Crohns vs appendicitis

[kimmidwife]

I wanted to run this by my fellow crohns gurus,
My youngest daughter has had something weird going on. Two weeks ago she developed a very high fever for about 24 hours. No other symptoms other then saying her stomach hurts. Since then she has been complaining about her stomach hurting on and off. Then Tuesday morning the complaining got worse. She didn't have a real fever, 99.2, but she was not herself so we kept her home from camp. Yesterday we took her to see a pediatrician. (Not our normal one as we are at my parents house for the summer). He thinks it is a virus but did a throat culture since strep is going around. The rapid was negative but the long one is still pending.
Last night she suddenly got a high fever again 103 and this morning it is back down to 99.4.
She is a little stuffy in the nose this morning but other then that keeps complaining of stomach pain. I am worried if this is the beginning of crohns or could it even be appendicitis?
Her pain is in the middle near the belly button and spreads a little more th the right then the leg but the right said is also where the terminal ileum is and for Caitlyn (her older sister) where most of her pain is.
I had a friend who is an EMT palpate her stomach this morning and she didn't feel the symptoms really point to appendix but of course my Mommy brain is worried and worried about crohns as well.
Trying not to freak out!

 

[crohnsinct]

Is this the same daughter who was recently tested or a different one? If different one, I would probably ask for an FC test to start with. If for nothing else just to put my IBD worry to bed. If it is the same daughter who was already tested and cleared for IBD, then maybe call ped and ask if they think it could be an appendicitis and get some blood drawn...although from my experience with appendicitis if you have it you pretty much know it.

 

[xmdmom]

Acute appendicitis pain usually starts centrally and moves to right lower quadrant over the first 24 hours, increasing in severity. The fever is usually low grade. People with appendicitis usually have lot of pain with palpation, walking or jumping.

Hope your daughter feels better soon and it doesn't turn out to be anything serious.

 

[Sascot]

I can just imagine the worry and wondering. It is possible to have a grumbling appendix that can cause issues without as much pain on palpation. Fingers crossed it is "just a virus" and it eases off soon.

 

[DustyKat]

:ghug::ghug::ghug: Such a difficult and worrying time for you Kim.

Unfortunately it can be difficult to differentiate TI Crohn’s from appendicitis (particularly a grumbling one) as many of the symptoms are the same and not only that but appendicitis can be a part of the Crohn’s process. By that I mean that the appendix becomes involved due to the Crohn’s inflammatory process.

Since this isn’t presenting a classic case of acute appendicitis and with the family history that already exists I would pursue further testing.
Baseline bloods: Particularly see what the red and white cell counts are doing and also the inflammatory markers.
Imaging: I would start with something inoffensive with little preparation - ultrasound. Have them focus on the TI and appendix. Explain the family history and if possible have the radiologist pop in and have a look too whilst the radiographer is doing the test. They should be able to pick up on any thickening if it is there.

Have you noticed any of the more insidious signs of Crohn's that may have been brewing for a while?…weight loss (if unsure look at pictures), lethargy, dark circles under the eyes, etc.

Thinking of you hun and hoping it all turns out to be something middling and nothing more! :Karl:

Dusty. xxx

 

[kimmidwife]

Thanks gurus,
I spoke with the doctor three times today. He is pretty sure it is not appendix because of the way the fever has gone up and down. He says in appendicitis when there is fever it usually stays elevated.
This is not my daughter who was recently evaluated this is my youngest who we once did a couple years back get a fecal calp. On because she occasionally has blood in her stools.
At that time it was normal but I think it is time to pursue further testing on her. The question at this point is what to do for right now.

 

[Mehita]

Have you asked her about or looked at her stools recently? Any blood lately?

 

[Catherine]

Start a diary recording the times of severe pain. Does the of pain appear like gastro but with no vomiting or Diarrhea? Are the coming together.

Get base line bloods done. Monitor haemoglobin levels and iron studies.

We had a number of trips to hospital and doctor with severe pain. Dx as gastro, appendicitis was rule out. Note gastro doesn't present without vomiting or diarrhea as a symptom.

 

[kimmidwife]

Mehita,
Her poops are normal for her. No blood the past few days at least since I have been checking again.

 

[kimmidwife]

Catherine,
Since this pain started it has been all the time pretty much. No gastro symptoms other then pain.

 

[Catherine]

Have faecal calprotectin run. My daughter has never had any gasto symptoms prior to dx. Also as per DustyKat comment an ultrasound would be a good idea. Sarah's ultrasound did show something. They were sure what but they did recommend GI consult.

Just severe pain and looking back no weight gain. Low iron levels (all numbers but ferritin which was low normal) and borderline anemia.

 

[crohnsinct]

yeah crohns could be stealth! O had no gastro symptoms until first huge flare. Just slowed weight, height, bit anemic, bit of fatigue, bit of blood in one bm in April then in one in August and that's it. Then whammo in icu in January. T had stomach symptoms since she could talk but everyone ignored me. Was fine when ped decided to test her and that was weight alone.

Tell them you want the fc. If they give you trouble just tell them with the family history you would feel better and the plus for them is if it is normal you will stop bothering them.

I have a friend who had a grumbling appendix. Never got to appendicitis but he demanded they take it out. He was a new man after that.

Could just be a virus also. Could be lots of things but we have all reasoned away crohns only to regret it later. Quick and simple fc will fix that.

Poor pumpkin! At least she has mom and grandma to dote on her!

 

[kimmidwife]

She is feeling a little better today. No fever. Still complaining of stomach pain but saying it is not as bad. Hoping this is just a virus which has to run its course. (You know there is an old saying De' Nile ain't just a river in Egypt)
So I am staying in my bubble wrap of DeNile for now and really hoping this is a virus. We are going to get a GI consult when we get home on her and my other daughter, number two who is still having stomach issues though all the tests on her have been normal so far. Looks like we might be preparing for a lot of scopes soon.

 

[Tesscorm]

Glad she's a bit better... but I am sorry you have all these worries. Once burned, twice shy... it's hard to not think crohns once you've already received that dx. :ghug:

Hoping it does turn out to be just a virus!

 

[kimmidwife]

She is not feeling well again.
And her Mommy is feeling very down in the dumps depressed and worried.

 

[kimmidwife]

She is feeling much better. Still complaing of tummy aches on and off but no more fevers so I think that was just a weird virus. Hoping the stomach aches get better soon.

 

[MamaHenn]

What a roller coaster. I hope she is feeling better and you get some answers soon.

 

[Sascot]

Hope this is her on the mend now!

 

[kimmidwife]

She is better. Not 100% back to herself. Thinking about it now I realized a whole summer she gets tired more easily then her friends at camp and no matter how much sleep she gets always has circles under her eyes. She definitely needs a full work up when we get home.

 

[Charlotte 2]

low fiber or even clear liquids to ease work of gi actions
REMEMBER THESE= our body's "smooth muscles" & "nerve fibers" are around intestines, and..."ALL " inner organs too.
MAYBE- Try monitor food, liq intake, & bm. I've had vomittig & PAIN with my appendicitis, inflamed area so lg almost had to open me more to remove it! DANG DRATS CRAPOLA! Its when sh have been dx wiyth Crohns, but in 1973, not much knowm of CD ! 4 yrs later,(1977) 1st of 2 bouts with ABD PAINS, & vomiting, Repeat= horrible mid- naval pains.....'77 REQUIRED emer bowel resection.If I tried ignore (not w/horrendous PAIN) I was at incr risk of intestines bursting open. Appendix also can do same. (THIS is about me & my bodys CD) Good luck to your precious daughter. (ps: encourage her to not sneak foods or it will take much longer & be much trickier to help figure out the real bugger bugging her tummy and full body. And might cause added testings that may not really be needed if not honest with her learning about her body with what she learns & knows. Hugs