New here with difficult diagnosis

Crohn's Disease Forum

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Joined
Jan 22, 2010
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Hi,
My name is Anne and for the past 7 months, I have pretty much succeeded in stumping every doc I am sent to, and still don't have any answers. I'll try to be brief as to what has been going on, but since June 2009 this has completely overtaken my life, so it may take a few paragraphs to explain.

I went to a outdoor rib festival in mid June, and that night at 2AM, I was violently awoken with extreme pain on my right side. Went to ER, where they thought appendicitis, but since no fever, or vomiting (only diarrhea), couldn't see appendix on CT scan, and blood tests came back ok, they weren't sure. After about 8 hrs, pain was getting better. But it still felt like something was swollen/or pressing on my right lower quad area from under my right rib to my hip area, and that puzzled them. They sent me home after about 12 hrs. Three days later I ended up back in ER after visiting primary doc for follow-up, since swollen/pressure feeling still there. More tests (gallbladder, liver, kidneys, spleen, etc), everything came back fine. In July they sent me to GI who did colonoscopy and biopsies showed deep tissue inflammation in the ilieum area. During follow-up with GI to go over colonoscopy results, he said he wasn't sure it was Crohn's, since although biopsie showed inflammation, I don't have the vomiting and diarrhea that is also part of Crohn's. And he said that Crohn's usually doesn't start as a violent episode like I experienced that night in June. He did try prednisoe for 1 week and said if that worked then we'll know it is Crohn's. But that didn't do anything to change the pain/swollen/pressure in my lower right quad area, so he thought might still be my appendix, so sent me to surgeon. She wasn't sure it was my appendix, so I was bounced between the surgeon and GI doc for nearly 2 months, while the pain/pressure/discomfort continued. In the mean time, more tests which came back fine (ultrasounds, HIDA gallbladder, barium x-rays, and small bowel follow thru), except for the camera capsule pill test which showed more inflammation/irritation from my stomach all through my intestines and small bowel. They took out my appendix in Sept and thought that would solve this mystery.

Well, it didn't, so I was back to square 1 again, with an added twist. Four days after my appendix surgery, my right eye was now swollen and painful. Eye doc diagnosed me with uveitis. Got the eye inflammation under control, but had another eye flare up on Thanksgiving day.

Went for follow-up with GI doc in Nov 2009, and he was still baffled and couldn't believe that nothing had changed, except now that uveitis is added to the mix. Personally, I was wondering how something would change, when I wasn't being treated for anything. He now wanted to do another colonoscopy to see if anything had changed. I refused, since I didn't see the point just yet when I still felt miserable with the continued pressure/discomfort, was not eating or sleeping, and it seemed the results would show the same thing. By now I was slowly figuring out that it was time for another opinion.

Had that appt last week with a new GI doc. She reviewed the test results and said that a lot of times Crohn's isn't easy to diagnose, but usually the biopsie results are what's used to help make a diagnosis. And that coupled with my capsule pill results and my 2 eye flare ups in 3 months with no prior eye issues, made her suspect Crohn's. But she couldn't say one way or another for sure whether or not this is Crohn's, but she did immediately start me on Entocort.

So right now, I guess I feel like I'm still in a limbo, not exactly sure what is going on, and why anyone can't get this pain/pressure/discomfort to subside. Not sure what I should/shouldn't eat since some days I seem to be able to eat anything, and then the next day anything I eat causes increased pain. I thought I was dazed, frustrated, scared and confused all at the same time after about 3 months of this, and now after 7 months, I don't know what to think anymore. The only thing I know for sure right now, is that I'm NEVER eating pulled pork again (that's what I ate that night at the rib fest ), since I'm pretty sure that food poisoning started all this fun.

I'm glad that I stumbled upon this site, since this seems to be a great group of people, in lots of different stages of this, with lots of different experiences. One of the many questions I have, is that I guess I'm not understanding exactly how Crohn's is diagnosed and why my situation (as I'm sure many of yours have also been) is so baffling to so many doctors?

I apologize for being so long-winded, and really tried to give just the cliff-notes version :). Thank you for taking the time to read a bit about my experiences in the past few months.
 
HI there, and welcome to the forum. Your story brought me back to my dx 17 years ago.. Except the eye problems and there was no pill cam back then. It is one of the hardest diseases to dx because it is not one shoe fits all. Because Crohns can be from the mouth to the anus and many other signs and symptoms that one may get and you may not. My blood work never matched or no fever with a low white cell count.... no matter what I ate it was pain and the LRQ. Took me a year and I lost 40 lbs in less than 2 months.

We all understand your frustrations, many people here are still waiting for a dx. I have had ( I counted from last weeks scope) 10 colonscopies that I remember and only 3 out of ten was shown patchy inflammation. Biopsies have to be taken exactly where the ulcers are or they miss it and say everything is fine. It's not all in you mind, and you unfortunately have to keep trying.

Lots of people here to help you , I hope you find your answers and soon. Hugs!
 
Before I was diagosed, I too had eye problems (only in the right eye), I didn't have diarrhea but I did have bloody stool. I had also lost about 60lbs in a matter of 3 months. My diagnosis involved a colonoscopy, blood tests, and a CT Scan (which cinched it for them). I was put on prednisone right away (I was on it for 3 months and didn't see any appreciable results till about the month mark), then was given pentassa. That worked for 2 years, and then things went downhill, resulting in a colostomy for me this past December. Fortunately for me, things are going pretty good now (yes, there is a happy ending...lol)..turns out to be the best thing that has happened to me in a long time (yes, believe it or not, pooping in a bag is pretty good!)

I don't think this has been helpful, but I do hope they find out what's going on with you, as I can understand the discomfort, and living with it.

Cindy
 
Wow! I dont understand how so many GI's have such a problen saying its Crohn's.

As Jetta said everyone is diferent and we all get diferent symptoms and respond to diferent drugs.
I hope the Entocort helps you out. If not and the GIs arent ready to try something else, I woukd find one who will!

Good luck and welcome Anne! :)
 
welcome :) I dont't have an appendix either for the same reason! when they took mine out apparently all my intestines were really twisted and they untwisted them and i was good for ages :smile: I went to so many doctors before i got a diagnosis...i really hope you find out soon. I was diagnosed with Crohn's after showing pretty much the same symptoms as you so i just hope you get an answer *hugs*
 
Welcome, I am sorry to hear you are having so much trouble getting a proper diagnosis. In the meantime try to eat a low fibre diet andstick to it for a few weeks to see if that helps. You may have to try different drugs before you find one that helps (that goes for docs too).
 
Hi Anne, Welcome to the forum. Hope you find lots of support on here.

My Crohn's was just diagnosed late last year after a serious typhoid/salmonella food poisoning. Seems like the food poisoning triggered it for me too. I also dont tend to get D. I get huge pressure pain around my back, flank and hips with the odd stabby pain thrown in for fun. Oh and also the bloating.

Very surprised to hear that after biopsies the doc still didn't diagnose you, especially if there was inflammation at least they could have said you've got either CD or UC and started you on some longer term treatment rather than taking out your appendix. seems a bit hasty of them.

Just from reading the forums, I think lots of us with any kind of IBD tend to feel in limbo for the first few years.

Low-residue diets are probably the best thing to try, see if it eases your guts. http://www.mayoclinic.com/health/low-residue-diet/MY00745

Good luck!

x
 
:welcome: Anne

I am so glad you joined the forum. There are a few people who recently have joined, without concrete diagnosis.....I have always believed an unfortunante food poisioning incident was the trigger for my disease......

The thing with Crohn's is that it is multi-faceted. No two people can have the same expression of symptoms. It can be very frustrating.

The fact that you have Uveitis and pain, as well as positive biposies really does suggest the disease. Unfortunately for you, it is not a typical presentation.....

Try to be patient. I really pray you will have some relief soon. Good luck.:)
 
Thank you everyone for your responses. They are really appreciated, since friends and family can't really related to what this experience is like, and don't believe that something like this could continue for so long without a diagnosis. So it's a bit comforting to know that I'm not completely alone going through this. I think even my dog is beginning to wonder when I'll start feeling better and take her for hikes and longer walks again :).
 
:welcome: Anne! Wow - everyone here is being so polite to your doctors! To me - it just screams Crohn's!! That first doctor couldn't have been more wrong. Uveitis is a documented EIM (extra intestinal manifestation) of Crohn's disease. You can get it other ways as well - but with the constellation of all of your other symptoms as well as *your inflammation* all over your small bowel, stomach and colon? IDK - sounds like Crohn's to me - not sure what I'm missing. I am at least glad they have taken the step to treat you with Entecort. However - Entecort's targeted area (where the pill actually opens up and releases the medication) is your ileum and ascending colon (http://www.medicines.org.au/locateaz.cfm?handle=appentoc&brand=Entocort&doctype=pi ) and from your description - your inflammation is through out your digestive tract (stomach and small intestine as well right?) - so this medication alone may not be "hitting" all the areas that you need to fully reduce your inflammation. This is just a layperson's observation. If it were me and I had inflammation in all of those areas - I'd want to be on an actual prednisone taper that is more systemic to get it under control (and for longer than a week! You should be on it for at least a month or more to really see if it works). If they are taking this seriously, they should also be putting you on a maintenance drug for long term use. They are probably trying this to see what your body's response is and my guess is - you are only "set up" to get a partial response from this one medication if you truly have inflammation in all those other areas. This may cloud their ability to properly diagnose you.

As for typical Crohn's needing to present with vomiting and diarrhea - not so. Many of us on here only have constipation. I have never thrown up due to my Crohn's and I have had it most of my life. That is just an incorrect statement. If you are not with a GI who specializes in Crohn's or UC - I would highly recommend searching one out and making friends because this is a life long thing and you want to be in the hands of a doctor who can take very good care of you from the beginning. It makes things go much smoother for you.....so you can get back to walking that adorable dog of yours! Let us know if you have any more question - we are glad you are here.
 
kayaker4157 said:
Thank you everyone for your responses. They are really appreciated, since friends and family can't really related to what this experience is like, and don't believe that something like this could continue for so long without a diagnosis. So it's a bit comforting to know that I'm not completely alone going through this. I think even my dog is beginning to wonder when I'll start feeling better and take her for hikes and longer walks again :).

I can relate to the dog thing. Sometimes I think I am doing it more for my buddy Bert than for myself.

the problem with diagnosing Crohns is Doctors have to piece together a few related observations and make a tentative diagnosis based on their opinion. In my case it was not until the lab results from compromised tissue removed during an operation came back they the surgeon made a Definite diagnosis.

I think there are two sets of criteria for diagnosing Crohn's at the moment. The Vienna classification and the newer Montreal classification. There is never anything more concrete other than that I am afraid. It is not one of those thing that conform to our ideals of absolute.
 
Welcome to the forum Kayaker. I really hope you get some clarity on your diagnosis soon, but I must agree with Peaches it really does sound like crohns to me too.
 
I agree with absolutely everything Peaches has said. it is so true. I've only ever thrown up once in 15 years and that was last week cos I was gonna blow up and implode, there was only 2 ways out! My gastro angel once told me that IBS does not exist, it is lazy bastard GPs who cant be arsed to refer people to gastros, he said there is always an underlying reason for pains in the abdo whether its gynae or gastro, and should never be ignored. My advice? second opinion, scream n shout for it, find someone who knows what they're talking about, on Endocort for one week? smacks of ignorance that one does.
best of luck Joan x
 
Welcome Anne! I have learned a lot from the great folks here over the past month - I'm sure you will too. There's as much knowledge and experience within this site as most hi-dollar docs!
Hang in there - good luck!
 

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