# A sufferer from India (Kolkata)



## smt (Jan 16, 2015)

Dear members,

Let me introduce myself briefly. I am a full-time Ph D candidate in a reputed institute of management in india, and had been diagnosed with IBS after a stay at a remote Indian village.* Before describing my symptoms, let me add that I have not been officially diagnosed of CD.
*
I have had loose bowel movements generally, which started 4 years back, after that rural stay. The bowels in most cases were not well formed, but not completely liquid. I went generally once or twice a day.

I took a leave for a year, and returned to my institute in December 2012. The physician, an MD prescribed me Normaxin, an anti-cholinergic, similar to Librax, and after taking that 2* daily, my stools were hard, and once every 3 or 4 days. I cut it down to once per day in December 2013, and that is the dose I use now.

In June last year my mother passed away, and I went home in Kolkata, and visited a gastroenterologist. I underwent blood tests and USG. ESR was 06, and Hb 13.7. USG was normal.

3 months back, I started suffering from balance issues and trembling and fatigue. I was found to be deficient in Vitamin b12 (139 *pmol/l)* I was prescribed 500 mcg of vit B12 per day as capsules. After taking them, my stools became mushy, and once everyday or once every 2 days. That is the frequency even now, after stopping those medicines. I am facing high pressure at work now.

A physician has, on hearing my symptoms suspected UC and has prescribed Mesacol. However, I have not stared it yet. I am scheduled to go home to Kolkata after about 2 weeks for a check-up. Till about 3 months back, I did not have blood in stool. Honestly, I am too scared to check it now. I suffer from gas, and am bloated on many occasions. Due to the contingent circumstances, I am a forced vegetarian, and perforce eat spicy and oily food. In October end, my Hb was 12.8 and ESR 06. Haematocrit, platelets, RBC, WBC were normal. Also, the local physician has this week said that I have normal haemoglobin on clinical examination (below the eye). 

My question to honorable members here is: What does it seem to be? Also, what sort of examinations should I push for when I am in Kolkata, hopefully, after 2 weeks?

I would like to hear constructive suggestions/opinions, from people all over the world. This Ph D means much to me; if necessary I would be able to make change in food quality and habits.

Regards
A sufferer


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## Justanothercp (Jan 16, 2015)

Have you had colonoscopy?


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## SarahBear (Jan 16, 2015)

Welcome to the forum!

Have you ever noticed any blood in your stool, or have you been refraining from checking for it?  Please don't be afraid - if there is any, just let your doctor know and I'm sure it will be dealt with.

I'm also curious if you've had any testing done other than blood work.  If not, a colonoscopy would be an appropriate next step.

You may not necessarily have to change your diet, but it could definitely help you.  Everyone reacts to foods differently - some people with IBD are very sensitive to what they eat while others are not.  It can help to keep a food journal, in which you detail what you eat and your symptoms so that you can more easily make connects between them.

In your situation, I would be certain to ask what testing is to be done to determine a diagnosis.  You may also want to ask your doctor for any suggestions as to what might help reduce your symptoms. 

I hope things go well for you!


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## David (Jan 16, 2015)

Greetings and welcome to the community.

That all this started after a visit to that rural area makes me first wonder about intestinal tuberculosis.

I agree with the others that a colonoscopy may be warranted.

The low B12 makes me think Crohn's is a distinct possibility though.

Are they able to perform a fecal calprotectin test there?


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## smt (Jan 17, 2015)

Dear All,

Thanks for the responses.

Tuberculosis has been ruled out through a TB PCR and low ESR count. This started 4 years back; w/o TB medication, I would have probably died by now.

*B12 deficiency has been attributed to a vegetarian diet. Many people are B12 deficient here*.

Colonoscopy would probably be ordered when I visit Kolkata soon.

Calprotectin test: I would try to find out.

Till October, there was no blood. I used a flashlight. Now, I would check. As I said, an USG had been done. Normal.

The work pressure is difficult to manage. If I have IBD, I do not know what I would do. I expect your guidance. I desperately want to complete the Ph d and earn a little money. There is no social care here, and my family is extremely unsupportive, and that is an understatement. It is an open question as to what would get me first: the stricture, the hunger or the humiliation. 

*Updation*: I visited the local GP (this is not Kolkata, but a small town) and he said he did not know the fecal calprotectin test. Medical care here is quite basic.

Regards


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## scottsma (Jan 17, 2015)

Hello and welcome, we have a forum member who gives his address as Kolkata too.I hope he will see your post and be of help to you. Best wishes.


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## David (Jan 20, 2015)

Best of luck to you smt.  Please keep us updated when you find more.


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## brunotheannoying (Jan 20, 2015)

Paging sid from Kolkata, India.


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## sid (Jan 21, 2015)

`hi smt,

I too am from kolkata. I have crohns since 2010 but it was diagnosed much later. I read your story and I feel sad for you since I too am pursuing my MBA from a management institute in kolkata and I understand how difficult it is to carry on your studies with IBD or IBS. 

I dont what place your are right now where colonoscopy is not available, but thats the first thing you must get done upon reaching kolkata or any city around you where you find this facility and if any sign of IBD detected then a biopsy as well. there are a list of A grade hospitals as well as private clinics in kolkata where you can get it done.

the symptoms dont really give a clear picture, gas and bloatedness is common in CD but it could be just as simple as gastritis. a proper diagnosis is required here. I for example suffer from gas and fatigue and thats pretty much all the symptoms I have. Local herbs and syurvedic medicines helps my case a lot.

Food free of caffein, milk and milk product and gluten helps me immensely, filtering out these may help reduce the gas and bloatedness.


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## smt (Jan 21, 2015)

Hello Sid,

Thanks for the mail. Truly, it is difficult with the IBS/IBD but I have delivered in the coursework; I was within the top 5%ile of the batch in this highly ranked institute. But it is a fact that people do not understand you, and in so far as help from the family is concerned, I am helpless - my mother is no more and my father does not care much. Sibling, the less said about him the better.

I am scheduled to visit Kolkata in early February, and would see a gastroenterologist, a professor. When my mother passed away last year, he advised blood tests: *ESR 06, Hb 13.7*, all other parameters normal. While investigating the B12 deficiency, in October, the tests were repeated: *ESR was 06 again, the Hb was a little less at 12.8*. An USG was conducted in July and it was normal. Based upon these results, colonoscopy was not deemed to be absolutely necessary in August.

How are you now? If it is IBD, can I hope for a remission? Would it be possible to travel abroad with this condition? Currently, with the anticholinetgic Normaxin once or twice per day, I go to the toilet once every day or once every 2 days. Initial part is formed and the later part is mushy with a lot of mucus.

Food here is VERY oily and spicy, and I take toast (gluten). I perforce take milk with tea. I suffer from heavy mental stress.

I am depressed as I would really like to complete this Ph D and then travel; anything short I would consider to be a failure.

I have talked about colostomy with a physician or two, and they have called that a remote possibility.

Please do write in with your considered opinion.

Regards


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## sid (Jan 22, 2015)

smt said:


> Hello Sid,
> 
> Thanks for the mail. Truly, it is difficult with the IBS/IBD but I have delivered in the coursework; I was within the top 5%ile of the batch in this highly ranked institute. But it is a fact that people do not understand you, and in so far as help from the family is concerned, I am helpless - my mother is no more and my father does not care much. Sibling, the less said about him the better.
> 
> ...


to be very honest yours and even my case are very mild compare to what many other CD patients go through. your blood work seem not bad and the other reports are good too and I just hope that your colonoscopy comes clear and there is no CD or UC.About your question on remission, yes, there is every possibility to achieve remission, personally I feel the term remission is subjective. what is remission for others may be a bad condition for me or vice versa since in CD, patients still experience the side effects of crohns. But you will definitely get better with proper care. sometimes medcines work for many and they achieve remission, for some changes in food does the work and many find exercise helpful.

Please dont lose hope, I am 100% sure you will be able to complete this PhD successfully and if you can manage your condition well, then there is no harm in travelling abroad. and very importantly do not be stressed. this forum has a lot of information about food and diet for CD patients, if you follow them, am sure you will definitely know what to eat and what to avoid... i helped me a lot.


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## smt (Jan 22, 2015)

Thank you Sid. 

You say that your and mine disease are mild; do you say this on the basis of the number of times we need to go to the toilet? My frequency is 1 or 0.5 per day.

Most physicians are dismissing it as IBS going by the blood count. My weight is fairly constant. Your opinions?


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## smt (Jan 22, 2015)

The opinion of many is that in IBD, without real drugs, one needs to go to the toilet many times a day. With Normaxin once per day, my frequency is 1 or 0.5 per day. Also, my food is very bad: spicy and oily.


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## smt (Jan 23, 2015)

I request anyone on the forum to answer my questions; after all we are all sufferers. Also, the inhuman treatment that I have got from my parents (one of them is no more) and sibling is bothering me a lot. Emotionally I am drained, and suicide is a consideration.

Regards


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## Justanothercp (Jan 23, 2015)

smt
I have moderate to severe crohns but only go to bathroom 1-2 times/day.  I think it largely depends on the type of crohns.  Mine is "stricturing" more than "inflammatory". I take Remicade, Lialda, budesonide, omeprazole, and a number of supplements.  I have had one resection.
I think we all get to the point of despair at some time, but I believe the right treatment can get you out of that, even if it means surgery.
Personally, I found the Paleo diet to really help with my day to day symptoms.
Good luck to you.


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## smt (Jan 23, 2015)

Justanothercp said:


> smt
> I have moderate to severe crohns but only go to bathroom 1-2 times/day.  I think it largely depends on the type of crohns.  Mine is "stricturing" more than "inflammatory". I take Remicade, Lialda, budesonide, omeprazole, and a number of supplements.  I have had one resection.
> I think we all get to the point of despair at some time, but I believe the right treatment can get you out of that, even if it means surgery.
> Personally, I found the Paleo diet to really help with my day to day symptoms.
> Good luck to you.


Thanks. I am as yet undiagnosed; please go through my reports (blood and USG above). All I want is to continue my research in management. And hopefully, go to the UK/Europe as a teacher/researcher. I should be able to work, that is all I want even if for the next 5 years.

Regards


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## Clash (Jan 23, 2015)

Since there are many illnesses of the GI tract then a colonoscopy would be the standard for diagnosis.

Blood work can be widely varied by those suffering from CD so not a good decisive tool. A USG can sometimes pick up abscesses but is also not great at detecting inflammation that may be present.

IBD is so highly individual that symptoms can vary greatly from one person to the next. It would be a good idea to keep a journal of your symptoms and bowel habits so you can relay them to the specialist at that appointment.

Once you are able to get more testing and a diagnosis then treatment can begin and remission could be quick. Many of those with CD have a full life with career, family, travel, finding the right treatment can make all the difference.

I hope the upcoming trip proves productive in finding a specialist that can run the appropriate tests and find the root of your symptoms.


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## smt (Jan 23, 2015)

Clash said:


> Since there are many illnesses of the GI tract then a colonoscopy would be the standard for diagnosis.
> 
> Blood work can be widely varied by those suffering from CD so not a good decisive tool. A USG can sometimes pick up abscesses but is also not great at detecting inflammation that may be present.
> 
> ...


Thanks for answering. Don't you think that blood inflammatory markers and hemoglobin would have showed up the inflammation if it was present? The GI physician told me that he would have ordered a colonoscopy had these been off; however, that was not the case.
Also, what is your opinion of the fecal calprotectin test? 

Regards


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## Clash (Jan 23, 2015)

Inflammatory markers can be a good indicator for a lot of those with IBD but not all. My son's blood work(inflammatory markers like CRP) is normal regardless of the level of active disease going on. So even when he is in a flare his blood work is normal. For this reason we use the fecal calprotectin stool test since it detects inflammation in the GI tract only and is a good tool for him.


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## smt (Jan 24, 2015)

Clash said:


> Inflammatory markers can be a good indicator for a lot of those with IBD but not all. My son's blood work(inflammatory markers like CRP) is normal regardless of the level of active disease going on. So even when he is in a flare his blood work is normal. For this reason we use the fecal calprotectin stool test since it detects inflammation in the GI tract only and is a good tool for him.


Thank you for the reply. I am scheduled to go to Kolkata in 8 days' time, and would undergo the tests. I only hope that I would be able to come back and resume my work with my colon intact. I am scheduled to finish my doctoral coursework in the next 6 days, and I am preparing my prospectus. I am under pressure. Also, the food is very oily and spicy, and I perforce eat small portions. The food at home is much better in Kolkata. The local physician did not know about the FC test; I hope that they would know in Kolkata.

I wish your son the very best. 

Regards


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## Clash (Jan 24, 2015)

Of the tests, still the colonoscopy, endoscopy and some type of imaging like CT scan or MRE will be probably the most useful.

A fecal calprotectin stool test is a great tool for determining if their is inflammation in the GI tract but it can't decipher what the inflammation is or where in the GI tract it is. So definitely a much better tool for after the official dx.

Some docs do use it as your doc used the inflammatory blood markers meaning to determine if further testing is warranted.


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## Snomir (Jan 24, 2015)

Hi,
to get a colonoscopy is the smartest thing to do. I had a normal bloodwork and calprotectin, but despite it they have found ulcers in my TI. Symptoms - on and off gastritis without proof on gastroscopy, lack of appetite, constant mushy stool, pain where a gallbladder is situated and lately back pain. B12 insufficiency can be because you are a vegetarian. Beware that I am still not officially diagnosed (due to normal FC and lack of D), but Pentasa did a big difference for me.


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## smt (Jan 24, 2015)

Snomir said:


> Hi,
> to get a colonoscopy is the smartest thing to do. I had a normal bloodwork and calprotectin, but despite it they have found ulcers in my TI. Symptoms - on and off gastritis without proof on gastroscopy, lack of appetite, constant mushy stool, pain where a gallbladder is situated and lately back pain. B12 insufficiency can be because you are a vegetarian. Beware that I am still not officially diagnosed (due to normal FC and lack of D), but Pentasa did a big difference for me.


I would ask my physician in Kolkata to give me a colonoscopy. I very occasionally have felt pain in my right abdomen, but no back pain. You say bloodwork was normal: can I know your ESR, HB, WBC, CRP and haematocrit values? 

The food here (today I had biryani, a type of Indian food, oily and spicy) does not help. I would get my own apartment and cook if they diagnose me and I am good enough to continue. The authorities would, hopefully, cooperate.

Regards


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## Snomir (Jan 24, 2015)

SED 6 (4-24), WBC 8 (3,4-9,7), CRP 1,54, HB 138 (119-157), haematocrit 0,405 (0,356-0,47), calprotectin < 30 (<50). I have had an ultrasound and MRI. Colonoscopy was the last thing they did. And they have found a couple of small ulcers in my terminal ileum.


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## smt (Jan 24, 2015)

Snomir said:


> SED 6 (4-24), WBC 8 (3,4-9,7), CRP 1,54, HB 138 (119-157), haematocrit 0,405 (0,356-0,47), calprotectin < 30 (<50). I have had an ultrasound and MRI. Colonoscopy was the last thing they did. And they have found a couple of small ulcers in my terminal ileum.


My reports were nearly the same: Sed 6 both times, WBC 6.2, CRP not done, HB 13.7 and 12.8 (normal by local standards), HCT 40. 6%.

Do you think MRI can help? I am a little wary of the colonoscopy. 

I believe local GI physicians need to look at their skills and see if they can improve.

Regards


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## Snomir (Jan 24, 2015)

MRI is a quite expensive thing to do, and trust me, if there is something to show up on MRI, you would feel it much worse than just an occasional RQ pain. Mine did not show a thing. Colonoscopy is nothing to worry about. Mine took around 15 minutes, I was a bit sedated and did not feel a thing. But if you are so afraid of it, maybe it would be the best to make a calprotectin test first. It is said to be a really sensitive inflammatory marker (not in my case though).


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## smt (Jan 24, 2015)

Snomir said:


> MRI is a quite expensive thing to do, and trust me, if there is something to show up on MRI, you would feel it much worse than just an occasional RQ pain. Mine did not show a thing. Colonoscopy is nothing to worry about. Mine took around 15 minutes, I was a bit sedated and did not feel a thing. But if you are so afraid of it, maybe it would be the best to make a calprotectin test first. It is said to be a really sensitive inflammatory marker (not in my case though).


Thanks. My institute has become access compliant and my doctoral coursework would hopefully be completed in 6 days; I would like to continue the Ph D very much taking advantage of the access compliance. I would go for colonoscopy - I have read that there is a danger of injury to it. Is this true?

I do not get any help from family (my father or sibling or anyone). Since here there is no social security, I would have to die if i cannot work.

Regards


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## Nym (Jan 24, 2015)

Try some fermented foods, bone broths, stewed, easily digestible meats off the bone. Keep it simple and highly nutritious.


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## smt (Jan 27, 2015)

Anyone, please answer this: what are the signs of intestinal obstruction? Is the pain that I feel for a minute or so very occasionally a sign (on the upper right quadrant; occasionally below the left rib cage)? Occasionally, I am nauseated; the physician says this is a symptom of IBS.

Regards


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## smt (Feb 16, 2015)

Thanks all. I have visited the GI specialist and the neurologist. I asked the former for a fecal calprotectin test and a CT scan. Unfortunately he was not willing and said that I can do a colonoscopy. Before doing this he also asked me to go to a neurologist and get bloods (B12, D3 CBC etc done) as per his advice. I have visited the neurologist as well. Now is the moment of truth. i would like to have your advice regarding colonoscopy. I understand it is a fairly safe but painful process. The other question is he has not written biopsy on the script. An individual told me that if something is not apparent they would not do it. Can you advice?

I am very wary of all this. My future plans, even livelihood is at stake. I would lose my identity, my work and eventually my bread if I continue to live with any illness. There is no social care in this country. I am thinking of the humiliation. I understand all of you are in this position. With great respects to all fighting this illness, if I get to hear any word of advice including if anyone has successfully fought this off I would be very grateful.

Regards


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## smt (Mar 19, 2015)

Dear members,

During the past 1 month I have gone through consultations with about 5 consultants. A neurologist tested me clinically and sent me for blood tests. I am now in the normal range in B12 (305 pg/l) and very normal in folate. However I am severely deficient in D3. CBC was also done. HB 14.1, HCT 44.8, lymphocytes, erythrocytes, platelets are normal. TSH, T3 and T4 are normal as well. MCV was at 82.5 and RDW was at 14.1%.

I went for my colonoscopy last week but due to the pain I felt they aborted it and repeated it this week. I was not properly sedated I think. They repeated the procedure again this week and this time they could reach the caecum. *The scope is normal.* Only a few internal hemorrhoids were seen. I took the report to the GI doc and he was satisfied. He says that I have IBS and can go back to my work.

Any suggestions are welcome. I thank you from the bottom of my heart for standing by me in this time. If and when the need arises I would again knock this door. 

Thanking You,
SM


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## buttER (Mar 19, 2015)

Dear smt

I have just been reading through your story and the posts.

For some of us, a diagnosis of IBD took years. 

My message to you is to look after yourself. Use this forum and other sources to find out ways to improve your digestive health. Once you start feeling better then everything in your life will be easier and not a battle.

Diet
You seem to mention fatty and spicy is bad for you. If you really think those foods make you feel worse, then try and avoid them. If you can cook for yourself, then you can control what you are eating alot more easily. I am sure many on the forum follow quite strict diets because they know it is helping them (and not because they really find it delicious). It is a slow process to work out what helps you and what you should avoid, but it is worth it. Try to keep a balanced diet though. For example, I avoid all dairy products but make sure I get enough calcium from other sources.

Stress and sleep
It seems to me you are putting alot of pressure on yourself and it is causing you to feel depressed. There is a link between stress and gastrointestinal symptoms. Please try and reduce your stress (easier said than done) and make sure you get enough sleep. Be realistic, life is not a race or a competition.

Be kind to yourself and look after yourself!

I have a PhD, I have worked in different countries, I admire your ambition. Now 20 years later I can seriously say that living a healthy lifestyle is more important to me than my career status. In fact, I even changed job direction to find something that suited me better.

Good luck and don't give up.


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## smt (Mar 19, 2015)

King of Orange said:


> Dear smt
> 
> I have just been reading through your story and the posts.
> 
> ...


Thank you sir. Your achievements give me hope.

The fact remains that at this time, there is nothing more that I can do. I already have 1 botched and 1 normal colonoscope. The GI doc would not give me any more time. Today he shooed me away saying that everything is normal. Everyone, from my father and my relatives to the physicians hate my habit of studying and consulting these matters on the Web, and I am a known "trouble monger" in this regard. 

Also I am aware that they did not go into the ileum, and here they probably do not go that far. I have spoken to 2 individuals here who had scopes, but unfortunately they were not aware of anything. 

I get your hint that method of science is falsification and we have to falsify the hypotheses that one has Crohn's. Unfortunately, unlike in the West, this is not a philosophy which most people appreciate here. For instance,  my father or my physician told me that this episode is now closed and I should not talk about it. One of my cousins told me that I should think "positively", whatever that means.

I thank you for reading my post and answering.

Regards


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## buttER (Mar 19, 2015)

Thinking positively is good for you. Do not panic about what might or might not happen in the future, enjoy your life now.

As for your illness, believe in yourself and your instincts, do not expect people around you to look after you or understand, the only person who can help you is you (anyone elso who will help you is a bonus). Once I accepted I had to look after myself I started to feel alot better.


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## smt (Mar 20, 2015)

Dear members,

Thanks to all who replied. Although somewhat relieved at the clean scope, I understand that the method of science has to be followed, that is to say, constant efforts have to be made at falsifying the hypothesis that one is suffering from CD. Under the circumstances, with physicians who are not very caring and other engagements, I would like to request you to tell me what can be done in the future. Please also keep in mind that I live in a developing country where physicians generally do not like to be challenged by patients. Hence if I ask for this test or that, they would not be impressed. The GI doc told me, for instance, that the FC test is a "bogus test".

Regards


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## UnXmas (Mar 20, 2015)

smt - you should feel reassured by your colonoscopy result. There are a lot of things that can cause your symptoms, and your symptoms are not particularly suggestive of Crohn's. Crohn's typically causes diarrhoea - often several times a day, and sometimes the diarrhoea can be bloody - and abdominal pain, which can be mild, moderate or severe. Fevers and weight loss can also occur.

While a normal colonoscopy does not rule out Crohn's, it does make it less likely, as well as ruling out many other causes of digestive issues. 

Is there any possibility you could get an endoscopy of your upper digestive system? This would check areas that aren't covered by the colonoscopy.

Which of your symptoms are preventing you from being able to work as you would like? While it is difficult to treat symptoms without knowing the diagnosis, it isn't impossible, and members of this forum may be able to advise you about managing symptoms such as diarrhoea and fatigue.


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## smt (Mar 20, 2015)

UnXmas said:


> smt - you should feel reassured by your colonoscopy result. There are a lot of things that can cause your symptoms, and your symptoms are not particularly suggestive of Crohn's. Crohn's typically causes diarrhoea - often several times a day, and sometimes the diarrhoea can be bloody - and abdominal pain, which can be mild, moderate or severe. Fevers and weight loss can also occur.
> 
> While a normal colonoscopy does not rule out Crohn's, it does make it less likely, as well as ruling out many other causes of digestive issues.
> 
> ...


Thank you for the answer.

I used to suffer from mushy stools and occasional diarrhea but after I started taking an anticholinergic similar to Librax I have gone once every two days. As I said stools are generally solid followed by mushy.

Whenever I take oily food (occasionally unavoidable) or are under stress etc. I get gas cramps. The stool becomes softer. Also I get acid reflux occasionally when asleep. And then there is the occasional bloating towards the evening. But  when I am relaxed and eat simple these things are minimal in intensity. 

Currently I have not been able to go for 4 days following the colonic wash. I have a strong appetite.

There is some amount of fatigue but not extreme.

I have not lost any weight. I do not generally have a fever.

Regards


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## UnXmas (Mar 21, 2015)

It honestly doesn't sound like you have Crohn's disease. Untreated Crohn's would usually cause symptoms more severe than those you describe. Again, I'm not saying it's impossible you have Crohn's, just that it doesn't sound likely.

Are your symptoms currently severe enough to be affecting your work, or are they interfering with your life in any other ways? From your description of your symptoms, as long as they don't deteriorate I don't think you should worry that they will prevent you from completing your PhD or traveling or doing anything else you want to do.

Are you able to purchase medications? You may be able to buy medications from an online pharmacy if they are not available where you are. There are many medications that can treat reflux and diarrhoea. For example, Imodium (also called loperamide) is an effective medication for diarrhoea and where I am (in the UK) it can be purchased without a doctor's prescription because it is a very safe medication. The same is true of some reflux medications such as Zantac Ranitidine. If you can find an online pharmacy who deliver to your country, let me know if you'd like more suggestions of medications that can be purchased "over-the-counter" - i.e. without needing to see a doctor or get a prescription. Different countries have different laws regarding what medications can be purchased in this way though, so you'd need to check the laws where you are.

It might even be possible for you to have food delivered, or maybe if you found somewhere that sold food that is easy on your digestive system, you could go buy large stocks of food that is non-perishable to keep at home, so that you always have the food you need available. Things such as bags of rice, and tinned food that won't go off. What sorts of foods are available where you are? Do you know of any online supermarket that will deliver to you?

If you are able to find a few medications to ease your symptoms and plan a way to sort your diet out, it may be possible to make great improvements in your health. It will take a bit of trial and error though, so don't be disheartened if things don't work out right away. If possible, try to find a more helpful doctor as well. I realise that's not easy, but it would be good for you to have the reassurance that you're seeing an expert about your health as well as the efforts you are putting into making yourself better.


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## UnXmas (Mar 21, 2015)

This is an example of a medication which treats diarrhoea, bloating, and stomach cramps, and which you can buy without consulting a doctor, if you are able to find somewhere that will deliver to your country:

http://www.imodium.com/products-imodium-multi-symptom

This only treats symptoms though, it doesn't treat underlying causes of digestive problems such as Crohn's.

However, from your latest post it seems you already have an effective treatment for diarrhoea. Are you able to stay on your medication long term or are you looking for other treatments? So at the moment your symptoms are sometimes loose bowel movements, some stomach discomfort and reflux and fatigue. This honestly doesn't sound like the kind of illness that's going to ruin your life in the ways you described in your earlier posts. I understand that it's disturbing to not know what is causing your symptoms and it would be sensible for you to keep trying to get medical tests to make sure nothing major is wrong, but don't put your life on hold because of this. 

What made you suspect you have Crohn's as oppose to the numerous other possible causes of your symptoms? In my first post to you, I asked you which of your symptoms are preventing you from being able to work as you would like, and I'd still like to know your answer to this, to know how your symptoms are interfering with your life and preventing you from doing the things you want to do.


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## smt (Mar 21, 2015)

UnXmas,

Thank you for replying. The symptoms that I mentioned, along with the fact that occasionally the bloating is severe, hampers my work. When I am bloated it is difficult to study or even walk. On top of that, I cannot burp from my childhood. And there is a problem of gas formation, which I have to expel through the rear as I cannot burp.

Medicines are available. Imodium and its generic as well as Rantac and PPIs such as RZole are available. However I take 1 Normaxin, an anti-cholinergic which decreases gut-mobility. This is a habit forming drug. It is difficult to get rid of it.

I have gone through various accounts on the Web, and thought that symptomatically speaking, it is difficult to distinguish between IBS and mild Crohn's. Probably, I do not have much of the red flag symptoms. However, India does not have many Crohn's patients. UC is the more prevalent disease here, especially in Kolkata. I, however, think that some UC patients might actually be Crohn's patients.

As regards food, I am thinking that I would employ a cook for my own. No, there are no online food stores in small towns here.

Regards and best wishes


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## UnXmas (Mar 22, 2015)

> As regards food, I am thinking that I would employ a cook for my own. No, there are no online food stores in small towns here.


I meant that you could order online from a supermarket based elsewhere. Have a look at online retailers and see if they will deliver to you. 

Is your medication still working for you? If not, you can gradually reduce the dose. You can also try medications for your other symptoms while still on the Normaxin as long as there are no negative interactions between them.

UC would have been detected by your colonoscopy if you had it. But there are many, many causes of your symptoms besides UC, Crohn's and IBS. Those are just the most common ones so they come up in online search results. There are numerous other causes of bloating and loose stools that you won't find as easily searching online.

I'm still not quite sure why bloating would prevent you from working, unless it's extremely painful? Have you read other threads on this forum to see how others manage to live and work with severe diarrhoea, passing blood, severe pain and other symptoms?


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## UnXmas (Mar 22, 2015)

This page lists some causes of abdominal bloating (it's written for medical professionals, so the language is difficult, but you can at least see that there are s lot of causes of bloating):

http://www.patient.co.uk/doctor/abdominal-distension-and-bloating


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## smt (Aug 7, 2015)

Hello members,

After a good four months after the normal colonoscopy in March, I am facing a rough time again. For the last 10 days or so, I am suffering from severe bloating after every meal. The doctor has prescribed PPI, that helps to an extent. I have minimal appetite and for the first time in years am suffering from completely mushy stools for the past three days. The GI doc calls it an IBS episode and is not worried. I had to go 4 times today. Normally, I go once every 2 days and the stool is solid followed by a little mushy. The pressure at work is high and the food is very oily. The GI has declined to give any more tests. Any suggestions please?


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## Madhu (Aug 7, 2015)

Hi smt,

My husband and I are from India too. Chennai actually, but we are in USA now. After coming here, he got diagnosed with Crohn's disease and currently under treatment. Your earlier posts didn't sound much like Crohn's since you didn't have huge symptoms but maybe now you should get checked again? I know how doctors in India work, try going to a hospital and finding a big gastroenterologist. As for the diet, I avoid tamarind (imli) for my husband and also reduced oil. Include a lot of protein in your diet, his GI recommended more chicken and fish, but since we are vegetarians we just increased the amount of dal in his diet. Please feel free to talk whenever you feel like and list out all your symptoms you feel so that somebody might help to give suggestions. Hope you feel better soon


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## smt (Aug 7, 2015)

Aarthiji,

Thanks. I am sorry that your husband is suffering from CD, but indications are that he is getting towards remission. I am sure he would do well soon. I visited a gastroenterologist yesterday and he has diagnosed this as IBS and nothing else. That was the diagnosis in Kolkata by a professor of the medical college last March. Yes, more protein is desirable, but due to my location (the state) not much of that is available. In any case, whenever I ask for the fecal calprotectin test or capsule endoscopy the physicians dismiss them. Also, it is undesirable that one gets a second colonoscopy too soon. These are the difficulties that one faces. 

The symptoms that I have felt in the last 10 days or so are:

Nausea
Bloating after meals
Mushy stools multiple times during the last few days (I generally go once every 2 days)

Regards
SM


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## Madhu (Aug 7, 2015)

I understand. But apart from requesting the doctors for the tests, I don't know what else we can do right?  I wish doctors there are more understanding. When my husband was diagnosed initially, we sent his reports to doctors in India thinking they would be able to help us and we don't have to go through all the pain. But I came to know that awareness for CD is very low in India and being here far from home was the best option for us. 

Consuming oily food can increase your nausea. I know you're doing your PhD, so you might not have much time to spare. But would it better if you try your hand at cooking? Atleast making some rice and dal at wherever you stay can help in consuming a bland diet and may provide you relief for a while. Not sure if it is possible for you, just a suggestion. Also, do you have medical insurance? If so, does that help in covering for the colonoscopy and other tests?

Aarthi


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## smt (Aug 7, 2015)

Thanks for the suggestions. Yes, the US/UK/Europe is a far better place for advanced treatment. You are right; I am negotiating with the authorities to get an apartment on campus, and I would employ a cook I think. 

Tests are very cheap in India. The colonoscopy cost me less than INR 3,000 in a top facility in Kolkata. I have some sort of medical insurance, valid in some local hospitals only. I paid for the colonoscopy on my own.

Regards


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## Madhu (Aug 7, 2015)

That's really good then. Eat a lot of curd, dal and avoid spice, tamarind in your food. It should definitely make you feel atleast a little better. I hope you feel better soon


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## smt (Aug 9, 2015)

Members,

Although I had a little appetite yesterday, the stools are still mushy and without any shape. It is also very difficult to eject them out, and the gas is not coming out. Perforce I had to eat bread yesterday night as there was no rice available, and I had to go to the toilet in the night. The GI doc would not listen to me even if I call him - he is saying this would be cured in 7 days as this is IBS. Any advice would be appreciated.


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## AnnieYa (Aug 9, 2015)

smt said:


> Members,
> 
> Although I had a little appetite yesterday, the stools are still mushy and without any shape. It is also very difficult to eject them out, and the gas is not coming out. Perforce I had to eat bread yesterday night as there was no rice available, and I had to go to the toilet in the night. The GI doc would not listen to me even if I call him - he is saying this would be cured in 7 days as this is IBS. Any advice would be appreciated.


From reading through the previous posts, I don't think you're going to get much help in the doctor-department. My advice is food diary - write down what you eat, when you eat it, and when you get any unpleasant symptoms. This will hopefully pin-point a bit better which food sets you off (as it sounds strongly diet-related). 

I know that certain regions of India are vegetarian, but are you still allowed milk? Rice pudding would be a good option to try out, provided you're not lactose intolerant. This will remove the spice and oil aspect of the food you are eating, to see whether it helps. Plus it's really tasty and easy to make, my version is simply rice, sugar, milk, vanilla and a little butter. Vanilla could be replaced for cardamom as well, to good effect.

Once you have an idea of the specifics of which foods set you off, you can then look into the science a bit more and try to identify what about that food sets you off. Then you can avoid food likely to have a similar effect. This should at least relieve your symptoms.


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## smt (Aug 9, 2015)

I am sorry that you have been suffering as well. Thanks, but I am lactose intolerant as well.  You are right, it is strongly diet-related I think. When I get to eat fish and rice, I am so well.

My father holds physicians in high esteem, although there are many cases of misdiagnoses and is constantly saying I do not have anything. I am having dark brown stools - they are saying black and maroon and red means blood. Cannot say for sure. Today I had stools once, and I have taken only lunch and felt nauseous after. Lunch was spicy. Skipped tea, and not very hungry for dinner. 

Regards


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## smt (Aug 24, 2015)

Hello all,

I noticed something which I had noticed earlier as well, but I need an advice from people out here. I went to the toilet just now, after 2 days, and although the stool was of reasonable consistency, and dark brown in color (I have this color most of the time) I saw occasional blotches of *darker brown*, which I cannot describe as black as in tarry black, *but very dark brown*. This I had noticed earlier as well.

I am going to a good surgeon tomorrow in a local hospital, he seems to be good. He diagnosed the H. pylori infection of a colleague. I am thinking of going to Kolkata for a check up sometime mid September, about 20 days from now. I am really terrified, thinking that I am going to lose my career and so on. This is a traumatic situation in a developing country. Any advice is welcome.

Would I be able to continue my work with Crohn's? For the record, I had a normal colonoscopy and blood work in March, *but crucially they did not enter the terminal ileum.* Physicians are dismissing me as a hypochondriac, and my father is calling me an unworthy person, and I just feel like jumping from the nearest roof.

Regards


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## scottsma (Aug 24, 2015)

A very many people with Crohns lead a normal life,they have families and jobs and commitments that they must get on with.I can understand your concern about losing your job,but you really shouldn't worry about something that hopefully will never happen.Wait and see what your new specialist says and take it from there.Worry can make you ill,so unless you're sure you've got something to worry about,try to be positive.
Think instead of the good things in your life and your hopes for the future.Let us know what your new Doctor suggests.Best wishes.


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## smt (Aug 24, 2015)

Thanks for replying. I have just floated a new project with the faculty for our post-graduate candidates, and I would need to stay for at least the next 20 days or so. That commitment I need to fulfill in the immediate term, and as you understood, my life is falling apart. Friendships, commitments, everything, and I cannot answer a simple question honestly to people who ask: what am I suffering from? No one should wait forever, and I am sick and tired of this. 

My GI told me that the "entire stool would be black", I think called melena, and dismissed this as nothing. Really really sick.


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## smt (Aug 26, 2015)

Dear all,

I went to a new surgeon in a locally reputed hospital. He and his PG students listened to me intently, and saw my papers (colonoscopy and bloods and USG). I told him about the very dark brown spots in stool, he listened. Then he asked me: "Do you have severe pain in the abdomen?" to which I said that I have felt light pain occasionally. He looked at me straight in the eyes and said: "(my name), you are suffering from stress." For my bloating he prescribed a PPI, and referred me to a psychiatrist. He further said that he was willing to write on a legal paper that I do not have Crohn's. He explained the very dark brown spots on the basis of bile secretion. I went to the psychiatrist, and he talked about the mind and so on, and I had to listen to that.

Really do not what to do now. Calcutta is a big city, and some days later maybe there would be some help there when I go, but feeling very very blue.

Regards


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## Madhu (Aug 26, 2015)

Hi smt,

I think it is a really good sign that the doctors swear it is not Crohn's. You really don't want it  As they say, maybe your PhD and living outside of home could contribute to stress. And stress almost always causes tummy trouble. I would say you take it easy, take the pills and see if your tummy trouble comes down. If not, you can go back to the doctor again. As for the stress, see if you can do yoga or meditation for just a few minutes everyday to calm your nerves. I dont think you need a psychiatrist. This could just be nerves. Hope you feel better


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## smt (Aug 26, 2015)

aarthi said:


> Hi smt,
> 
> I think it is a really good sign that the doctors swear it is not Crohn's. You really don't want it  As they say, maybe your PhD and living outside of home could contribute to stress. And stress almost always causes tummy trouble. I would say you take it easy, take the pills and see if your tummy trouble comes down. If not, you can go back to the doctor again. As for the stress, see if you can do yoga or meditation for just a few minutes everyday to calm your nerves. I dont think you need a psychiatrist. This could just be nerves. Hope you feel better


Aarthiji,

Thanks so much for the encouraging message - I really appreciate that. I would sincerely like to believe the physicians. I have learned a few mindfulness techniques from a psychologist and occasionally use them. I am trying to reduce stress. I agree that it can be a case of nerves, and it is possible that the physicians are right. 

I understand that your husband is making steady progress, and extend my best wishes to him, and you. I am sure he would beat his illness.

Best regards
SM


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## happy life (Oct 28, 2015)

Hi , I am new on this forum, 1am 21 yrs old and suffering crohns


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## earthshine (Nov 2, 2015)

smt,
i had diarrhea issues begin while visiting india about 2.5 yrs ago.

when i returned home to US, mostly 1-2 bowel movements per day and sometimes unformed but not watery.

i feel probiotics (need to start slow and see what works for you...too much can be bad also) help. i use orthobiotics brand, which i order on amazon.com. i take one at night.

if you picked up some bacteria your system was not used to while in the village, perhaps that is causing an issue. i think that is what might be contributing to my concern. so probiotics can help to balance the intestinal flora. also, read about oil of oregano.

my tests have all been negative, but unfortunately this on and off diarrhea has taken a toll on my body and now i have an anal fistula. so i may need to consider crohn's medicine, though that is a last option for me. you are fortunate in india that there are many center which offer ayurvedic treatments for these types of issues, which have higher success in treatment.

with respect to stress, check out this online guided meditation

www.ishakriya.org

there are also videos for yoga practice, look up Tools from Sadhguru on youtube or as an app.


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