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Could this be IBD? Thoughts?


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Old 10-20-2018, 01:51 AM   #1
jclea
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Could this be IBD? Thoughts?

Hi there,

I have a somewhat odd history of GI issues that have been worsening and are now accompanied by persistent low grade fevers, an elevated WBC count for over 2 months, elevated CRP and ESR for 2 months (though only mildly elevated CRP:15-19 and ESR: 31), joint aches, and fatigue.

As far as GI symptoms go, Iíve had chronic constipation since childhood. My constipation was eventually managed on a regimen of miralax but as a teen I experienced frequent stomach aches and then developed rectal pain and bleeding. I had a workup at that time and after a colonoscopy I was diagnosed with solitary rectal ulcer syndrome attributed to constipation. I was given mesalamine enemas for 6 weeks and the bleeding and rectal pain resolved. I continued to struggle with constipation into adulthood which I managed by titrating my miralax doses. I had several episodes of rectal bleeding and pain over the years but didnít follow up with GI. Constipation remained an issue and I started pelvic floor physical therapy for spasmed pelvic muscles which did help the constipation eventually. Last year the bleeding and rectal pain returned and werenít resolving on their own. I had also lost over 100lbs without making much of an effort at all. I saw a GI and had a colonoscopy and the diagnosis was solitary rectal ulcer syndrome again. They recommended I increase my miralax and continue with pelvic floor PT.

The bleeding and pain continued despite a strict regimen of multiple miralax doses daily to keep my stools soft. In August I had a sudden worsening of pain and was found to have a peri rectal abscess. It was drained under anesthesia and I was treated with 3 days of IV antibiotics. The doctors said sometimes infections like that just happen and didnít seem concerned.

People keep mentioning IBD as a possibility to me but the GI I saw last year didnít feel that was the issue. I wasnít having the joint aches, fatigue, and abnormal lab tests at that time but still IBD doesnít usually present with constipation.

Should I push for another workup given the new symptoms?

Any thoughts would be greatly appreciated!

 
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Old 10-20-2018, 11:02 AM   #2
quincy
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Re: Could this be IBD? Thoughts?

Hi....absolutely IBD presents with constipation if it's limited in the rectum...as your issues are.
With abscesses and ulcer, I thought maybe perianal Crohn's disease.

When did you have the c-scope? And did you have biopsies done throughout?

q
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Old 10-20-2018, 11:06 AM   #3
quincy
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Re: Could this be IBD? Thoughts?

Hi....absolutely IBD presents with constipation if it's limited in the rectum...as your issues are.
With abscesses and ulcer, I thought maybe perianal Crohn's disease.

When did you have the c-scope? And did you have biopsies done throughout?

q
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