My intro, question of Crohn's/UC

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Hello all,

I did a bit of reading on the forum last night, and my heart goes out to all of you. It also makes me wonder if maybe we are barking up the wrong tree again in looking into Crohns, as my symptoms are not near as bad as many of yours.

I hope you don't mind me still asking the questions in the hopes that you might have some ideas. I too am very leery of accepting the word of any doc, and refuse to do it over my own intuition. I've been burned a few times before, including at least one unnecessary surgery, so I know they are not Gods. I've found that people who have personal experience often have better leads than the docs who really don't care much (as a whole), how we feel.

I was diagnosed with IBS in my 20s (I'm 36 the end of this month). Spent those years working as a home-based therapist with tons of bathrooms in Southeastern MA mapped out. I worked a stressful job, with lots of people who could have cared less about the kids that we worked with, so I chalked it up to that. Oh wait, prior to that, in 1997, I had my gallbladder out if that's significant.

The IBS has been mostly in check since I stopped working that job, with some bouts at the beginning of each pregnancy (3) and some after. Fast forward to 2005 when my dd, then 2, developed symptoms that prompted the NP to test her for Celiac. She came up high on one panel out of 5 (for those that know, the IgG, which is not very specific to Celiac, but I believe one of the first to be elevated), which started me on a journey to understanding intestinal health. Well, first, I ignored my instincts that something was wrong, until little guy was born a couple of years later and had very similar symptoms to dd. Finally, I trusted mommy gut.

In March of last year, I had a car accident. Turns out, I have sleep apnea, and had no idea. None of us was injured, but I started having RUQ pain around then. Well, it wasn't the first time. I used to joke that they had left an instrument inside of me during the gallbladder surgery, b/c it sometimes felt like there was something there, but it never caused me a great deal of discomfort. I never hit anything, and the seat belt really doesn't cross there, so I think the accident was a red herring, and never the cause of the RUQ pain.

The pain eventually subsided, until I had this nasty nasty stomach virus back in December of 08. I don't vomit generally, I have diarrhea, so it got to the point where there was no point in laying down anymore and trying to sleep. This kicked the RUQ pain into high gear.

Since then, I've had an abdominal u/s, ct scan, pretty extensive blood work including liver enzymes, and a whole slew of other things that I'm currently forgetting (and have misplaced the darn results sheet for); nothing showed.

The gastro, who had previously been very receptive to my self-reports (even testing me for Celiac despite the fact that I am overweight and my dd was eventually diagnosed by an "alternative" lab that does stool testing, arguing that celiac will first show up in the stool not the blood), finally wrote me off when I admitted to him that extra activity did seem to make the pain worse at times. It feels to me like something is in there, under my ribs, and at times it feels swollen and then it will be painful. It's very hard to describe.

He did an endoscopy, and reported that I have a polyp in the small intestine, a hiatal hernia, and silent GERD. No evidence of celiac, but he did tell me with measurable tTg, despite being largely Gluten-Free, that I should also be strictly Gluten-Free. The guy is pretty remarkable that way; most docs will dismiss anything but the gold-standard biopsy results, arguing that being GF is too restrictive (it's really not that bad).

As I said, he later wrote me off, when he did an exam, and pushed on my ribs, asking if it hurt. Duh, of course it hurt. He never pushed in and to the left where the pain has generally been localized. He told me to take Naproxen and to call him if any new symptoms came about. Oh, he had previously surmised that it was possible that I still had gallstones despite not having a gall bladder and that scar tissue had built up where the cut a hole for them to pass, not allowing the stones to pass. He was talking out loud, so I may be misunderstanding some, but that was the gist. He said that the ERCP carries risk, and he didn't think it was warranted given that activity increases the pain (which interestingly, it does seem to at at times, but I'm not certain now).

Sure enough, I start developing fecal incontinence, and the pain, though at times a bit better, had bouts that got worse again. The pain can be a pulling sensation along the ribs, sometimes like a stitch in the side, other times a burning, stabbing pain deep. It affects my daily life.

It extends along the back with what I would describe as a fullness sensation. Like something is pressing against the ribs (in the front, along the side and in the back) that shouldn't be. I've had frequent bouts of diarrhea, urgent need to go to the bathroom, frequent acidy sensation in my rectum, increased flatus, nausea from time to time (mostly in the morning), and the fecal incontinence, which I find very stressful.

Continuing exhaustion, at times with no explanation (i.e. 8 hours of sleep with the CPAP on the entire time). I believe this is tied to the unexplained pain. Sometimes the burning comes up under my bra band very deep and briefly intense. I've also had several bouts of intermittent chest pain, which could be anxiety but I don't think so.

So, there you have it. I finally decided to call the gastro and risk being dismissed further, but whatever I said to the receptionist got me straight to the nurse, who is the doc's wife, and appears to run the show in many respects. She immediately said that we need to do a Crohn's and UC work-up, as well as Lyme tests, FOBT (and other stool tests) and probably some other things she didn't share.

I have a colonoscopy scheduled for the 20th, which of course I'm not looking forward to, having had a flexible sigmoidoscopy in 1999, for unexplained rectal bleeding *only* during menstruation, which continues to this day. If I don't need a colonoscopy, I'd much rather not do it, of course.

Sorry so long, but I've found it better to share too much than not enough. I've probably left several things out as a matter of fact, so feel free to ask.

And thank you so much. Many wishes for improved health for all of you!

Christie, NY
 
christiecc said:
as my symptoms are not near as bad as many of yours.
Hi Christie! Any symptom is a symptom - and your symptoms don't sound any too pleasant, and even when we go into remission we are still welcome here, so welcome!
I hope you get some answers from your colonoscopy.
Do you ever have air escape from your V or a tiny bit of brown? Your bleeding from your butt only during your period sounds like it could be a recto-vaginal fistula. Almost like a tunnel or a little tear between your rectum and your V. It can be very small at first, and you almost wouldn't notice. I diagnosed mine on my own, no doc or ob/gyn had seen it cuz it was that tiny. When I was pushing my daughter out, blood was coming out my ass. The doc was like 'Wow, look at that - interesting!" Yeah - thanks.
So that might be something to watch for.
Good luck and welcome again. Let us know how your scope goes!
 
hey christie!
yup gotta agree with mbh on that, my first thought was the rectovaginal fistula. if you have the other symptoms of that like mbh describd, they can do a dye or air test to see if they can confirm its prescence. though, the tests are not always 100%, in my opin the best way to know if its there is your own thoughts about it.
glad that you are gonna get a scope soon, thats usually the best way to make a disgnosis.
i have chest pain too at times, especially when eating and drinking and i know its from inflammation in my esophagus. crohns can affect any part of the digestive system from your mouth all the way down to your bum, so esophageal ulcers happen sometimes and it definitly feels like a sharp burning pain behind your ribs (its been acting up the past couple days actually). i had an endoscopy to check it out once and my GI did in fact see them. it was good to know that the chest pains were that and nothing heart related. maybe they can do that test as well, was your last one awhile ago?
also, MANY of us on here suffer from the incontinence. we can totally relate to you in that area and it is definitly one of the most stressful, embarrasing, and life interupting symptoms.
dont feel embarrased to talk about anything!
welcome to the forum :)
 
My Butt Hurts said:
Hi Christie! Any symptom is a symptom - and your symptoms don't sound any too pleasant, and even when we go into remission we are still welcome here, so welcome!
Thank you; it's very kind of you to welcome me. I guess I just feel a bit intrusive when I'm not really sure I belong, yk?

I hope you get some answers from your colonoscopy.
Do you ever have air escape from your V or a tiny bit of brown?
Yes, but not often. I will have what I describe as sharp, painful cramps that move vertically and feel like they come out vaginally. So hard to describe. Honestly, I never have known if it was normal or not. In fact, I thought everyone bled rectally during their period until I was in my 20s; how would I know?

Your bleeding from your butt only during your period sounds like it could be a recto-vaginal fistula. Almost like a tunnel or a little tear between your rectum and your V. It can be very small at first, and you almost wouldn't notice.
It's amazing how much we non-MDs know isn't it? I have said for years that I suspected that there was some kind of unintended pathway between my vagina and rectum that explained the rectal bleeding. But why only during my period? The only explanation I came up with for that was some kind of endometriosis, and that doesn't really fit either, though a friend of mine suspects that endo could explain my RUQ symptoms too.

Btw, I have an interesting anatomy to begin with. I have a septate (divided) uterus, and possibly a second cervix (I had 2 cesareans and then a vaginal birth, and during my labor with my 3rd, the midwives said that I had a 2nd cervix dilated to 3 cms. This has since been found by a few other people, otherwise I might suspect that what they found was the fistula. Who knows.

I diagnosed mine on my own, no doc or ob/gyn had seen it cuz it was that tiny. When I was pushing my daughter out, blood was coming out my ass. The doc was like 'Wow, look at that - interesting!" Yeah - thanks.
So that might be something to watch for.
Good luck and welcome again. Let us know how your scope goes!

So nice of docs to treat us like freak shows. They honestly don't remember that we are human beings lying there a lot of the time. And ime, think we are too dumb to comprehend anything anyway.

Thank you so much, btw. I will do that!

I don't think I have a siggy yet,

Christie (Upstate NY as well)
 
kello82 said:
hey christie!
yup gotta agree with mbh on that, my first thought was the rectovaginal fistula. if you have the other symptoms of that like mbh describd, they can do a dye or air test to see if they can confirm its prescence. though, the tests are not always 100%, in my opin the best way to know if its there is your own thoughts about it.
glad that you are gonna get a scope soon, thats usually the best way to make a disgnosis.
Thanks for your reply too Kello. Forgive my ignorance, but what is the benefit of knowing if I have it? I ask, b/c I prefer to avoid as many painful and humiliating exams as possible (don't get me started on OBs who insist on early pregnancy pelvic exams for no good reason), so if knowing wouldn't affect treatment, then I'm not sure I want to know badly enough to endure additional tests. Does that make sense?

i have chest pain too at times, especially when eating and drinking and i know its from inflammation in my esophagus. crohns can affect any part of the digestive system from your mouth all the way down to your bum, so esophageal ulcers happen sometimes and it definitly feels like a sharp burning pain behind your ribs (its been acting up the past couple days actually). i had an endoscopy to check it out once and my GI did in fact see them. it was good to know that the chest pains were that and nothing heart related. maybe they can do that test as well, was your last one awhile ago?
Interesting. I'm not sure that my symptoms are exactly in line with yours, but I will say a couple of things with related questions.

First of all, I believe that I have inflammation in my esophagus--I can feel it. One of my other new symptoms (in the past 3-4 months), is that my throat feels scratchy, maybe a bit raw (also hard to explain). It has been increasingly hard for me to swallow, and things seem to get "stuck" in my esophagus. In fact, I've stopped taking my pills (all OTC vitamin supplements) for this reason. I keep wondering if I have new food allergies/intolerances, but that seems far-fetched.

The endoscopy was in April, I think, so not that long ago. Are the ulcers easy to miss?

They did prescribe Prevacid. I did some research on this, wasn't crazy about taking it for silent reflux, but ultimately decided to try it to see if it affected my RUQ symptoms. I took it for 30 days with no change in symptoms and stopped taking it. It seems unlikely that I would have new symptoms so soon since the endoscopy, but it may have been shortly after that time that the burning/scratchy throat thing started. I wish I was disciplined enough to write it all down!

also, MANY of us on here suffer from the incontinence. we can totally relate to you in that area and it is definitly one of the most stressful, embarrasing, and life interupting symptoms.
dont feel embarrased to talk about anything!
welcome to the forum :)

Thanks again! Oh, and are there any specific things I should insist on when I talk to the Gastro? I'm really not sure what to expect from him at this point. I've asked my dh to come, even though he's crazy at work, because a). I think I'm more likely to be taken seriously, much as that sucks, and b). The gastro is a fast-talker and I want my dh there to help me remember what the heck he said and to make sure I get any questions answered before he runs off.

I'd appreciate any words of wisdom for what to ask/insist upon for Friday. Thanks!

Christie, NY
 
Saw the Gastro today. DH does not think the Dr. is writing me off, he thinks he is puzzled.

Oh, first off, my inflammatory markers--CRP, P-ANCA, P-ASCA all came back normal. I don't know how all of my labs are coming back normal. This is NOT all in my head!

He ordered nutrition studies: carotene, B-12, Zinc, Folate, Magnesium, Vitamin D-25-OH,

TSH/Free T4,

Inflammatory Markers CRP, P-ANCA, P-ASCA,

and

CBC with DIFF, IRON, TIBC, %SAT, FERRITIN

Liver Studies ASMA, AMA and ANA (he had ordered other Liver studies previously)

Oh and he wants to do a Barium Swallow on Thursday.

HELP!!!!! Is there anything I need to ask him/tell him on Monday? And I am sooo dreading the prep for the colonscopy. I just feel like a sick person. I'm rambling and stressed and I'm sorry. Ugh.

Christie
 
I'm back again. Not sure anyone is reading these, but oh well. Anyway, I just had a horrific experience. The staff preps me for the conscious sedation, and when I ask the nurse, just to make sure, the doc walks in. He says that I can do the procedure with no drugs if I want.

Honestly, I am the type to not do drugs if I can, but I did not feel like I had time to decide. So, I thought he was almost finished, and then he says something about it being the part he had mentioned that would be the worst 20 seconds (I already thought it had been pretty bad), and I started screaming. I really do think I have a decent pain tolerance too. The nurse is asking him to hold up a minute so she can give me the versed. I think he paused very briefly, then started going again, and maybe I blacked out but it only seemed like another 20-30 seconds.

And after all of that? I never saw the doctor, but the nurse said that everything looked good. I'm in quite a bit of pain and it was all for nothing? During the prep, I could feel it burning in spots. It's hard to explain, but it almost felt like canker sores inside in a few spots, but he saw nothing?

I honestly don't know what to do. I have a barium swallow scheduled for Thursday, and I don't even know if I should bother. And maybe I shouldn't be, but I'm ticked at the guy. I don't feel like he gave me informed consent, and he totally blew it when I was screaming in pain. I mean, I swear if he had just paused for a few seconds, I could have regained my resolve and had him finish. Instead, I feel all weird from the Versed.

The big question is if I should even go Thursday. I haven't done the stool tests because I had my period. I should be able to start that tomorrow. I'm overwhelmed and exhausted.

Given that my labs came back normal though (he ran them again, but I'm assuming they were normal again) and now it seems the colonoscopy came back normal, what on earth else is there left to do?

Any suggestions welcome!
 
Welcome Christie. Firstly, let me say that I am so sorry you are going through all of this. This "process of elimination" can drive a person insane!

Secondly, I have yet to be diagnosed, but my labs are normal, too -- it's annoying as HELL because if there's nothing abnormal in blood work, it seems a majority of docs (my own included) will pull the ol' "it's stress/in your head" card. I feel your frustration. Blood, ultrasound and MRI's came back perfect. Currently I'm awaiting my barium enema results which I did on Friday.

I wish I had more advice, but as someone who has been struggling for an answer since Oct./Nov. 2008, I have little to offer. :(
 
Hi Christie, I'm sorry that the colonoscopy was so painful! The unknown of no diagnosis is horribly frustrating...

I am also not diagnosed, dealing with this bs since March. My labs as well, every last g/d one of them, has come back normal.

My colonoscopy, at the time, showed my bowel looked great, then I got a letter in the mail, after they tested the biopsies, telling me there was indication of colitis...did they take biopsies during yours?

You could go through with the small bowel barium swallow deal, I had this done also. All normal he said, but showed 'an area of non filling' whatever that means...hmm...
The test is more info, can show strictures or difficulty swallowing or issues with valves at stomach and small bowel to large entrance...totally up to you though! Some might consider us lucky for someone to have ordered these tests on us as many docs do not believe the symptoms to be significant as vshirey also mentioned. Who knows they may find something!

Well take care dear and keep us posted! We are here for you! And I have been reading your posts without much time to respond, but I am now :).
 
Follow up re: recto-vaginal fistula and colonoscopy

My Butt Hurts said:
Hi Christie! Any symptom is a symptom - and your symptoms don't sound any too pleasant, and even when we go into remission we are still welcome here, so welcome!
I hope you get some answers from your colonoscopy.
Do you ever have air escape from your V or a tiny bit of brown? Your bleeding from your butt only during your period sounds like it could be a recto-vaginal fistula. Almost like a tunnel or a little tear between your rectum and your V. It can be very small at first, and you almost wouldn't notice. I diagnosed mine on my own, no doc or ob/gyn had seen it cuz it was that tiny. When I was pushing my daughter out, blood was coming out my ass. The doc was like 'Wow, look at that - interesting!" Yeah - thanks.
So that might be something to watch for.
Good luck and welcome again. Let us know how your scope goes!


MBH, I've been thinking more about this one. I definitely have air that escapes from my V, but I never thought much about that. I did some reading on it, and like most things, it doesn't quite fit b/c I have no reason to believe that stool escapes vaginally, etc.

Would they see a fistula on a pelvic MRI or during the colonoscopy? Then again, as I posted last night, I have no confidence in the colonoscopy. Seems to me that he easily could have missed things with me in so much distress. Who knows if he even got enough samples.

Have other people had the colonoscopy with no meds? Did the dr. go slow to make it more tolerable? I'm really upset about yesterday and don't know that I can face this guy again. It's hard enough w/o having had this experience.

And I just don't know. I read one thing and I think "yeah, that fits", and then I read another and think "nope".

I just want to feel well.:depressed:
 
vshirey317 said:
Welcome Christie. Firstly, let me say that I am so sorry you are going through all of this. This "process of elimination" can drive a person insane!

Secondly, I have yet to be diagnosed, but my labs are normal, too -- it's annoying as HELL because if there's nothing abnormal in blood work, it seems a majority of docs (my own included) will pull the ol' "it's stress/in your head" card. I feel your frustration. Blood, ultrasound and MRI's came back perfect. Currently I'm awaiting my barium enema results which I did on Friday.

I wish I had more advice, but as someone who has been struggling for an answer since Oct./Nov. 2008, I have little to offer. :(

Many wishes to you on a diagnosis as well. I keep telling myself "but you don't want to have any of these things", but my brain quickly answers "but you have something!"

Ugh. Hoping you get answers from your test asap.
 
Lisa5326 said:
Hi Christie, I'm sorry that the colonoscopy was so painful! The unknown of no diagnosis is horribly frustrating...
It is. Oh, btw, did anyone else have a significant increase in pain after the colonoscopy? Walking, moving was so painful last night. Just sitting was not so bad.

I am also not diagnosed, dealing with this bs since March. My labs as well, every last g/d one of them, has come back normal.

My colonoscopy, at the time, showed my bowel looked great, then I got a letter in the mail, after they tested the biopsies, telling me there was indication of colitis...did they take biopsies during yours?
Ugh, I'm sorry about your labs. As for biopsies, I have no idea. I had assumed that he would take biopsies (he did from the endoscopy), but with me in so much pain, I don't know if he did less than he normally would.

Oh, and get this--this guy told me to be gluten free based on having measureable (though not technically positive) tTg even when I was mostly gluten free, and Friday said "well, we know you don't have celiac". Maybe he's senile.

You could go through with the small bowel barium swallow deal, I had this done also. All normal he said, but showed 'an area of non filling' whatever that means...hmm...
The test is more info, can show strictures or difficulty swallowing or issues with valves at stomach and small bowel to large entrance...totally up to you though! Some might consider us lucky for someone to have ordered these tests on us as many docs do not believe the symptoms to be significant as vshirey also mentioned. Who knows they may find something!
I think he wanted to order this based on me saying that I've stopped taking my pills because things get stuck. Who knows though, he's not forthcoming at all.

Well take care dear and keep us posted! We are here for you! And I have been reading your posts without much time to respond, but I am now :).

Oh, I understand, I just am not used to forums, and didn't know if they were going through, or if I should be posting differently so that people saw them. And I know that no one has answers necessarily, but more questions to consider and/or experience/support are great too.

What I know is that I am 35 years old and I am not ready to be "old". I need to feel well again.
 
UPDATE, possible diagnosis and possibly some promising research for Crohn's

Hi everyone,

So, on Friday, I received a call from the gastro dept. Turns out I have an intestinal amoebae, d fragilis, apparently. Lovely.

So, for now I'm on Flagyl and I'll see what that does. I have a feeling this isn't the whole story, but we'll go with it for now.

In my researching, I came across this interesting article that they are researching how bacteria can prevent and treat Crohn's. My apologies if this has been discussed/shared in the past.

http://www.sciencecentric.com/news/article.php?q=08052855

In the meantime, I'll probably sign off this forum at least until the Flagyl treatment is through. I'll re-assess at that time. Apparently, Flagyl isn't always effective in treating the d fragilis, but I'll cross that bridge when I come to it. If anyone has experience or information to share with me, I'd love it.

Thanks all, and best wishes to all of you on your quests for health.

Warmly,

Christie
 
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