Is a Small Bowel Series the most accurate?

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Mar 12, 2023
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I'm in the UK so not sure if that changes the type of tests available but here goes....

I've had IBS for about 15 years and diagnosed with Bile Acid Malabsorption 6 years ago. Since then I've suffered lower right abdominal pain which I've been sent to A&E numerous times for as the GP thought it was my appendix every time I rang in about it (which I only did when I was finding myself needing daily pain relief and having trouble sitting/standing etc). Tests always showed no issues with appendix. GP referred me to gynae thinking it could be ovary related but after many tests they gave me the all clear.

So, I asked the GP could she refer me back to the bowel specialist who diagnosed me with BAM and she agreed but only if bloods and fecal calprotection showed any need. Both stool samples came back around 200 so not high but enough for the referral to be done. She rang me to say bloods and stool samples showed likely IBD and she'd send the referral. The specialist orders a small bowel series, a colonoscopy and puts me on Colesevlam which I'd been on before for BAM and said he'd see me once those tests were completed.

Last week I had the SBS and it was all clear. He's written to say I need to do another stool sample and if the results are still elevated then he'd order a capsule test as the wait for colonoscopy here is almost 2 years!

So what I'm wondering is, is the SBS enough for me to think I don't have IBD at all and there's some other cause? I don't get numerous loose stools every day, I do have constant pain in the lower right area and now it leads upwards to below my ribs and a small section going across to the right. I get awful pain to alert me of the need for the toilet, so much so that sometimes I need to crawl upstairs to the toilet as I can't stand up. Then it's 20 minutes or more of awful stomach pain and loose stools. Repeat again about 20 mins later and sometimes a third time and then that's it for another 2-3 days when it happens again. I do take Imodium pretty much every day as if I don't then the attacks can happen when I eat throughout the day, this means I usually don't eat if I need to leave the house, even with Imodium (please tell me someone else relies so heavily on Imodium as I'm starting to worry about my excessive use!)

I'm just at that stage where I want a reason for the pain and to get treated but I'm worried the results I've had so far with the FCP only being 200 and the SBS clear that I'm not on the right pathway for discovering what's wrong.

Sorry that's so long, I didn't want to miss anything.
 
It’s depends
Before dx my child had a small bowel series follow through
At the time the radiologist assured us he didn’t know what was wrong with my child but he could say “for certain it wasn’t crohns “ since they couldn’t see the terminal illeum light up on the SBS
That was in July when he was 7 years old
Colonoscopy and CTE in Sept showed evidence of crohns including non caseating granulomas.

so in his case the sbs was wrong
Very wrong

he has had crohns for 12 years now

hope you get answers
 
Thank you both. I forgot to add in my (very long) OP that my son and brother both have Chrons so it's definitely in the genes. I guess I'll just have to wait for the colonoscopy now.

MyLittlePenguin, your poor son, how awful for you both to go through that so young. My youngest is having some issues and we've had to send stool samples. She's 9 and I keep thinking how awful it would be if she had anything like IBS nevermind IBD! Such an awful disease.
 
Yeah the NHS waiting list is so bad after covid that everything is taking a hit. They did say they are working on sending patients to other hospitals to have it done so might get it sooner but I would think it'll still be a few months.

The Chol Powder is so bad! I tried to take that but it was gross so was put on the tablets which do help but they're so hard to actually take as you can't take any other medicines 4 hours before or after them which doesn't really fit well but I do need to be better at trying to get them taken.
 

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