Ibuprofen damage or Crohn's?

[Tesscorm]

Hi, looking for opinions...

A bit of background, my son, 16yrs, was diagnosed with Crohns in May. His first symptom was pain between/just below his ribcage and burning after he ate. As there is family history of acid reflux, his doctor prescribed Nexium. Pain disappearred. About a week or so later, his newer symptoms appeared - tiredness, fever, diarrhea, lack of appetite (no pain or blood). The symptoms would disappear after a few days and return 5-10 days later, recurring 3 to 4 times (he had some canker sores twice). Over two months, blood tests, x-rays, ultrasounds were done (results showed mild duodenitis and anemia) and he lost approx. 15 lbs. At the next recurrence, we took him to the hospital, where more blood tests, ultrasound and stool sample was done. Within 3 hours we were told they believed it was Crohns and would confirm with colonosopy, which was done two days later and diagnosis confirmed. Unfortunately, I'm a bit sketchy as to these results (everything happened so quickly, it was overwhelming and I knew very little about Crohns) - not sure if a biopsy was done, how long biopsy results take (they told me the Crohn's was confirmed while he was still in recovery, so I don't think they would have had biopsy results within minutes...)

I apologize if this is a bit long, am trying to condense!:ywow:

Almost at my question... my son has had back issues for a couple of years (not spinal problem, muscular) and, over the winter, he plays on two hockey teams (plays approx 11 games per month plus practices). Months ago/last year, his doctor suggested that he take an Advil or ibuprofen before games to help reduce the muscle inflammation. And now, thinking back, he was probably taking close to 15 ibuprofens/advils per month, September to April.

His use of ibuprofens didn't cross my mind during these GI episodes (which started in March/April) and the issue was never brought up by any of the doctors, but now I'm wondering if it was overuse of the ibuprofens that have caused his intestinal inflammation/ulcers.

Would the test results distinguish between inflammation/ulcers being caused by Crohn's or by ibuprofens? Would the treatment for the inflammation/ulcers be the same (he is on an enteral diet)? I believe this could certainly be the trigger for his Crohn's flares but, at the same time, I'm wondering if he has Crohn's at all and if he's being treated incorrectly???

Any thoughts?

 

[tiloah]

I think my excessive use of ibuprofen (for headaches) is one of the things that led to me having Crohn's.

Why do you doubt that he has Crohn's? What tools/tests/methods did they use to diagnose him?

 

[Tesscorm]

Initially, I was surprised at how quickly he was diagnosed (especially after reading the stories of so many others who had such difficulties in reaching a diagnosis). He was in 'emergency' for 3 hours, had blood test and ultrasound and they told us that he most likely had Crohn's and that they would give us a schedule of educational seminars! I'm not even sure they had time to get blood test results back??? But, in any case, after scouring this site and gathering other info, I can see that he has some, if not all, symptoms (then again, no one has 'all' the symptoms!).

But, something prompted me to think of the ibuprofen last week and when I started to research that, I started to realize that all of his symptoms could also be be realted to excessive use of ibuprofen. However, not sure that his level of usage would really be considered 'excessive', i.e., not even on a daily basis, although it was long term.

As for his diagnosis, as I mentioned, the hospital did blood tests, ultrasound, stool sample and colonoscopy. Blood tests and ultrasound confirmed inflammation/swelling in the terminal ileum, anemia, CRP level was high (190 when admitted, 22 a week later, when discharged), and not sure about stool sample and/or biopsy (feel dumb about not knowing this but really was just overwhelmed with everything those few days...)

So, of course, I'd love it if he did NOT have Crohn's, however, was initially researching the ibuprofen as a possible trigger but then got to thinking, questioning...???

 

[Tesscorm]

I've attached one of the articles I found re nsaids, thought you might be interested. Also, wanted to comment on something you said ' one of the things that led to my having Crohn's'. From my understanding, the use (excessive or not) of ibuprofen or nsaids cannot cause Crohn's but can either trigger the underlying illness or may mimic the symptoms. So, it could be that my son had crohn's earlier but never presented any symptoms until he began to regularly use the ibuprofen.

http://www.sciencedaily.com/releases/2005/01/050111123706.htm

 

[tiloah]

I've attached one of the articles I found re nsaids, thought you might be interested. Also, wanted to comment on something you said ' one of the things that led to my having Crohn's'. From my understanding, the use (excessive or not) of ibuprofen or nsaids cannot cause Crohn's but can either trigger the underlying illness or may mimic the symptoms. So, it could be that my son had crohn's earlier but never presented any symptoms until he began to regularly use the ibuprofen.

http://www.sciencedaily.com/releases/2005/01/050111123706.htm

No one knows what causes Crohn's. The best guess is that some individuals are susceptible to it and/or a combination of environmental factors "triggers" it. In my case I believe my ibuprofen use was one of those "triggers," as may be the case with your son.

I would say the fact that your son has his inflammation in the terminal ileum and the fact that he had a colonoscopy are probably pretty definitive, along with the other tests he has had.

 

[tiloah]

He's not taking the ibuprofen now, is he? If he is, he should stop! Ibuprofen is terrible for Crohn's, for obvious reasons. If he isn't and he still has the symptoms, it probably isn't the ibuprofen causing them (though it might have "triggered" them, as mentioned earlier).

 

[David]

Edit - pay no attention to me, I r stupid.

 

[Tesscorm]

No ibuprofen now! His current treatment is only the enteral diet and one nexium per day. For the 'most' part, his symptoms have gone. His fever gone, tiredness gone (after one week on the diet, he's been doing 2+ hours of phys.ed. each day plus 1-2 hockey games per week), no fever and he's been 'starving' for the past two weeks(dietician said this implies the inflammation is disappearing but unfortunately they can't increase his dosage - he currently gets 3,000 cal per day). He has been on the diet for 4 weeks now and continues to have liquid BMs (however, we were told to expect this because of his liquid diet). But, one other symptom he's had that's worried me is that he continues to have some mucus in the diarrhea (during the 4 weeks) and twice (just within the last week) there have been specks of blood in the mucus (never had blood before).

Emailed with the IBD nurse, she said the bowel heals top to bottom and that this could be the tail end still healing (she seemed to be vague). However, if this is the case, why wasn't the blood there earlier? I'm thinking that the inflammation is not healing or worsening???

But, even this is confusing me... why would the inflammation not be healing but no other symptoms showing up? Again, once I started reading about the ibuprofen, I began wondering if he's not being treated correctly? Wud treatment for inflammation caused by ibuprofen be different from the treatment for a Crohn's flare?

To be honest, I've tried to learn so much in the last few weeks, sometimes, I think my head is going in a million directions so, perhaps, this whole ibuprofen thing is barely relevant???

 

[tiloah]

The biopsies they take aren't to confirm Crohns. Those are for other diseases such as Microscopic Colitis. Mine took a few days to come back.

Are you sure? After my colonoscopy I was sent a report that said my biopsies confirmed Crohn's.

I know also that biopsies that show crypt granulomas are indicative of Crohn's.

 

[tiloah]

The enteral diet (as long as he doesn't cheat) should reduce inflammation. Poor kid though! Sticking with that is tough. I don't imagine the treatment would be much different for damaged "caused by ibuprofen" versus Crohn's (as far as healing inflammation goes). If it were as simple as the ibuprofen, discontinuing them would probably be all it took to heal it.

I wouldn't worry about the blood and mucus. In most people that clears up, but it may not. I don't think the inflammation is getting worse. As long as it is only a small amount of blood, and especially if it is recognizable as blood (it's red, not black) it should be ok. It's definitely worth mentioning to the doctors, either give them a call or at your next visit.

Have they talked about maintenance for your son? He can't be on an enteral diet indefinitely. Studies have shown it to be as effective as steroids in healing inflammation (as long as the patient doesn't stray, which can be difficult).

In any case, while it sounds to me like your son does have Crohn's, I'm with you in hoping that he doesn't. Nobody should have to deal with a diagnosis like this for life. I hope he gets some good treatment and starts healing and feeling better.

 

[lola99]

I always had abdominal cramps but never had any of the other "crohns" symptoms. But after having my second son i had a really bad tear and was taking a ton of perscribed ibuprofen. Soon after that I flared and i got a partial blockage. I went into the er and had urine,blood and a ct scan/mri/x-rays. They told me i had crohns after that. Then they did the colonoscopy with biopsies which showed inflammation but thats it. Since I've flared up i've had mucus with a little bit of blood in it. I always had mucus but not like it is now its alot more than before and i never had blood in it. i think its just from flaring. I read somewhere on a medical website that ibuprofen can cause crohn's to become worse. My crohns cramps were always bad but after taking all that ibuprofen after my sons birth it got so bad i got the blockage.

 

[Lydia]

I got dxd with crohns in the ER. They did a scope and the GI was "Yep thats Crohn's" The skip lesions made it pretty obvious. They did take some biopsies and such for comfirmation and more investigation. But they can tell by looking at the scope in some people.

 

[David]

Are you sure? After my colonoscopy I was sent a report that said my biopsies confirmed Crohn's.

I know also that biopsies that show crypt granulomas are indicative of Crohn's.

Hahahah, looks like my farts are coming out BOTH ends. You're right, thanks for keeping me on my toes. I'll edit my post

 

[tiloah]

Hahahah, looks like my farts are coming out BOTH ends. You're right, thanks for keeping me on my toes. I'll edit my post

Haha. I only asked because I was wondering if my GI's office was full of it. XD

 

[StarGirrrrl]

Every single CD patient is different, there A typical cases, but there are also those who fit none of the conventions yet have the disease.

If he was diganosed in May then I imagine you are all still getting used to it, it can take time

 

[Tesscorm]

It is hard to accept the diagnosis, especially coming so quickly, but I do think I have started getting used to it (or, at least, 'was' until I started on this ibuprofen path). However, his symptoms do confuse me, and did so even more when I started reading about the ibuprofen. I don't understand why all his symptoms would be gone without any real drugs (other than nexium) yet the mucus is still there as well as the recent blood. Anyhow, we are going to the doctor soon for his follow up and I'm sure they will answer my questions. Hopefully, they have a hour or so to spare!

Thanks everyone for your help! Very much appreciated!

 

[crazycanuck]

Hey there.

I too was diagnosed at 16 while playing a ton of hockey. I was playing 5 to 6 times a week when I was diagnosed. I too took a ton of ibuprofen for aches and pains as I don't think a season could go by without it. I for sure was diagnosed with Crohn's though which was proven with pictures, biopsies and the continued disease again confirmed nearly 4 years later. Not to say this isn't what could have happened with your son but I'm not sure 15 pills a month is enough to cause something like this. Something to ask your doctor thought. Good luck!

 

[Tesscorm]

Yes, I questioned what would determine 'extensive' use. Although he took the ibuprofen regularly for months and, thinking back, it seems like a lot now (i.e., I don't take 15 ibuprofens/tylenols each month), it wasn't even one per day. I'm sure people with chronic pain take many more per day for long periods. So, that was a question mark for me? What constitutes 'extensive'. Found quite a bit of info on long term ibuprofen/nsaid use (interestingly, quite a bit referred to its use by athletes) but no where did I find mention of quantity.

thanks

(by the way, was sorry the Canucks weren't able to bring the Cup to Canada!! Maybe the Leafs'll do it next year! LOL)

 

[Jennifer]

I can take almost 15 Advils in a day. Last time when I was sick I took 12 (4 tabs 3x) to help reduce my fever and stop the body aches. I usually only take advil as tylenol just doesn't cut it. I know a lot of people say its a no no but until I have an issue with it I'm not gonna give into the hype (I don't take it daily and I would never take it for abdominal pain so there's little cause for concern). And no it did not give me crohn's either cause I didn't even start taking it until well after my diagnosis.

There's no proof that Advil causes Crohn's and I HIGHLY doubt his symptoms were caused by the Advil since he took on average about 100mg of it per day (one tablet contains 200mg). Its not going to do anything. Yes you can get CD confirmed during a colonoscopy even before the biopsy results get back just by looking at it (similar to diagnosing ring worm, you can just tell when its in full bloom so to speak). Its better to begin treatment before the biopsies get back anyway especially when his symptoms are so bad.

The mucus is from inflammation and the blood is from an open wound. I hope he gets the treatment he needs soon. I know its hard to accept a diagnosis like that but if you're really that concerned you can always try to get a second opinion. Although I'd only go that route if his treatment plan wasn't working.

 

[purdueCrohns]

There actually is research indicating that NSAIDS can be a trigger for onset of Crohn's if you are predisposed to the disease. My doctor is actually recommending that my immediate family avoid NSAIDS to avoid the trigger.

 

[shamrock15]

My diagnosis for Crohn's came just after I finished my minor hockey. The last year had me playing three teams for awhile. Hope we aren't coming to the conclusion hockey is responsible! (Just kidding..., mind you us canucks do seem to have higher incidences of crohn's). I didn't need a lot of pain killers when I played, but needed a bunch later when I was reffing. I did have troubles with anemia then, and a lot of the killers were advil because it worked quicker and more effectively.