Undiagnosed questions after 2nd colonoscopy

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Jan 9, 2018
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Hi Everyone
I don't really have anyone I know to ask questions to with similar health issue so am hoping someone here may be able to help out. It has been a little over a year now that I have had abdominal pain on my left side. I first went to a walk in clinic about it and was then sent to the hospital to be told I probably have diverticulitis based on a brief conversation and was told to eat a very low fiber diet for a few days. That seemed to make the symptoms start to go away but then as soon as i stopped they came right back. Then I had a CT scan which my doctor said showed I had some pockets in my colon as well as severe constipation (even though I was having regular daily bowel movements). They said to take miralax, again it seemed to start going away so they didn't recommend anything and then the pain came back. Had a colonoscopy that showed patchy inflammation/irritation throughout my colon as well as some ulcers saying my symptoms were ileitis and indeterminate colitis. At my follow up the nurse said they don't know what it is because the biopsies were normal and said to try miralax for 2 months and come back. I had to stop that after about a month because it made my pain and BM's significantly worse. After that I had much sharper pains, more diarrhea, very undigested BM's, back pain on the bad days, and was easily fatigued. I had a different nurse when I went back in that was much more inquisitive and explained everything much better. She suggested an additional colonoscopy and an endoscopy as well as more blood tests and a stool sample. She also suggested following a low fiber/residue diet for the month and a half leading up to the procedures. This helped until recently but the symptoms never went away completely. I have had bloodworm done 5 times to rule out things and check for inflammation and it has all come back normal.
I had the second colonoscopy and the endoscopy yesterday. I figured for sure it would look the same as the one over the summer, especially because my symptoms have been really bad the past week. However, the doctor came in afterwards and said everything looked great. They took biopsies to check for more but he wasn't very concerned. I was still a bit groggy but I am pretty sure I had a very snappy response about how the pain hasn't gone away for over a year and he said we would discuss it when I go back in two weeks.
Sorry for the rambling but wanted to explain what has been done so far.
So I guess I was wondering if others have had similar experiences in the diagnosis phase of things that may be able to give suggestions? I want to go back with a list of questions and other exploratory options we can take but would like some input of what may have helped you finally figure out a diagnosis.
Any information is greatly appreciated.
Thank you
Patrick
 
I had the second colonoscopy and the endoscopy yesterday. I figured for sure it would look the same as the one over the summer, especially because my symptoms have been really bad the past week. However, the doctor came in afterwards and said everything looked great. They took biopsies to check for more but he wasn't very concerned.

I presume by "endoscopy" you mean an upper GI endoscopy, right? If so the one part of your gut here that has not been examined is your small bowel. So even though the latest colonoscopy looked great, there still could be inflammation and ulcers somewhere in your small bowel. Only the terminal ileum of the small bowel can be seen via colonoscopy.

Since your earlier colonoscopy showed patchy ulcers and inflammation in the ileum and colon (which sounds a lot like Crohn's) which has apparently cleared up, you may wish to ask your doc to examine the small bowel by either an MRI or capsule camera endoscopy to see whether there is still disease there that could account for your continued symptoms.
 
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I would also suggest a scan such as MRI, CT or the capsule camera. That's how my diagnosis got narrowed down. It was a CT scan that showed inflammation in my small intestine, then a colonoscopy confirmed that I had a stricture at my terminal ileum. The CT scan gave the doctor a clue to go further than he normally would during a colonoscopy. My colon leading up to that point was perfectly healthy looking, so if I just had a routine colonoscopy I might not have gotten a diagnosis.
 

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