Hi everyone, I've been a bit lazy of late and haven't thought too hard about my GI issues because I started taking Humira for arthritis and they are now mostly under control.
But, I have this niggling feeling that I should probably be trying to get a GI that I feel will take things seriously if everything goes to he'll in a hand basket (aka the Humira stops working / I get a stomach bug so bad I have to stop taking the Humira and it sets off an enormous flare - I regularly visit remote camps in west Africa for work).
So, previous tests indicate;
10cm of moderate bowel wall thickening in terminal ileum on contrast CT, minor fat stranding, consistent with crohns
Chronic inflammation and infiltrates on small bowel biopsy
Minor bleeding ulceration in anastomosis of small bowel described as normal by GI
Faecal calprotectin within normal range, but only just (very high normal - 39)
Faecal calprotectin dropped significantly (to 4) after 6 weeks of Humira, correlating with improvement of symptoms
Symptoms were;
standard symptoms consistent with crohns (blood, cramps, d, night sweats, lost 10% body weight in 4 months, terrible fatigue as well, but I have inflammatory arthritis, so its impossible to tell which is which)
Previous history;
Resection of terminal ileum age 16, cause never resolved, crohns mentioned but never excluded or confirmed.
Current Dx IBS and short bowel syndrome.
So - given the above sounds a whole lot more like its Inflammatory than irritable, should I try to pursue what I think is the likely diagnosis, which might be a bit difficult to demonstrate while I'm on Humira and its under control, or just leave it until something goes wrong?
But, I have this niggling feeling that I should probably be trying to get a GI that I feel will take things seriously if everything goes to he'll in a hand basket (aka the Humira stops working / I get a stomach bug so bad I have to stop taking the Humira and it sets off an enormous flare - I regularly visit remote camps in west Africa for work).
So, previous tests indicate;
10cm of moderate bowel wall thickening in terminal ileum on contrast CT, minor fat stranding, consistent with crohns
Chronic inflammation and infiltrates on small bowel biopsy
Minor bleeding ulceration in anastomosis of small bowel described as normal by GI
Faecal calprotectin within normal range, but only just (very high normal - 39)
Faecal calprotectin dropped significantly (to 4) after 6 weeks of Humira, correlating with improvement of symptoms
Symptoms were;
standard symptoms consistent with crohns (blood, cramps, d, night sweats, lost 10% body weight in 4 months, terrible fatigue as well, but I have inflammatory arthritis, so its impossible to tell which is which)
Previous history;
Resection of terminal ileum age 16, cause never resolved, crohns mentioned but never excluded or confirmed.
Current Dx IBS and short bowel syndrome.
So - given the above sounds a whole lot more like its Inflammatory than irritable, should I try to pursue what I think is the likely diagnosis, which might be a bit difficult to demonstrate while I'm on Humira and its under control, or just leave it until something goes wrong?
