Crohn's Flare up or Anxiety Problems?

[Nic]

Hello everyone! I just found this forum yesterday while trying to do some more Crohns research! Love that there is a place to come that people understand I will post my "Crohns Story" later, but wanted to ask a question about flare ups.

When I first found out that I had Crohn's it was because I was having a flare up, the horrible pain..all day in the bathroom..etc..

Well 2 weeks ago I started to get sick, my anxiety (which has been hugely caused from the steriods and the Army hasn't helped it!) started going crazy as well..I went to my primary doctor and she put me on anitdepressants, which I had a horrible reaction to and spent all weekend in the ER. I ended up not being able to eat for 4 days, went to my GI appointment on the 5th day and they immediately decided that it was my Crohns and that I had to be admitted to the hospital right away. After finally being admitted I had 3 doctors arguing over weather it was my Crohns causing my problems or my anxiety. My primary doctor had me do a Cat Scan to show the GI doc that it wasn't my Crohns, because he got tired of the GI doc trying to load me up with steriods and make me worse. Well the Cat Scan showed nothing but the fact that I have Crohn's. My GI docs still want me to start on the Remicade because they are still convinced that its my Crohns and that I am past any pill treatments, which worked fine for me until I moved here to NY and my anxiety problems started (I stopped taking my Imuran because I thought it was an allergic reaction to it but looking back I think it was just my very first panic attack). So now in the end I'm stuck trying to figure out on my own if its actually a flare up or if its my anxiety and panic attacks that are causing my problems. My GI won't listen to anything I say, just keeps saying Remicade over and over..so I feel like I'm stuck. I have no pain in my stomach like I had before...it used to be when the docs came near touching my stomach I was already curling up, now I can push on it all day and its only slightly tender. I'm just blah all day long, 2-3 bathroom trips tops and its just mushy most of the time, sometimes only once a day and it will be more solid. I know some of the symptoms are the same as anxiety and depression and since I'm not having any pain and when I give in and take a Xanex I feel much better, I'm really convinced it's my Anxiety. Can you have a flare up without having any pain? I'm extremely lost on this and would love any advice and help you guys can give me! I don't want to start Remicade if its not necessary, I would rather save that for when I really need it. But I also don't want to continue feeling like absolute crap everyday...I have no motivation and no energy due to the fact that I'm still having a hard time eating because my anxiety makes it hard and makes me feel sick!

Thanks in advance for reading this and any help/advice you can give!

Nicole

 

[imisspopcorn]

:welcome: Nic....Wow, that's some question you have posed! Are your lab results...SED(ESR) rate or CRP elevated? These are used to determine inflammation?

I really can't give you an answer. Your Crohn's symptoms don't sound extreme to me, but everyone here is different......

My suggestion is to pursue the anxiety stuff. Whether or not this is the cause is irrelevant. Severe anxiety can be just as disabling as Crohn's. I would check into some sort of treatment i.e...counseling to get down to the bottom of it. Sooner or later you will need to deal with it anyway.

Good luck to you.

 

[Crohn's 35]

Hi there, and welcome. We all understand how you feel. Yes, anxiety can cause a flare up and crohns can be a bit inflammed and you dont have to be in pain necessarily. Crohns is hard enough to detect as a dx.

IMP has good advice for counselling issues, it could make a difference. I know you feel like Remicade is like putting a candle out with a fire hose. Maybe having another opinion from another Gi? Not all are created equal. Good luck.

 

[Nic]

Thanks for responding! I have my next counseling tonight at 6. I can't see an actual therapist until Feb 26, so I just get to see a counserlor right now. She has been teaching me breathing techniques to help control the panic attacks, which is great, but its not getting rid of the anxiety and the feeling like crap. They prescribed me Celexa (anitdepressant) when I was discharged from the hospital, but I haven't taken it. I don't want to get on anything that I will have to wean off of later. I also have Xanex, I'm supposed to take 3 a day as needed, but I try to only take 1 a day because I don't want to become addicted or dependent on it either.
I'm having a really rough time today though. I feel like crap..I know I need to eat but I can't find anything that even sounds appealing (I did eat aroun 10:30 but haven't eaten since). I just told my husband, who is luckily home today, that if I didn't do something, I was gonna end up back in the hospital because I'm starting to feel like I did before I went in. It has to be my steriods, I usually take them before I go to bed at night so that I can sleep off some of the side effects, but then I wake up with horrible panic attacks. My GI's office told me yesterday that the Entocort should be taken in the morning, so I took it this morning instead of last night and I feel horrible! I'm all shaky and weak and now I feel like I'm starting to sweat some. I have no energy.... I was fine all morning until I took that darn Entocort!!

 

[Crohn's 35]

Entocort is what I am on, (my 6th time) and it takes awhile to work and is for mild to moderate cases, very few side effects, but could be rare and be affecting you. If you dont want to eat, try Ensure, you need the nutrients and may make you feel better, having an empty stomach and or taking pills is going to make you feel like crap. I know I do. BTW I take my Entocort 3 pills in the morning.

 

[uli]

Strangely Entocort here in Sweden is a clysma with liquid where 1 pill is dissolved and then you press the liquid into your rectum. A local treatment - but it must be taken just before bedtime in order not to give you any discomfort. Well small differencies - but it worked well for me, stopped a lot of my bleeding.

Sorry NIC, cant give you any advice on the panic attacks - maybe you just need to accept having a chronic disease which is hard but nescessary.

 

[Nic]

I've been on the Entocort since October and I didn't start having any anxiety issues until after I started them. Before I moved here to NY I was on Prednisone and Imuran and I was doing really good (aside from the good ol moodiness lol). My GI wanted to up my Imuran dose because I was right under the remission area with my blood work, but I was also close to the toxic levels, so he waited and put in my records to have my next GI do this so that I could be monitored on it. Well instead of getting in to a GI right away it took months because they don't have the facilities here. The pharmacy here switched me to the generic brand of Imuran..the azathiopriene (sp?) and then my primary doc switched me to entocort for some reason. We thought I had an allergic reaction to the Azathiopriene so I went off of that and have just been on the Enotocort since. While in the hospital last week they started me on Asacol but my new GI says that its not going to do anything for me...?

I just talked to the head nurse at the GI's office and she thinks that I'm loosing my mind but is going to talk to them and see if I can come off the Entocort until my appointment next week and see how it goes.
I know it sounds crazy because the Entocort isn't supposed to have bad side effects and I'm only taking one a day, so its a very small dose, but it is truly driving me crazy! I feel like I did in the hospital when I finally gave in and took the IV steriod..I ended up thinking I was gonna loose my mind, my nurse made sure to put in my file not to give it to me anymore. I feel like my whole body is racing or something...I can't really describe it lol And like I said, I felt fine before I took it today, I even woke up without a panic attack and that was very nice!
I am drinking an Ensure..thankyou for that idea..I luckily had one more in the fridge and getting it down with no problem. I am starting to feel a little better. Maybe I'm just one of those weird cases that can't have Entocort...my body seems to reject everything else I put in it med wise!
Also, I have accepted that I have Crohn's. I was actually kind of relieved when I found out. I was diagnosed with IBS 8 yrs ago and my GI said he thinks I was misdiagnosed then. It was nice to finally know why I was having so much bathroom time! My dad has UC so whenever I'd spend a bunch of time in the bathroom he would start freaking out, so it definitely eased everyones minds to finally know.

 

[Crohn's 35]

Sounds like Entocort is not for you! I too have to switch drugs alot because they dont work. I was told antibodies can build up and become resistant and have to trick the body by changing... I asked last week about Asacol but my Gi says Pentasa works better at least for me. Everyone has different symptoms and places of Crohns. Keep drinking the Ensure, it can give you a break. Hang in there, let us know what your GI says on the next appt.

 

[Nic]

Another update: The head nurse just called me back again and said that I could discontinue use of the Entocort! I asked if I started having bad diarrhea if I should go back on it and she said no, just to stop taking it and don't take it anymore! I really hope that this will make things better! I'm a little worried about it making me spend more time in the bathroom but at this point I think I would rather have diarrhea than panic attacks! I'm just going to keep a positive outlook at it and hope for the best!
She also suggested I start taking the Celexa, she said that I don't have to be on it forever, just long enough to get my system back in order from the steriods so that I don't end up dependent or addicted to the Xanex while waiting it out.
Ohhh things may be looking up after all Goodness I hope so!!

Thanks again for the advice! I appreciate it very much!

 

[imisspopcorn]

Did she day to wean off it??? I don't think you should quit cold turkey. I have always weaned down off of it......Double check.

 

[Nic]

They said I've been on a low enough dose, just 1 pill a day, for long enough to just stop taking it. I was on 3 a day then I went down to 2 a day for a week or so and have been on one a day for a little over a week.

What are the symptoms of withdrawl or whatever from just stopping cold turkey? I'm gonna have to look that up, so that I can keep any eye on myself and make sure!

I'm also trying to figure out why they have me taking the Asacol if they said it won't do anything for me?? Why put my body through taking even more pills?

I've started wondering if I just didn't take anything but my herbal supplements that I used to take, if I would be better off? I went 8 yrs of being misdiagnosed with IBS and was never on any medication and was fine, I was tired alot however, but I only had diarhea around the time that I would have my menstral cycle and if I ate a food that didn't agree. It seems as though ever since they diagnosed me with Crohns, its been med after med and has got me no where but worse!! My stepmom is really big into homeopathic stuff and used to give me stuff when I had diarhea and it would always work wonders...My dad was scheduled to have surgery for his UC and he went to a homeopathic doc in germany and took some stuff one time and all of his ulcers and such disappeared and have never returned! He has been in remission and on no meds for 20+ yrs, and he eats whatever he wants!! Still has his yearly colonoscopy, but never any more problems! Maybe I could get super lucky and the genes that got him better with just herbal stuff were passed on to me and could work for me as well Long shot, but who knows?? LOL

 

[imisspopcorn]

You probably would be okay if you are only on 1 pill......Our bodies can stop producing cortisol if we are on steroids for long periods of time. That is why you have to wean down...

Good luck Nicole...Maybe a second opinion would help?

This disease is such a pain in the butt!

 

[shazamataz]

Hi Nic, sounds like you are having a rough time with the anxiety! Sorry to hear that. I found i went a bit mental on Pred, but haven't had Entocort so no experience with that. Definately take the suggested medication to at least try to deal with the panic attacks because you can't go on as you are! Good luck and keep us posted

 

[D Bergy]

Inflammation can cause all sorts of mental problems and anxiety is one of them. Depression is another one which I had not very long ago.

Once I knocked down the inflammation, I also rid myself of the depression.

Even low grade inflammation that is not readily apparent can cause these problems.

Dan

http://itsnotmental.blogspot.com/2008/04/inflammation-of-body-and-brain.html

http://www.sciencedirect.com/scienc...serid=10&md5=4909cbe76c3076159ea949eefe0325b0

http://www.sciencedirect.com/scienc...serid=10&md5=def237fedd9a4ad2eb2ae144de374175

http://www.sciencedirect.com/scienc...serid=10&md5=f62d706809449aeb90ff47bb73974a85

 

[Nic]

Thanks ya'll
I'm feeling much better now that my steriod has gone through the "crazy" phase! I drank my Ensure and then had a little snack later on and then actually had an appetite to eat dinner! Made it to my appointment with my counselor, ran some errands and did a little much needed cleaning around the house!! Those are some big accomplishments from what I've been able to do the last week!! My counselor suggested I go ahead and start the Celexa as well, so I guess I'm gonna start those tomorrow and see how it goes!

Dan thankyou for those websites, I'm going to continue reading them and looking into that possibility. I just had a catscan and they said there was no inflamation, but maybe its getting ready or something!?!? But I've also been having this anxiety problem since Octoberish and I've had a couple catscans since then and nothing ever shows up and my blood levels never show any signs of inflamation either....

I'm really hoping that once my steriods are completely outa my system things will settle down!! I know my tummy is making all sorts of noises right now tho...lol fun times! Trying to keep a positive outlook this time around

 

[shazamataz]

If it helps, Nic, I have found that when my tummy is noisy that is usually when it feels better

 

[Jennifer]

Hi Nic. When you said that your whole body was racing, that sounded like a panic attack to me. I've been getting them for about 2 years now. As far as I'm aware, similar to crohns, it never goes away but you can keep them at bay with meds or using different techniques to control them when they do happen.

Many things can trigger them and just because you had one before because of _______ doesn't mean it will happen again. You can also work yourself up to have a panic attack so it's best to learn the signs of panic attacks and start your self treatment at that point. Self treatment could be focusing on something else, say you're in line at the store for check out and you have a panic attack, rummage through your purse and read a couple business cards or something or grab an object that you keep in your pocket and rub it or chant in your head while controlling your breathing. Never take deep breaths while having a panic attack because often times it can lead to hyperventilation. Taking one deep breath is fine but leave it at that and concentrate on slowing your breathing. This will help make the physical symptoms go away. The mental symptoms take time to go away. Don't avoid doing things or going to places where you had a panic attack before because then you're allowing it to control you and bad things could happen. For instance my end result of doing that was never leaving the house and not showering often (I had a panic attack in the shower once). You cannot let them control your life.

Here are the main symptoms of a panic attack and my counselor told me that one must have at least 7 of these symptoms:

Symptoms of a Panic Attack

* raging heartbeat
* difficulty breathing, feeling as though you 'can't get enough air
* terror that is almost paralyzing
* nervous, shaking, stress
* heart palpitation, feeling of dread
* dizziness, lightheadedness or nausea
* trembling, sweating, shaking
* choking, chest pains, distress
* fear, fright, afraid, anxious
* hot flashes, or sudden chills
* tingling in fingers or toes ('pins and needles')
* fearful that you're going to go crazy or are about to die

I'm sorry you're going through this and I don't wish it upon anyone. If you want more help in trying to control them without meds, feel free to talk to me anytime. I'm not currently on meds but that doesn't mean I won't take them again in the future. They are a tool just like the other techniques are. I was on Klonopin for a while but it's not the type of drug you can take forever so I needed to learn how to deal with these attacks on my own. Best to start out with meds imo to help get rind of stress which will make your crohns worse.

 

[shazamataz]

The attacks are AWFUL aren't they? I agree with Crabby to try not to let them stop you going somewhere. Like I used to get them in the supermarket and for ages I used to just dash in and ended up coming away with stuff I didn;t need and none of the stuff I DID need! One thing that seemed to be the issue was the feling of being trapped. I managed to improve things by reminding myself that I COULD leave at ANY time. Just put down the basket or leave the trolley and go. Noone would even notice. I never had to do that but it definately helped.

I ended up with going more often but for shorter periods and it helped. That was years ago now and to be honest i STILL feel 'uncomfortable' in there - go a bit weak in the legs and such - but I don;t have the panicks anymore.

Good luck with getting a handle on them, I really feel for you!

 

[Nic]

Thanks for the panic attack advice ya'll! I'm learning how to keep it from getting too far, but it still stinks! I'm actually better when I leave the house! Today I had my hubby get in the truck and drive me around for a little while to get it outa my system! My worst times are when my hubby is at work, so I need to learn how to get over him leaving and it making the attack worse..any suggestions? I know nothing is going to happen just because he's gone, so I don't understand why its worse. The other thing is that it only happens in the mornings...towards the afternoon and end of the day I'm fine...it makes no sense to me at all!
I tried the Celexa and it made me sick as a dog..went to the doc on Friday for my after the hospital check up (just my family doc) and he said that since 2 of them have affected me like that that the antidepressents just aren't for me. Told me to keep taking my Xanex, that since I'm on such a low dose it should be pretty hard for me to get addicted, esp since I limit myself to 1 a day. He also gave me some dissolve on your tongue Zofran, since the pills seem to upset my tummy more!
Today was much better, I was doing stuff around the house and with the kids around lunch time, instead of curled up on my couch trying to figure out how to get the anxiety to go away!
Thats my biggest problem, I take the Xanex in the morning and I still have really HIGH anxiety all morning that I just can't get rid of sometimes..I do some breathing exercises and it just won't go away...any suggestions on that either?
Thank you guys so much for the help! I'm trying really hard to kick this in the butt so that I can start living normal again, its driving me nutty!!

 

[shazamataz]

Hi Nic, I am glad you've been out and about. Sitting at home makes things worse because the more you do that, the more easy it is to get trapped and not feel like going anywhere!