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Old 03-11-2008, 04:23 AM   #1
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hukleberrie HB User
Inflammatory Bowel Disease....

Well, here I have finally been diagnosed. The GI said I have Inflammatory Bowel Disease, just not sure if it's ulcerative colitis or crohn's disease. My small bowel series showed an area where the contrast clumped in the area of my cecum/ileum & my colonoscopy back in October (done by a general surgeon, not a gastro, and they didn't go to the ileum or take biopsies of the cecum or ileum) showed ulcers, active colitis, mostly in the rectum/sigmoid colon with "crypt distortion" & inflammation in all biopsies. (The EGD showed mild chronic gastritis.) The gastro wants to do another colonoscopy to do a biopsy of the ileum to find out if it's CD or UC. I don't want to do it again, but want the best treatment & want to know what disease I have.

I would love any suggestions on how to deal with this pain. Sometimes I feel so much pressure in my pelvis, it is horrible. I am keeping myself busy working my butt off because my husband is laid off, but I am finding myself more & more exhausted. I am afraid my gastro will want to up my prednisone, I am so scared of the side effects... I am also worried that my colonoscopy won't show anything because the prednisone will clear it all up by the time I go in for it (May 1).

I am still trying to understand why I have this disease & what it means to the rest of my life. I am now currently on prednisone & azulfidine. I still am having pain in my lower abd./hips/low back/pelvic area, that everyone seems to think is due to my IBD. I have been on prednisone for 11 days & still have this pain.....

 
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Old 04-07-2008, 01:24 PM   #2
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Re: Inflammatory Bowel Disease....

Hey there, so sorry to hear about your discomfort. But I am happy for you that you are leading in the right direction of a diagnosis. In fact, I am a bit jealous of you. I have been dealing with abdominal pain and a whole mess of other symptoms for 8 months now, and it is really starting to drive me crazy. I feel as though I have been a lab rat with no results. I have gotten a colonoscopy and endoscopy (none of which showed any abnormalities). I have had my blood taken (and this did not show inflammation)... however, my doctor thinks it is still a possibility that I could have chron's in more of the middle of my intestines (the part that he couldn't see with the colonoscopy and endoscopy) and as a result I am now scheduled for an ultrasound (to rule out the gallbladder) and a small bowel series (of drinking barium, icky). Anyways I feel like there is no point anymore, I'm sick of doctors and tests. A diagnosis would be sooo welcomed right about now. I was wondering if I could ask you for some advice as well... if you wouldn't mind sharing, what are your symptoms, and also what tests did you endure to come to a (partial) diagnosis. I feel there are no real suggestions I can give to you in regards to feeling better and relieving the pain, as I am very unsure myself. Hope you feel better though!! Hang in there!

 
Old 04-07-2008, 03:34 PM   #3
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Re: Inflammatory Bowel Disease....

Hi. I am sorry you are having pain too. I understand how frustrating it is.

To let you know what road I went down, I had a small bowel follow through that showed an issue in the ileum/cecum area. I also had a colonoscopy & had inflammation in my colon. Yes, you can have Crohn's & not have it in your colon, but just in your small bowel.

Getting my dx only happened after seeing a gastroenterologist. You need to get a referral to one right away. She looked at my colonoscopy info & also looked at my symptoms & told me right away that I for sure had IBD. There was no question for her.

Did you lose weight? Have you had blood in your stool?

When getting this an IBD dx, you will have these tests that will show SOMETHING:
• Metabolic panel (dehydration & low potassium is what I have had. I was not anemic though, but sometimes it shows that...)
• SED rate (mine was still normal)
• CBC (I had a high WBC, which the GI said is normal with IBD.)
• Small bowel follow through (showed a problem in the cecum/ileum area)
• Colonoscopy (Showed ulcers & inflammation in my colon. Nothing specific for ulcerative colitis or crohn's disease. The problem is I went to surgeon for the colonoscopy instead of a GI & he didn't even look at my cecum or ileum & didn't do a biopsy in that area, so I have to have ANOTHER colonoscopy at the end of this month!!)
• Hemoccult test (Mine was positive. Then I started noticing the blood in my stool, I haven't had it lately though.)

As of late, I have had a bulge in my belly every once in a while, where I am sure my stool is getting caught in the inflammation. I am currently on prednisone, azulfidine & liquid vicodin (The norco pills I was taking weren't digesting, they were coming out hole. I was having problems digesting lots of foods.). I have had dizzy spells & migraines (this is new, never had migraines before).

My current pain (I STILL have abd. pain, too.) is in my hips/pelvis/low back area. No one helps me with this. It is the worst. I don't know if it's due to the IBD or not, and my doctors aren't giving me any info or sending me on for any more tests. It's frustrating. I don't know what else to do.

So, even though I have a dx, my dilema isn't over.... I don't know where to go or what to do about my new pain & no one seems to care. So I guess I am just stuck masking it with pain meds....

I hope all is better for you soon. Let me know if you had any of these tests & what results you had....

 
Old 04-07-2008, 04:48 PM   #4
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Re: Inflammatory Bowel Disease....

Hey there! Thanks so much for the speedy reply, I REALLY APPRECIATE IT! Sorry to hear of all you have had to go through, I can relate to you in terms of getting soo annoyed with the endless tests and endless unanswered questions. As far as the migraines and dizziness... I certainly have those as well, however, sometimes I like to chalk those up to possibly being in so much discomfort. As far as additional symptoms I have mixes of diarrhea and constipation, headaches, chills then periods of sweating, I wake in the night sweating, abdominal swelling and discomfort, back pain, pain under my right rib cage(although this is once and a while, not constant), and a whole mess more that I am sure I missing right now. What is your abdominal pain like? Mine is more a cramping or almost gnawing feeling, however when under the rib cage it is a stabbing pain (making it difficult to breath at times). Went I went to the Dr. I had originally thought I had an ulcer, however, he did some bloodwork and thought I needed to be referred to a gastroentologist. Upon meeting him, he did a colonoscopy and endoscopy all were clear. While I was still asleep from the anestetic, the Dr. told my mom he felt that since he couldn't find anything it was most likely IBS and lactose intolerance, gave me some pills to try and sent me on my way. Well needless to say these meds did not change any of my symptoms. My mom, being in the medical profession, explained to me how often many times doctors write symptoms off as IBS in hopes to move on with the case. I went back in for my follow-up last week, Dr. was surprised that the meds weren't helping for IBS and also the fact that the pain was not just after eating, but sometimes occurred 7-8 hours after digesting anything, and was often present when I woke, and then decided the pain most likely wasn't associated IBS. He told me that it was possible to have Chron's disease in the portion of the intestine that can not be seen via a colonoscopy or endoscopy. (Please forgive me if I am repeating information I have already shared with you, can't recall... and easier to just retype that to skim over again and check). Anyways... since he thought the lower right rib pain sounded like gallbladder issues, he decided to book me for an abdominal ultrasound and for me to have blood work done to check my CBC. My CBC results came into today and everything looked fine, however, my mom informed me that often times CBC will be normal even though there is a problem going on. Anyways, in two weeks I will have my ultrasound. When that comes back normal, as I am sure it will (everything seems to come back NEGATIVE. And don't get me wrong of course I am pleased, but at the same time a small part of me wants a POSITIVE diagnosis, I just want some guidance... I'm starting to doubt myself and wondering if this is all in the head... even though I am not that kind of person, I have always been very healthy and active... I even try to deny colds because I don't want them slowing me down). Anyways... after the ultrasound my Dr. said he wants to run a small bowel series (drinking the barium). Any idea how effective these are? And as a last resort Dr. said that he wants to do a capsule endoscopy. .... Also I found interesting today, it mentioned on a previous board how haaving taken Accutane in the past... how now shown to lead to some cases of Inflammatory Bowel Disease (have you heard this)? To answer your question... yes, I have had blood in my stool but this was only for a cpl of days and then it ceased. Days following I had lots of mucus in with my stool. Upon telling this to my Dr. he told me to get on Miralax to help regulate my bowels (as I have been having diarrhea and constipation). After being on this for a few days, I have 5-6 bowel movements a day all diarrhea still.

Anyways... I am sorry this is so lenghthy... but I really appreciate your advice and story. It's nice to know someone else understands some of the discomfort that you do.

Lastly, I was wondering... your abdominal pain, is it more of a terrible pain you can't move... or more of a discomforting pain? Like a bad stomachache, yet you are still able to function.

As far as the other tests you asked about I do not believe I have had any of those. In truth I feel as though my Dr. is trying hard to write this off, and is not very vocal about what he feels this may be. I understand, he may not be the best people person but I am strongly hoping he has the appropriate knowledge. He comes recommended, and I would love for him to be able to dx me. Otherwise, my mom said is pursaying me to give it two more months, and then without a dx to come to her place of employment (Mayo Clinic) and get checked out. (my fear is having to start all over again with all my tests)...


Thanks in advance for your support! Much appreciated! And wishing you relief!!!

 
Old 04-07-2008, 05:50 PM   #5
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Re: Inflammatory Bowel Disease....

Please listen, you need to be on a diet. Did you doctor give you a diet to follow? If this is IBD, you will notice a change when you start this diet. Look up low residue, low fiber diet. No raw fruits & veggies, no nuts, no seeds. I call it the mush diet. But it does work. It has lessened my frequent BMs. I now have between 2-4. ; ) (May also be the prednisone & the fact that I am on more pain meds than before....) The diet sucks, but the difference is there. If you have CD, you will notice this diet helps at least a little.

The small bowel series (follow through) sucks. But it showed a lot in my case. FINALLY backed up what the GI said that I for sure had IBD. Finally. What they do is make you drink this NASTY stuff & then they take an xray, then another, then when the contrast gets to your large intestine, they take this paddle & do flouroscopy on your small bowel. I had an area where the small intestine meets the large intestine (the cecum & ileum) & the contrast puddled there & stopped. It moved REALLY fast & got all the way down to that area in 10-15 minutes, but then just sat there for an hour. I was already having BMs during the x-ray. I knew right then by the look on the radiologist's face that I had a problem. He couldn't tell me for sure though it if is CD or UC, because he couldn't tell if the problem was in the cecum (large=UC) or ileum (small=CD). Let me warn you, you are going to feel crampy & sick.

I get lots of pains, and to tell you the truth, I don't know if there is more than one thing going on or what. I get pelvic pain in my groin area. I get hip/SI/low back pain. I get this feeling of pressure in my lower abd. I get cramps from time to time. No upper right pain. I have had a problem with my left rib in my back, but that is due to what seems to be a rib out of joint partway. The left rib pain is stabbing & burning & there all the time. The hip/SI/Low back pain is a ridiculous ache that is just hard to handle. It's the worst for me. It comes on after long times of sitting & seems to get better when I stretch & move. Other times I just get random abd pains that are mostly discomfort. A lot of bloating & cramps from time to time, depending on what I eat. (Another hint, keep a food diary of what irritates you, what makes your pains worse or makes your D worse...)

Here's the thing when it comes to doctors... your doctor may be a very good doctor, but crohn's disease is not something regular doctors are used to dealing with. You NEED to see a GI. Period. If you even think you have CD, find a GI.

My other advice? Get ALL your medical records. Everything. All your tests. Sometimes doctors don't think low electrolytes or something is that big of a deal, but it could really mean something for you. YOU are going to have to be your own advocate & research your reports. Here's the thing, the surgeon who did my colonoscopy told me that I would be better in a month of taking the azulfidine. What he really thought was he HOPED I would be better (that's what he told my PCP). I think he thought if he told me that, that I wouldn't feel better at all & I had a better chance if I thought I would be better. The only problem was my brother was dying of cancer at the time, so things in my life were really crazy & I was really really sick for a while & didn't push it because the surgeon told me I would be better when the pills were done. So I suffered wondering. When if I had gotten a copy of his report, I would have seen that I did not have a curable colitis at all, he didn't say IBD, but he did mention lymphocytic colitis, which is another rarer form of IBD (but I am pretty sure it's CD). He didn't think I needed a small bowel series because I had had a CT scan like 4 months earlier that didn't say anything about my bowels. But as soon as I went to the GI she ordered the small bowel series that confirmed what she thought I had, IBD.

I would take your mom up on the Mayo clinic if you don't get anywhere with the small bowel series.

BTW, my mom just had her gallbladder out. She was beginning to have a lot of D with it. So, it could be your problem. Upper right pain, cramping, diarrhea.... Have you had a hida scan? I would think you would need that more than an ultrasound. My mom only had thickening of her gallbladder, no stones. But it was for sure causing problems! She feels so much better now that it is out!

I don't have diarrhea much. It's much softer or I go sometimes a zillion times a day it seems (but not lately, lately, I am going much less). I only had actual diarrhea for a week or so in January when I was getting dehydrated. I go much more frequently since I have been sick than I used to, I used to be constipated all the time & only go two times a WEEK. That's why my docs weren't too rushed to dx IBD... But the GI said that's still a big change in my BMs.

I wish you relief, too! And at least a DX!

 
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