Humor me.

[mrbianos]

Humour me.

I can't stop thinking about this. Mainly because it could end my career.

Symptoms started 6 weeks before appendix was removed. Symptom free for 3 weeks post appendectomy. Been 6 months since Appendectomy.

Reasons why I think I DO have crohns:

1. It keeps coming up when searching symptoms.
2. LRQ (belt line) pain occasionally with LLQ pain and ULQ pain.
1. Pain is a 1-2/10 and lasts 1-2sec.
3. LRQ gugrling.
4. Mucus on toilet paper occasionally.
5. Anal discomfort occasionally.
6. Softer stools but only occasionally true watery diarrhea (3 occasions over past 6 months).
7. Waking up feeling a nervy/stomachy feeling that goes away after standing up and going #2.
8. Occasional nausea.
9. Psoriasis on scalp has started.
10. Bright red blood on toilet paper after taking 2x ibuprofen NSAIDs.
11. 6 weeks after appendicitis a CT scan showed "minor residual inflammation and reactive lymph nodes".

Reasons why I think I DONT have crohns:

1. Calprotectin was <5 ug/mL.
2. CRP 3
3. October colonoscopy was normal (terminal ileum and cecum was vizualised - no biopsies).
4. October upper endoscopy was normal (biopsies normal).
5. WBC is normal on the lower end.
6. RBC is normal.
7. I have days where I don't wake up feeling shit, and I poop a nice level 4 poo.
8. Alcohol makes me worse, could be intolerance?
9. I had an abdominal surgery that could have triggered some sensitivity.

Help me think this through. I have another colonoscopy booked in 2 months.

 

[crohnsinct]

Hi and welcome!

First - Crohns does not have to be career ending. If it is Crohn's, once diagnosed you will get appropriate treatment and be on your way.

Second - yes Crohn's comes up in the search. This is because the symptoms of Crohn's overlap MANY other GI diseases and conditions.

Third - that fecal cal result is VERY, very reassuring. When was it taken. The colonoscopy is also very reassuring.

Mucus could also mean IBS as well as many of your other symptoms.

Usually symptoms of Crohns do not come and go. It is true that disease activity waxes and wanes but before diagnosis, once your symptoms start to present, untreated they usually just get worse and worse.

The bright red on the TP could be hemorrhoids or fissures.

All of this does not mean that nothing is wrong. I think it is good that you are continuing to get checked out and advocating for more investigation. Diagnosis in GI world takes a long time. They have to rule out one thing at a time. IBS is not taken seriously by a lot of GI docs and not understood as well. If it turns out to be IBS, please seek out a GI and registered dietician familiar with IBS

 

[mrbianos]

Hi and welcome!

First - Crohns does not have to be career ending. If it is Crohn's, once diagnosed you will get appropriate treatment and be on your way.

In my industry its pretty restrictive but thankyou

Third - that fecal cal result is VERY, very reassuring. When was it taken. The colonoscopy is also very reassuring.
It was taken in December when my symptoms were somewhat worse.


Mucus could also mean IBS as well as many of your other symptoms.

Usually symptoms of Crohns do not come and go. It is true that disease activity waxes and wanes but before diagnosis, once your symptoms start to present, untreated they usually just get worse and worse.

Do you think that 6 months of symptoms that get better and come back is less characteristic of crohns?

I have negative ASCA and negative ANCA also.
Thanks for replying. I replied in the quote

 

[my little penguin]

So symptoms are just symptoms

Crohns is evidence of damage /cellular changes to the intestine through tests

These show on fecal caloprotectin,colonoscopy ,imaging (ct or mri )
If no changes or damage is seen
If nothing is found

Then it’s not crohns

That is a good thing
Symptoms can be managed by a Gi who treats irritable bowel syndrome (IBS)

All of your test results were good meaning no damage


So not crohns

 

[crohnsinct]

I am curious what industry are you in? My daughter wanted to join the army and was turned down because of her Crohn’s but I hadn’t heard of any other situation and just like to educate myself. Incidentally, since my daughter applied, I have heard even the army might be changing their constraints.

How soon after they went away did your symptoms come back? If you had those tests when you were feeling poor then that is very encouraging. Generally, when symptomatic if it is Crohn’s it will show in blood lambs or fecal cal or scopes visually or at the very cellular level biopsies taken during scope.

 

[mrbianos]

Commercial aviation.

The feacal calprotectin was performed when I was having daily diarrhea in December. Now I can have days where I have type 4 poos.

The CRP, WBC and the test was done in January.

Colonoscopy was pre-appendicitis, it is assumed I had a blocked appendix during the procedure but it wasn’t seen until a CT 3 weeks later.

 

[crohnsinct]

I figured that was the industry. It is harder but not impossible and you will definitely be sidelined until you are in remission but maybe not career ending? Check this link out: https://www.flyingmag.com/taking-wing-grounded/. and this one https://www.airlinepilotforums.com/pilot-health/54150-ulcerative-colitis.html

The key would be to get into remission with the right med.

Ironically, IBS in general is the preferred diagnosis because it doesn't cause damage but since every person is so different and it is so hard to control, I fear that dx would affect your career opportunities a lot more that Crohns.

Honestly, if that calpro was taken when you had daily diarrhea then I would really be surprised if you ended up with a Crohn's dx.

I am so sorry that they didn't catch the issues with your appendix until so late.

I am glad you are getting that second colonoscopy. It will set your mind at ease and hopefully point the physician in the right direction. Even if it isn't UC or Crohn's, it is something and it is affecting your quality of life so make sure they keep investigating!

 

[mrbianos]

Thanks for chatting with me I really appreciate it.

The symptoms that bother me popped up 3 weeks after appendicitis so it's the surgeon that conducted my appendectomy that is also conducting the second lot of photographic journalism on my bowels.

I forgot to mention I had a CT scan about 6 weeks after my surgery that said
"mild residual fat stranding in the right illac fossa with a few reactive lymph nodes, no evidence for abscess, no suggestion of perforation, no dilated loops of bowel and no signs of obstruction".
Everyone said that's normal after appendicitis to have some residual inflammation especially after having it for so long undetected.

 

[crohnsinct]

Hmmm are you followed by a GI who specializes in IBD also?

 

[Guerrero]

Humour me.

I can't stop thinking about this. Mainly because it could end my career.

Symptoms started 6 weeks before appendix was removed. Symptom free for 3 weeks post appendectomy. Been 6 months since Appendectomy.

Reasons why I think I DO have crohns:

1. It keeps coming up when searching symptoms.
2. LRQ (belt line) pain occasionally with LLQ pain and ULQ pain.
1. Pain is a 1-2/10 and lasts 1-2sec.
3. LRQ gugrling.
4. Mucus on toilet paper occasionally.
5. Anal discomfort occasionally.
6. Softer stools but only occasionally true watery diarrhea (3 occasions over past 6 months).
7. Waking up feeling a nervy/stomachy feeling that goes away after standing up and going #2.
8. Occasional nausea.
9. Psoriasis on scalp has started.
10. Bright red blood on toilet paper after taking 2x ibuprofen NSAIDs.
11. 6 weeks after appendicitis a CT scan showed "minor residual inflammation and reactive lymph nodes".

Reasons why I think I DONT have crohns:

1. Calprotectin was <5 ug/mL.
2. CRP 3
3. October colonoscopy was normal (terminal ileum and cecum was vizualised - no biopsies).
4. October upper endoscopy was normal (biopsies normal).
5. WBC is normal on the lower end.
6. RBC is normal.
7. I have days where I don't wake up feeling shit, and I poop a nice level 4 poo.
8. Alcohol makes me worse, could be intolerance?
9. I had an abdominal surgery that could have triggered some sensitivity.

Help me think this through. I have another colonoscopy booked in 2 months.

The DONT list make a stronger case than the DO list in my opinion.
You should be safe

 

[mrbianos]

Just had some more results come through.
CRP 1
FBC Normal
ESR 2 mm/H
B12 286 pmol/L
Active B12 111pmol/L

looking good i guess