believe what you want but just remember whenever you're discussing it here at HW you blatantly say "IBS is not real, it's a form of IBD" when in fact IBS is real, just doesn't leave others thinking you have a whole lot of credibility compared to if you said "IBS is often misDX by bad docs that don't do biopsies to confirm there is no microscopic colitis going on." At least that would give you credibility in my eyes (not that I expect you to care what I think) I'm just pointing out how silly it sounds when anyone say's IBS isn't real and it has to be some form of IBD.

Your article that you posted the link for doesn't even suggest IBS isn't real, it only suggests that people should go to all lengths to make sure microscopic isn't the actual reason behind symptoms BEFORE an IBS DX is made...meaning IBS is real...I learned about microscopic colitis aka; lymphocytic colitis and collagenous colitis, years and years ago.

Yes, I'm all for that, I believe many docs give misDX of IBS too, but I know that IBS is real. It is important that people get DX properly but it's also important not to minimize IBS cuz it's pretty tough to live with too for many.