My Story - Any advise/thoughts appreciated

[andyw]

Hi Everyone,

I hoped you can help me as I'm getting confused looking on-line.

I'm a 38 year old male based in the UK, 3 weeks ago I had a bout of diarrhoea which isn't like anything I've had before, I'll pass brown soft stool, often then followed by a volume of clear/greenish liquid, I may have to have a few closely times visits to clear the clear/greenish liquid. This may happen once, twice or three times a day. My timing is all over the place, normally I'd go once a day in the morning, now I'm sometimes waking early needing to go, sometimes I don't need to go till the afternoon.

In addition I've have some generally central tummy pain, which has varied in intensity day to day. I've also noticed an increased amounts of flatulence and gurgling from stomach.

I saw my doctor last Friday who did blood and stool tests, they said the blood tests were "borderline" and the stool test was normal. I then had to push with their receptionist to get a follow up appointment as they seemed happy to leave it at that, but while the symptoms don't seem as extreme as the first 2 weeks things aren't as they should be.

Other things that I don't know if are relevant is my stools have always been flattened/ribbon like rather than round and log like. Also my grandmother and other family members have died from bowel cancers so my family is obviously concerned.

Looking on-line I seem to be a strange age to be diagnosed with IBD, flatulence made me thing IBS, but I didn't think IBS would show on blood tests.

What do you all think? Could it be something completely different that I've not considered? Given my doctor seams a bit laxidasical, are there any pertinent questions you think I should be asking her?

Apologies for being so graphic and thank you for any help/feedback.
Andy

 

[24601]

I'd ask for a referral to a gastroenterologist. Also ask your GP what they mean by "borderline" bloods.

With your family history of bowel cancer it's completely understandable that you'd want this checked out thoroughly and cancer ruled out. I think your doctor should understand that - and would see a greater need for the tests with your family history in mind too. Have you talked about this family history with your doctor?

If you have some imaging that should confirm or rule out IBD or some of the other possible conditions too. Flattened stool can be due to a stricture (or adhesions or some other unusual morphology). You say you've always had that so it sounds less likely that it is a cancerous growth causing that but it definitely sounds to me like your symptoms are worth checking out.

 

[andyw]

Thanks 24601 (a Les Miserables reference??),

Spoke to the doctor, explained how my week had been, to which she replied "Do you think it is IBS?" errrm..... hang on, who's the doctor?

I asked about the bloods and stool, she said the stool was normal and the inflammatory markers in the blood test were ok. She said the neutrophils count was high, possibly because I had diarrhoea. She is aware of the family history.

She wants to prescribe me something for IBS and see me in a month.

What do you think? Do you think this is a good approach?

Thanks again,
Andy

 

[24601]

Hi Andy,

I don't think it's ever acceptable to treat for a milder condition without first ruling out the potential serious causes. So nope I wouldn't go for that.

And I think it's clear - YOU are the doctor here!!! With assistance from forums like this one it sounds like you are already better qualified. Sadly this is too often the case with our GPs. I once had one ask me if I thought a wound on my arm was infected. I was like let's think about this...redness? Check. Yellow pus? Check. Red marks radiating out from wound? Check. Duh, yes, I think it's infected. And to myself I thought...are you really qualified? And if so how???

If it were me, I would say that I want a referral to a gastroenterologist to rule out a serious cause for these symptoms, including bowel cancer. Tell her that it would be a real shame (deliberate understatement because you know who wants to get labeled hysterical) to get a late diagnosis on bowel cancer - especially in your case with a warning sign like your family history. It really is not very likely that you have bowel cancer - but it's possible and should always be ruled out - but also I think if this focuses her mind on finding a cause of your symptoms instead of taking the easy "maybe it's IBS" option then that's good.

I hope you have some luck with that approach - or whatever you decide on! Maybe you need to try a different GP. Do update us.

p.s. yes my username is a Les Miserables reference...I admit I was thinking along the lines of the possibility of a Crohn's lifer getting some sort of reprieve but I probably should have decided that was a little too dark. Oh well, maybe people just think I'm in jail? Btw, I don't want anyone reading to misconstrue this, Crohn's is not a life sentence for most people but there are times it can feel like it. It's so tricky to do PR for this disease.

 

[GotCrohns]

Hi Andy,

Looking back on my diagonsis 26 years ago , I realize it could have been so much quicker if I had had the knowledge to ask the right questions. The day after i finally had a colonoscopy and was diagnosed (28 years old) I had my first resection.

Crohn's is a sneaky disease in my opinion. Symptoms one day, gone the next. Feel great, than out of nowhere symptoms again. It can go away for long periods and then decide to come back.

A few years ago I had an obstruction from previous operation scar tissue and because of the narrowing, the colonoscopy could not physically go any further. Surgery fixed the scar tissue and some Crohn's infection upstream. Interest entity enough the active Crohn's did not show up in any of my regular blood tests.

The best advice I can give you is to insist on a colonoscopy, probably something that has to be scheduled by a GI. With better medicines for clean-out and pain management during the procedure, they've come along way from my first one. I've always stayed awake, watched the screen and asked questions (even in my inebriated condition). One procedure can take away a lot of uncertainty by putting your mind at easenor getting treatment that will put you into remission.

I wish you well In your quest for answers,

 

[andyw]

Thanks Both,

Over the last few days, my stools have firmed up, though my tummy has still felt a touch delicate. The doctor has prescribed mebeverine which I haven't started taking as I wanted to see if things were improving naturally.

This morning I went and noticed while my initial visit was relatively firm it was really pale with the odd brown bit in (think choc-chip muffin), I then had to revisit when things were a lot looser and still light grey.

Googling pale/white poo suggests a lack of bile problem, which is odd as the last few weeks I was thinking I had too much bile!

Is any of this consistent with Crohns and do you think I should postpone taking the mebeverine?

Thanks Andy

 

[24601]

I personally wouldn't treat the symptoms until I had a diagnosis.

And in my experience pretty much any strange stool issues can be consistent with Crohn's but they're also not specific to Crohn's and could be caused by a number of other gastro conditions.

Best wishes