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Could this be Crohn's?

Hi

Just looking for a bit of advice off people, who suffer with Crohn's. I have always thought that diarrhoea and pain were the primary symptoms, however I have recently read about a lady who suffered constipation as her primary symptom. Which brings me here asking for advice.

My story (apologies for the length)

For the last 10 years until 2013. I have suffered with alternating diarrhoea/constipation and bouts of severe bloating. The diarrhoea would be very crampy and painful and looked like porridge (sorry tmi). It would wake me in the night and I'd be literally sweating on the toilet. This would pass then I'd be normal for weeks, even months, then I might have an episode of constipation etc..

Went to the doctors got diagnosed with Ibs

Fast forward 8 years (2013)

Started experiencing joint pain, that moved around my body. Started in my wrists, moved to my knees, then my hips. The knee joint was so swollen, I couldn't bend my knee. Had x-Rays which were normal. Got tested for everything ie lupus, RA etc all normal. Except my rheumatoid factor was 19?

Discovered I had a B12 deficiency and that I was anemic. The joint pain was put down to this and I was issued b12 injections.

I quit smoking, now this is where my story changes.
As from the 21st February 2013 - I have been seriously constipated. It has never gone away and I have taken laxatives daily. Sometimes they help, sometimes they don't. There has been odd bouts of diarrahea, but I think this is overflow. I also have severe bloating daily. I wake up bloated, and I go to bed severely bloated.

After repeatedly going back and fourth the doctors for a year and trying every known laxative to man. I have eventually been referred to a gastroenterologist and a rheumatologist for the joint pain which has still not gone away despite b12 injections.

She thinks I have a slow transit constipation and tried to give me a script for laxatives, which I've already tried. A recent blood test showed I was anemic again, So she has also ordered a sigmoidoscopy.. Which I'm having next week.

If you've gotten this far, thanks for reading..so I suppose my question is could this be Crohn's or am I barking up the wrong tree?

Any advice would be gladly received, I'm at my wits end...
 
I would request more than a sigmoidoscopy as it doesn't even see the whole of the colon. Most CDers that have b12 deficiency have issues at the terminal which can only be partially seen with a full colonoscopy.

With anemia, b12 deficiency, joint pain and GI symptoms I would be adamantat haveing a colonoscopy, endoscopy and possibly some imaging. Though the first test I would request is non invasive as it is a stool test that tests for inflammation in the GI tract called a fecal calprotectin test. It can definitively dx IBD but would give an indication that there is indeed a need for full testing.
 
️️Thankyou for the advice.. I will mention this at my next appointment with the gastro :ysmile:

Just nice to know that somebody else thinks that further tests are warranted! So thanks : ),
 
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I don't know that your symptoms sound like Crohn's specifically. But waking in the night due to digestive symptoms and deficiencies suggest you need more investigation rather than an IBS diagnosis.

Did the doctor who felt you have slow transit constipation suggest a transit study to confirm it? Impaction and overflow could be a possibility, depending on the nature of the diarrhoea you get (i.e. if it's watery diarrhoea that has got around an impaction in the colon, or if it's a rush of diarrhoea when the impaction clears and leaves you less bloated afterwards). But impaction can be a symptom of a bigger problem or can occur along with other motility issues, so again, more testing would be needed.

A sigmoidoscopy is a start, but more investigations may be needed. One basic test would be an abdominal examination which can detect an impaction. Hopefully you'll get some answers soon.
 
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Thanks for your message unxmas. I had an abdominal examinations at my appointment and it was 'unremarkable'..

I do not wake in the night anymore with diarrhoea, that was when my symptoms were alternating between constipation and diarrhoea a couple of years ago.

Ever since I quit smoking, the only diarrhoea I get is if I induce it with laxatives or if it's overflow (I'm presuming its oveflow as this normally happens when I feel sick and incredibly bloated) . However , it never makes me feel better or any less bloated. The only time the 'bloat' subsides a little bit is overnight. But never completely. I haven't had a flat tummy since the chronic constipation started... And I go up 5 inches throughout the day.

At my appointment the gastro gave me a script for milk of magnesium, and said that if this doesn't work ( it hasn't) then after the scope she will perform a sitz marker study..

This is disgusting but I already know I have a slow transit, by food markers ie sesame seeds and sweet corn ... Sorry gross I know..

Again thanks for your input..

I just hope one of these tests yield something..
 
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