Telling difference btwn flare or other sickness?

[watertiger21]

Hey all! I've been diagnosed with Crohn's for 15 years now, but sometimes I still feel like I can't tell the difference between a flare up and other possible stomach illnesses (such as stomach flu, food poisoning, etc etc). I just feel like my Crohn's has always been a bit weird... Every "flare" I've ever had follows the exact same formula:

It usually only lasts a day, maybe two. It starts slowly in mid-morning with gassiness and bloating. Then a few hours later I get a few sporadic abdominal cramps. An hour or two more and I'm having intense cramping that has me in the fetal position on the bathroom floor. It's usually dinner time by now but of course I don't eat. I manage to get out a few crappy bowel movements (but they usually don't relieve the pain, bloating, and full feeling I have). Add another hour or two spent on the bathroom floor, and the pain finally gets bad enough to make me nauseous and I throw up for an hour. Sqiush out a few more bm's, then I'm so exhausted I usually ignore the remaining cramps I have and pass out asleep on cushions I've gathered and put on the floor next to the toilet. The entire process usually ends by 4-6am, and after I wake up a few hours later, I'm fine!

Literally all my "flares" have been this way and there seem to be no trigger foods. My GI has never mentioned strictures, and I get these episodes about once a month.

My problem is that other issues like the stomach flu affect people in exactly the same way, so I feel like I am never able to truly know if it's my Crohn's bothering me or just some other sickness. Anyone else have this problem?

 

[Jennifer]

To me it sounds like a stricture that's causing partial blockages from time to time. The stricture could be from active inflammation, scar tissue or both. What's your current treatment? What tests have you had done recently? Have you told your GI about these episodes? What did they suggest?

For strictures eating smaller meals more often can help along with soft and easy to digest foods while avoiding foods that move through you quickly like anything greasy or things that have a lot of fiber. The low residue diet is a good start.

Changing your diet may not solve your problem however even if it's scar tissue. It's important to find out the exact cause through scopes and imaging tests to see if you require a different treatment or to see if you may need to have a procedure done to widen the stricture or if you need surgery to remove it.

 

[shamrock15]

I second Jennifer's response. Your attacks sound very much like mine did. I was advised to go to a low residue or liquid diet when having difficulties, and they only fully went away when I had the strictures addressed. It does sound like you need some testing to determine exactly the cause of these.

 

[DEmberton]

Yep. That pretty much describes what happened to me every now and again over the years. Second time I ended up in hospital with suspected Appendicitis, but just like you I was fine once I'd got through the vomiting stage. The doctors just sort of shrugged and send "probably food poisoning".

A couple of years ago it was happening about once a month and that's where things did get worse and I started losing lots of weight; finally got diagnosed with something and had the surgery to fix it.

 

[24601]

When you have these episodes do you get in touch with your GI so that they can do bloodwork and perhaps fecal calprotectin at the time that you experience those symptoms?

It can also be useful for them to send off a stool sample to rule out any enteric infection - as you say the symptoms can be very similar/identical so that really is the only way to be sure.

As the others have said, I think you need more testing including imaging (which would tell you whether you have any strictures) to get a better idea of what is causing these symptoms.

What has your doctor been saying about these "flares"? Does the fact that you have continued to have these symtpoms not prompt a change in treatment?

Best of luck

 

[watertiger21]

Thanks for your responses! I've suspected strictures for awhile now but still haven't gotten any confirmation for it.

I've never been impressed with any GI I've had because none of them have ever been very proactive with my CD. It's really driving me crazy!!! :ybatty: I've told my current doc about these episodes and all he said was "Huh, sounds kinda like a stricture." He just left it at that! Grrrrr... I've had a colonoscopy since then but he never mentioned seeing anything stricture-related.

Unfortunately my options for GI's are slim. The office is the only one within two hours of where I live and it serves four pretty big cities, so they're always busy and appointments have to be made 3 months in advance. I also never get calls back from my doc's nurse, and when I first started B12 shots they sent the prescription to the pharmacy and never even told me they'd prescribed them!!! It's terrible! But I am indeed thinking of at least trying yet a different GI from the same office... at least one of them has got to be good, am I right?

 

[DougUte]

It sounds like a stricture to me also. Your attacks are very similar to the ones I had years ago. I would be fine in the morning and withering in severe pain by evening. I finally was diagnosed with Crohns and had a resection to fix the stricture.

 

[Jennifer]

Hopefully with another new GI you'll get some imaging tests done to see what's going on and where and hopefully get this resolved or at least managed. As for the diet, that's something that needs to be done on a regular basis to try and avoid these episodes. When you do have one then you may want to stick with liquids only. If you can't keep liquids down, have severe pain and/or develop a fever then you may want to consider going to the ER as having a full blockage can be life threatening. Take care and keep us posted.