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A new and unusual case!

Hi guys

I'm Lulu, I'm 26, I'm almost a doctor myself (hopefully in 6 weeks) and I was diagnosed with Crohn's in september, largely on some non specific signs and my gastro's clinical suspicion.

I don't tend to have long flare ups like most patients, instead i get flares that last 2-3 days max, with the most incredible abdo pain and obv loose stools often with blood and often the pain makes me vomit. I lost a lot of weight with the crohn's before I was diagnosed, but since I was started on mesalazine I've found my symptoms to be much less and I've put my weight back on.

I guess I'm here for support and to try and find other unusual cases like mine, I'm currently in the middle of the worst flare of the disease I've had, indeed it's the only flare I've ever had that's caused my CRP to raise.... and oddly my ALT also (which consultants have said can also be an inflammatory marker although I've never heard of this and a recent literature search churned up nothing!).

I've found this forum now because this recent flare is occurring as I'm sitting my medical finals to finally qualify as a doctor, and I'm at the end of my tether with it! I sat 2 exams last week with a proximal bowel obstruction before being admitted to hospital and having to sit another exam as an inpatient (med school is next door to the hospital and the drs very kindly let me leave to sit the exam and return to the ward when it was over). I'm really just completely depressed at the moment, I have another 2 exams this week and although I've persuaded doctors to let me home to revise, I'm still very unwell with my symptoms currently (although my symptoms are now the opposite to crohns as I took an overdose of loperamide [immodium] and some codeine when my crohns flared just before my first exam and I managed to obstruct myself for 24 hours! So now Im trying to pass everything thru my system with little success and Im in an horrendous amount of pain).

So sorry for the rant and possibly even a little too much information, I just feel currently like I have nowhere to turn at all.

I'm just hoping to find someone else who has an unusual presentation of their crohn's like me.


L xx


Your Story Forum Monitor
Hi Lula and welcome! I am glad to hear your Crohn's seems to be under control with thanks to mesalamine, but I am sorry about your current flare. It could be due to all the stress of your exams. I sure hope it passes soon as your others in the past. Good luck with everything - let us know how those exams go!


Naples, Florida
Hi Lulu,

Welcome! Congratulations on almost being a doctor, that's fantastic. It must have been a long journey for you and that's exciting that it's coming to fruition. I'm just so sorry to hear that Crohn's has reared its ugly head at this point. However, I do believe there is a reason for everything and maybe your being a doctor and being able to literally feel the pain others have may somehow come into play.

By all means, post in the other forums to see if you can find others as you expressed a desire to do. And we'd love for you, once you get things under control and learn more about IBD from a professionals perspective to come back here and share. As you can see, there's a lot of people in dire need of support here.

*hugs* to you.


Staff member
Hello Lulu,
sorry to hear that you are having bad flares right now.
My flares come a few days at atime but there are repeats regularly.
Also every bm has blood sometimes more than others.
I do get nausea and abdominal pain most nights, wake up from sleep with it, and usually need at least one bathroom visit. My GI terms it mild crohn's.
Cortifoam enemas seem to help but when I finish a course the symptoms return.
I have refused imuran because of high incidence of cancer in the family.
The next appointment with the GI will decide an alternative course of action.
Mostly I can cope with it, but the pain and nausea can be very tiring to say the least.
I cannot take salicylates in any form due to a former bleeding problem.
My CRP and ESR are both greatly increased. ALT is ok though.
Hope you will soon feel better and good luck with your exams, what an awful time for you to flare.
Thanks guys, it is so nice to have all your replies and feel less alone! In a professional capacity I know an awful lot about IBD, but that does not help at all with actually dealing with the disease. I'm also realising that despite my determination to not let it stop me, it will have to influence the path in medicine I take; I doubt I could be a surgeon because flaring during theatre time would not be ideal!!

Trysha, your flares sound very similar to mine, I also wake in the night to go, in fact thats often how a flare starts! The flares for me are short lived but quite frequent; a few days flare, a week of being fine then a few days flare again! But very recently I enjoyed six whole weeks of quiet until this latest very very bad flare!

What gets me so much with it is the PAIN! My word there is no pain like it!!! I consider myself to have a high pain threshold but this pain can have me in tears!

The docs at the hospital offered me immunosuppressants but Im very reluctant to start down that road at this stage; and working in a hospital (well hopefully, I do have a job waiting for me should I pass my exams) it's not ideal to have a poor immune system so I'd rather trudge on with the 5ASAs.......

Yes David I'm very excited to be about to qualify, Im just worried that with all this going on I may fail! But Ive carried on regardless so hopefully I'll pass........

Its so nice to meet you all and have some understanding support! My partner is great, but he's a doctor and I'm constantly surrounded by doctors and medics in my social life and they're all lovely but only understand from a professional point, and its sooooo different on this side of things!

Welcome. I think you will learn that everyone has a very unique presentation of the disease. I don't think there are many "textbook" cases on here. Me for example - 3 hemorrhages and zero other symptoms.ever. Weird huh? I, like you, did not want to go on the immune suppressing drugs, but eventually took the leap and am so glad I did. I've been on Imuran 4.5 months now and besides having 2 yeast infections (not sure if related or not) have had zero other issues Crohn's related, or immune supression related. 5ASA drugs are not likely to get you the mucosal healing that is the true goal of the disease. Just wanted to share. Good luck with your finals and your treatment options!
Thanks for that! I am tempted by immunosuppressants but I dunno..... I will be working in a hospital from, well really this coming monday onwards, and I don't want to pick up everything that comes my way! Esp cos my first job is on the admissions unit.....

Yeah reading round I've noticed that nobody seems to be a 'textbook' case, yet the doctors who were treating me whilst I was in the last few days were confused by my case cos my CRP and ALT as I said before were up, folate was waaaaay down, I was obstructed on xray (which later resolved itself thankfully) but my CT was relatively normal/ non specific (general signs of inflammation ie large lymph nodes, free fluid), so one of them even asked if had IBS (until I pointed out that IBS does not wake you from sleep, make you pass blood, give you an obstruction and raise your CRP and ALT..... he agreed and said that he'd leave treatment up to the consultant who knows my case!)

Just so frustrating not being a typical case! And not knowing anyone else battling with a chronic illness.........



Welcome! Wow, what a combo, being in the hospital and trying to prepare to treat people in one! Goodness! I hope your exams go well!

I agree with you completely, it seems like most people with crohn's are not the "textbook case". There are many of us here that are undiagnosed because we don't fit the boxes. I have been diagnosed with IBS twice, once at 17 and again a few months ago (I'm 21 now). Yet, I have blood in my stool, D 8 - 12 times a day, awful pain, mucus, malabsorption signs, etc, that show that this is more serious than IBS. I, like you, have short flares, about a week on average. But lately I am hurting and not able to eat much constantly, so I'm hoping the tests they run show something, finally.

I hope your flare goes away soon!
Keep at it eventually ur tests will show something! I was lucky my gastro diagnosed me initially largely on some non-specific signs and symptoms, but after this latest flare I have harder evidence..... it will come just persevere!

Crohn's is horrendous and I will ALWAYS sympathise with my patients!

I hope you get your diagnosis soon, it feels weird saying that but I understand how awful it must be to be so sick and have no real help with it!!!

One thing I've learnt - treat the patient NOT the numbers!!!



Hi Lulu and welcome!

Congrats on almost finishing your exams! Good luck - hope you get thru the rest of it okay.

As for the immunosuppressants - not everyone experiences increased illnesses while on them. You can pop over to the Treatment section and read about others experiences with them. I was on Humira for a year and never had so much as even a sniffle. I think doctors and people who work in hosps are so vigilant about handwashing and using hand sanitizers. Don't let that fear stop you from using a treatment you feel may help!

You probably already know this but the codeine can cause constipation. And Immodium, I have read, can be contraindicated for Crohn's. So be careful with those because they can both take your GI tract in different directions!

Good luck! - Amy


Your Story Forum Monitor
Hi Lulu! Welcome to the forum. I have come to accept that CD hits everyone differently. My brother and I both have it and we have similar symptoms, but some of triggers are different, and different parts of our bodies are affected. Strange! It's almost like you need to become a detective when you have CD. Good luck with your exams, and I'm sending well wishes your way. :)
Thanks guys, quite scared.... and still quite sick too! :-(
Oh well just a little over 24 hours to go then I can sleep!
Hi Doc LuLu2,

Exams in med school. Dx woth Crohns. Stress? Over the top. How have your eating habits been? Fast food and caffeine? Smoke? Just throwing out some potential causes. I know down time is precious, but if you can, mediate or get into a calming zone. Try music, aromtheerapy, anything. Lack of sleep is also a contributor to flares. I suffer from insomnia from the pred as well as work and it plays havoc on me. How long ago was your obstruction? Mine took weeks to finally reduce down to a somewhat normal size. Whats your specialty going to be?