UC without visible blood or daily diarrhea?

New here but I've been reading over threads on this site to help with my question. I haven't been able to find the info I need so I'm asking the experts.

July 2014 I had a horrific stomach bug (we think) that caused me to have cramping and diarrhea 50+ times a day (all day, all night) for 5 days. The doctors suspected c diff so they gave me Flagyl and the diarrhea stopped suddenly after 24 hours on the antibiotic. The c diff test came back negative and they told me it is not uncommon for folks with other stomach bugs to respond to Flagyl. Bowel movements were not quite normal after that but I did not have any major issues, aside from a few 3-4 day long bouts of morning diarrhea.

In February 2015 I started taking Acidophilus Pearls (had taken them without issue in the past) and developed worsening gas over the course of a week culminating in a weekend of horrible cramping and a couple bouts of diarrhea. After that I began having urgency issues, regardless of whether I had diarrhea or not. I saw the GI for the second time and he said he thought I had post-infectious IBS and to try the Low-Fodmap diet. I did it for 5 weeks and my symptoms continued to get worse. I originally doubted the diagnoses of IBS because I never had abdominal pain, but after several months I developed intense cramping during/after bowel movements so I accepted it. At my GI appt he told me he really didn't believe it was anything more than IBS but that he wanted to do blood work. The bloodwork came back with slightly elevated CRP and ESR and I got a letter saying I have to have a colonoscopy. I thought that seemed a bit extreme.

I now experience pretty extreme urgency with all my bowel movements, even though it is usually not diarrhea. I generally have 0-1 bowel movements a day almost always with urgency and some degree of pelvic pain. However, once every 7-10 days I have an attack of sudden bowel evacuation in the morning right when I wake up. I get lower abdominal cramps and go and go and go until nothing is left in me - usually for 1 to 4 hours straight without being able to get off the toilet. These attacks have pushed me over the edge and I scheduled the colonoscopy for the Xmas holiday. I recently went back to the GI and he is insistent now that I have UC, even though most of my bowel movements are solid and don't have any visible blood.

Everything I read seems to indicate that UC causes many watery bowel movements on a daily basis, which I don't experience, though I do experience urgency with every BM. Is it still possible to have UC with the symptoms I exhibit?

The daily urgency and weekly attacks are ruining my life (I'm 26 and single with a demanding job) and I want to mentally prepare myself now for the likelihood that they will do the colonoscopy, find nothing, and tell me I just have to live like this, because it just really doesn't seem to me that this could be UC.

P.S. I don't know if this is relevant but I've been experiencing fevers of unknown origin since July 2014 as well. They do not correlate with my digestive symptoms at all and the doctor does not believe they are related. The fevers only occur about once every 6-8 weeks and usually only last 1-3 days.

The urgency sounds like inflammation in the rectum (like uc or at least an infectious colitis). The weekly bouts of emptying sounds irritable bowel with constipation. Without more tests it's really hard to say what it is, maybe it's a combination of things. Another stool test, colonoscopy and biopsies would be in order.

Inflammation can cause constipation for some, for others it's diarrhea. One end of extreme or the other...

Thanks, guys.

Sheri, how do you manage your IBS?

I'd not use steroids a month before a scope, it will hide the inflammation. Anything other than steroids is fine but nit a steroid. Just my view. Or at least tell the doc.

Dikid - The doctor did give me the fecal calprotectin test. It came back normal. I also had the celiac blood test and that was normal.

Here are my lab values that were marked abnormal:

Absolute Monocytes: 0.75 thou/mm3 (reference range: 0.24-0.36)
C Reactive Protein 0.6 mg/dl (reference range: 0-0.5)
Sedimentation Rate: 23 MM/hr (reference range: 0-20)

Erythematous means redness in color and it's usually suggestive of inflammation. Usually, when stated like it is in your report, it's very, very minor. I've sometimes heard "it looked sunburned" to describe Erythematous mucosa, before. Sometimes it even can be from the enema prep (if you had one). My last sigmoidoscopy noted this, and I'm in remission.

It's a sign of IBD, more likely suggestive of ulcerative colitis (due to it's location). Wait and see what the biopsy results say.

Did they diagnose anything yet (might be waiting on the biopsies)?

*To clarify, I did not have an enema prep, but the prep I used (Suprep) says on the box that it can cause inflammation that may look like IBD.

So I thought I posted an update here when I got my biopsy results but it appears I did not. I received a phone call from the Gastro nurse and she told me the biopsies were normal. I never received anything in writing so that's as detailed information as I have. They didn't mention anything about the areas of erythmatous rectal mucosa so I guess that was normal too. At this point I just accepted that I had IBS.

The doctor prescribed Levsin (sublingual) for my severe cramping/diarrhea attacks. I've had mixed results with it. It seems to help a bit with the pain but does nothing to stop the diarrhea.

At the end of May I started on Amitryptiline (10mg to start, then increased to 20mg), which I am still on. The first month or so I felt like it was helping to slow things down in my intestines and also helped with pain. Then I started having bowel movements 4 or 5 times a day (small amounts, somewhat loose). I increased to the 20 mg and continued to have several BMs a day. about a month ago (2 weeks after increasing my dose) I started passing mucus with my BMs and then passing mucus only. At first it was 3-5 times a day and only a few teaspoons in volume. Now I am passing quite a lot of mucus 5-10 times a day. Sometimes there are blobs of blood passed along with the mucus but I think that is from my hemorrhoids (even though they have never bled before). I would guess I'm passing around 3/4 of a cup to a full cup of mucus a day.

It is getting very exhausting running to the bathroom up to 10 times a day just to squirt out a bunch of mucus. (At least I think it is mucus - it is usually tan-white, somethings light brown, and very slimy). I experience urgency with all BMs (still) and passage of mucus. I can't get in to see my doctor until Sept 19.

I continue to experience the fevers of unknown origin (they occur randomly).

Can passing this much mucus be normal for "just IBS"?

Also, I took quite a lot of ibuprofen prior to my colonoscopy (I was in a car accident 4 days prior). I stopped the ibuprofen 24 hours before the colonoscopy per the instruction of the gastro office. Could taking ibuprofen in the days up to the colonoscopy disguise anything?

I'm just wondering if I should press my doctor on the IBS diagnosis.