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Flareup?

I was diagnosed with Crohn's in the early 80's and had resection surgery in 1986. I am happy to report that I have lived with extremely limited complications since my surgery. I am very mindful of what I eat and I maintain an extremely active physical regime (biking 50 miles every other day, and walking 10 miles on the other days). I am very, very lucky and fortunate and I thank God for my good health these past 30+ years.

My last colonoscopy was in Sept 2018 and my GI noted "ulcerated strictures" and "discontinuous congestion, erythema and ulceration with contact bleeding" in my transverse colon. He said that I would likely need to eventually consider some form of biologics to maintain my current status of health. I told him my preference was to continue my current course (daily dose of Mesalamine only).

Fast forward to October 2019 (last week).
  • On Wed night I ate my dinner but left several bites as I felt really, really full.
  • I had significant abdominal pain all night that night.
  • Thursday morning I could only eat part of my breakfast as I was so bloated.
  • Tried to go for my morning walk but came home feeling bad. On the drive home I had multiple projectile vomiting episodes.
  • My GI Dr got me in right away and I vomited multiple times in his office. He sent me to ER immediately.
  • Got to ER and threw up a few more times (painfully - with little coming up). At this time I had abdominal pain, but bloating had been reduced. No fever.
  • 6 hours later CAT scan showed no blockage.
  • I left the ER with no plan for steroids or treatment.
  • My GI Dr called me at home the next morning and he said "let's see how today and tomorrow go before I sign you up for a round of steroids". He gave me his personal cell number in case I had any issues. I agreed with the course of action.

Three days alter I am feeling quite a bit better. Abdominal pain and tummy tenderness is very minimal. I had a solid BM this am. Energy levels are returning. I am eating small portions of carefully selected foods that I feel are ok for me to eat. It is interesting to note that I have had an increase in my joint pain level thru this whole ordeal.

I have an appointment with my GI on Tuesday to discuss the plan going forward. I want to be armed with questions and as much information as I can when visit, so here are my questions for others in this forum:
  • Does the episode above look like a classic Crohn's flare?
  • Or do others have similar episodes where a stomach flu or virus presented similar symptoms? (I had my flu shot 5 weeks ago and I had no fever thru the whole ordeal.)
  • Can a flare clear itself up this quickly, with no treatment?
Thank you to all on this forum. I appreciate the hours of input that some put in to this site. It's extremely helpful to me.
 
Interesting that you lived with Crohn's, medication free, for 30+ years after resection surgery. Was the resection in your large or small bowel?
My thoughts on your questions: The bout of vomiting is common with small bowel obstructions. But, the CT scan did not reveal any blockages so apparently not. Perhaps you just had a bout of food poisoning, totally unrelated to your crohn's. What's your status now?
I read on your other post that you suffer from anemia. Took me many years to recognize the impact that anemia was having on my athletic performance. If a doctor had spelled that out for me, I would have been more compliant with their medication suggestions. The biologics will address the Crohn's and the root cause of the anemia, GI tract bleeding. In the meantime, iron infusions will bring your hemoglobin, etc back into normal ranges and you will likely find that your are less breathless during your biking & walks! If you track times, you may very well see an improvement.
 
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I was really sick in the mid-80's and had re-section surgery when I had severe pain and could not eat or function. The area was my terminal ileum. Since my surgery in 1986 I have been almost symptom free (though I do occasionally have a little discomfort and abdominal pain - especially if I stray from my diet that works).

I think you may be right that my bout this time was food poisoning or virus in my intestinal tract. The vomiting was very strong and I was blocked from inflammation in the bowel wall. I have had no problems the past several weeks and am back to eating my normal diet and walking and biking lots of miles. My Dr wants me to do a colonoscopy and I have it scheduled for early December.

I have had no anemia issues since my bout over a year ago. Your comments are right on - when I had my anemia issue I was scheduled to do a 100 mile backpacking trip with the last day including a summit of 14,500' Mt Whitney. Right before the trip I had an iron infusion. That infusion was like a turbo charger for my hiking. In years past I have always labored as I climb to the summit. After the iron infusion I was able to hike faster than ever before - I raced past all the younger folks on the way to the summit and felt great doing it.

Thank you for your comments and wisdom. It's a horrible disease and I feel bad for how bad so many others have it. I know I am lucky.
 
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