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Psychiatrically unstable patient

Any experience/insight/advice for the treatment of Crohn's in someone who is very psychiatrically unstable? Someone who has about 10+ stools a day, causing a lot of abdominal pain, but also is psychiatrically unwell and denies that they have crohn's but rather says they are cursed with snakes in their stomach? I know this is a strange question but I work with a woman who has been diagnosed with Crohn's in the past (though it is unclear as to how she was diagnosed, she is a very poor historian in regards to medical history) She has had a resection, but there is no clear notation about the details that preceded the surgery. Lab work shows elevated CRP. Due to the frequency of stools we are awaiting a stool sample to test for c-diff but I am almost positive it will be negative. Any other easy tests that might bring clarity to her diagnosis? Due to her resistance to care, denial of crohn's, and guarded nature related to psych issues, the doctors working with her are reluctant to force her into testing she is refusing bc she is currently "stable" however the frequent stools and chronic abd pain are chronic and distressing to her. She does not have any family or outside support to help with medical info or to help with supporting further testing. Any ideas would be greatly appreciated. Thank you!
 

my little penguin

Moderator
Staff member
She needs to work with her psychiatrist and psychologist . The mental health docs need to work in tandem with her Gi team they can best direct her mental and medical care
 
She needs to work with her psychiatrist and psychologist . The mental health docs need to work in tandem with her Gi team they can best direct her mental and medical care
Yes I agree. I am asking for advice from this group so i can relay any info I find to her doctors, who are very receptive to suggestion. I advised them to consult GI which they did and she adamantly refused colonoscopy after repeated refusal they will eventually just say she’s noncompliant (bc she is) but in the meantime I would like to push for as much as I can while they’re actively trying. I’m also finding a good amount of research articles that correlate mental illness with gi disturbances. I’m just trying to be her advocate. She’s definitely getting intensive inpatient psych care in the meantime
 

my little penguin

Moderator
Staff member
Unfortunately Most crohns tests are invasive
MRE
Cte
Colonoscopy
Capsule endoscopy
That’s it
Some places have experience with ultrasound but contrast typically needs used as well so still invasive

Fecal caloprotectin is a stool test for gut inflammation but not specific to just Crohn’s inflammation .
Sorry
 
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