Hello! I have had Crohn's for the past 25ish years. For the most part, I had a mild case until about 2016 when I was hospitalized for what was a suspected fistula (poor visualization?) and put on Remicade in addition to the Lialda I was already on. After giving birth last summer, I noticed some abdominal tenderness and aches creeping in. The doctor wanted to "wait and see" because the colonoscopy didn't show much concern to her. She did mention a polyp near my appendix that came back as pre-cancerous and just wanted to schedule a follow-up colonoscopy to remove that but not change meds. Well, the pain was getting frustrating so, I got a second opinion. They ordered a CT scan which showed an appendicolith and mild appendix inflammation that connected to mild ileitis on the scan. I had my appendix removed, and the surgeon was very surprised that the appendix showed chronic appendicitis, which he said was rare. He also did not think it was related to Crohn's. (I am not sure about that.) After the recovery, 75% of the pain went away and just a dull ache remained. (I should mention I have never had any cramping or diarrhea ever with my Crohn's, and this time was the same.) I just went in this week and had the suspicious polyp removed. I was hoping this would remove the last bit of the ache since it was right where the appendix was, but it seems to still be there. I am worried that at my follow-up, the doctor will continue this wait-and-see approach since I am not cramping or having diarrhea. I feel like this nagging ache is robbing me of enjoying time with my toddler son. Has anyone else developed chronic appendicitis from their Crohn's disease? I know I will have to be more adamant with my doctor, but maybe just a small tweak of my current medication would fix this. Or do you think this sounds like something else? Thank you for all your insights!
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Crohn's for decades...then chronic appendicitis. Related?
- Thread starter satterae
- Start date
I have, sort of. Except in my case they were diagnosed in the opposite order. I had nagging right side abdominal pain that came and went for at least 10 years, maybe longer. It finally flared into acute appendicitis, and in fact the appendix ruptured. I went to the ER and ended up with an emergency appendectomy. It was then that they diagnosed all those years of episodic pain as chronic appendicitis.
In a routine follow-up x-ray a few weeks after the surgery the surgeon noted some thickening of the small bowel in the terminal ileum near the appendix. He said it was probably just residual inflammation from the appendicitis but that I should follow-up with a gastroenterologist to make sure it went away, which of course I didn't do.
Over the course of the following year the abdominal pain was much reduced but not quite completely abolished. But the big reduction in pain episodes tended to confirm the diagnosis of chronic appendicitis. But then routine annual blood work ordered by my PCP showed that I was severely anemic. A GI was called in to examine the gut from both ends to look for the source of the blood loss. Scopes were clear, but capsule camera endoscopy showed aphthous lesions in the terminal ileum, and thus Crohn's was diagnosed. I've been on Stelara for the past 5 years, which keeps me in near full remission with just a little nagging inflammation in the TI that won't quite go completely away. But the level of disease is low enough that overall I lead the normal life of a person without Crohn's.
So it seems in my case that the Crohn's and appendicitis were intertwined somehow for years. But which one triggered the other is hard to say. Or maybe they just coincidently happened but weren't directly linked. Who knows?
Thanks @Scipio for your reply. It does sound similar. It seems I also have nagging inflammation in the TI. I wonder if the chronic appendicitis aggravated it since it was not symptomatic before. Pregnancy could have made it all go haywire. Although, I think the chronic appendicitis started while I was pregnant.
Even with the inflammation, does your Stelara keep you from feeling any pain? I'm wondering if my meds just need a slight adjustment. Hopefully, the GI is helpful next month.
Even with the inflammation, does your Stelara keep you from feeling any pain? I'm wondering if my meds just need a slight adjustment. Hopefully, the GI is helpful next month.
Not completely. Before Stelara I used to get bouts of moderate pain that could last for three weeks. Now I get bouts of mild pain that might last for three hours. And the mild pain becomes more common in the last two weeks of my 8-week Stelara cycle - when the drug concentration in the blood has presumably dropped to lower levels. But the Stelara has completely abolished the occasional random fevers I used to get. I never did have all that much diarrhea to speak of, but I would get an occasional sudden attack of diarrhea with intense urgency maybe once every month or two. That's all gone now too thanks to Stelara.