Hi, new to forum/mild crohns

[Dowie]

Hi, I'm new to this forum though it seems like a very helpful resource. I've recently been diagnosed with crohns albeit it is fairly mild.
I previously had a few issues with abdominal pain which I'd assumed were just IBS and a few instances where I'd wake up feeling fairly sick and end up vomiting by lunch and then regular instances of pain in the abdomen. I had an endoscopy with ultrasound two years ago and was diagnosed with gastritis and gallstones were also discovered. Had surgery to remove my gallbladder and took omeprazole for a few months. More recently in December I had a few instances of diarrhea and continuous mild pain in my lower abdomen, lower chest. I've also had various chest pains, acid reflux etc.. when the first instance of diarrhea occurred I also had chest pains and a very rapid pulse, went to my local GP who ended up calling for an ambulance - in the end it probably was a combination of anxiety and dehydration.
The pains in my abdomen and around my ribs hadn't gone away so I went to see my GP again and had a blood test. Ferritin levels were low(though I'm not anemic, just), C reactive protein high, vitamin D low.
I was referred back to the consultant that performed my previous endoscopy, this time he suggested a colonoscopy and endoscopy together - took various samples for biopsy. Oesophagus was visibly inflamed biopsies found inflammation in my oesphagus, stomach and colon.

so now I'm on omeprazol, iron tablets and have just been prescribed pentasa, I'm hoping a mild case can be controlled

unfortunately I've also been getting heart palpitations/skipped beats - I keep getting pain to the left of the bottom of my sternum and it seems to sometimes cause my heart to flutter, skip a beat etc.. I presume it is because my oesophagus is inflamed and/or there is some nerve being irritated

any tips regarding mild crohns appreciated and any comments from anyone else who gets palpitations/skipped beats (I understand they can be triggered by gastro related issues)

 

[mrjustaguy]

Welcome to the club!
I had heart palpitations and tachycardia while hospitalized from dehydration and aenemia, and since you're on iron supplements I'd say that aenemia might be contributing to it. Then again, it's your body, so I'm just stabbing in the dark. Have you mentioned this to your doctor?

 

[24601]

Hi Dowie,

Sorry to hear about the issues you are having. You probably already know but only a small proportion of people with Crohn's have disease in the esophagus (American spelling, sorry) so you're already a little special there It might help other people with experience of Crohn's in the esophagus find your thread if you mention esophageal Crohn's in the title. I have jejunoileitis but thought I'd reply anyway

In order to get inflammation under control, most patients go on what is called a first-line treatment - usually steroids of Exclusive Enteral Nutrition. This first-line therapy is designed to get the inflammation under control and then another maintenance therapy is introduced to reduce the probability of relapse. Maintenance medications are usually one or a combination of an immunomodulator (azathioprine, 6mp or methotrexate), a biologic (often Remicade or Humira) or a 5-ASA med.

I'm surprised that your doctor hasn't suggested a first-line treatment to get the inflammation under control quickly. I believe topical steroids are another potential option for esophageal Crohn's disease.

Also it's always important to stay on top of Crohn's inflammation, for which a lot of doctors now recommend a top-down approach to treatment.

And the type of medication that your doctor has chosen is the mildest (but also the least effective) type of medication. I realise that you have been told that you have a mild case of Crohn's but these sorts of classification are very uncertain and not always helpful. It looks like your doctor may perhaps not believe in top-down therapy as they seem to be taking a step-up approach to your treatment but I think a second opinion might be in order to make sure that you are getting the best treatment for your particular case of Crohn's. I think it's really important to get this inflammation reduced quickly and to use an effective treatment to reduce the likelihood of recurrence.

Good luck! I hope you are feeling better soon!

Here are a couple of papers on esophageal Crohn's:
http://www.ncbi.nlm.nih.gov/pubmed/11383583
http://www.hindawi.com/journals/crim/2010/418769/

 

[buttER]

Hi Dowie
I also have palpitations (skipped heart beats). For me it is a sign that I am not well, often before I get a cold or something, or when my intestines start playing up. It has been enough to concern doctors so I have had a couple of 24 hour ECG tests. Luckily in my case they are harmless but I would say it is worth having checked out for piece of mind.
When it does happen I find that coughing helps to get back to a regular beat.
I also get a pain over my lower left ribs and always assumed it is muscular.

I don't know what to think about the treatment. I always wonder when mesalazine is given at first, rather than something a bit stronger to get the inflammation under control, such as steroids. It seems to depend where you live (i.e. what the local recommendations are) and also who your doctor works for - the university hospitals tend to be more adventurous in their treatment. I was also given mesalazine as the first treatment for "moderate" IBD although in my case Crohns has not formally been diagnosed. 3 years since I started taking it and the inflammation is still not gone although I am alot better than I was.
I hope you start to feel better soon.

 

[Dowie]

Thanks for the replies, I have mentioned the palpitations to my doctor, I understand they're usually benign. I have previously had a holter monitor for 7 days, though that was a while ago and when I had palpitations which were probably triggered by stress anxiety. This time they seem to get triggered with some pain from the left side of the base of my sternum which I was assuming might be some irritation from the esophagus. I will ask re: the medication. Reading up on Pentasa it seems it targets the colon so presumably won't help with inflammation in the esophagus. I think he has the esophagus inflammation down as being from acid reflux which presumably the omeprazole can take care of. It is the colitis from the biopsies which has resulted in me being prescribed Pentasa.