What kind of Crohn's do you have?

[cheeky]

okay so my GI, i don't think i like him... he is quite insensitive and doesn't ask me anything about my other symptoms... all he asks about is diarrhea and i've told him more than once that i don't suffer from diarrhea... but i wish he'd ask me about my other symptoms...

anyway, he said that based on my results it was hard for him to determine for sure whether i have crohn's or colitis, but he's leaning more towards crohn's... however, i did a quick google search and easily could see that i have crohn's based on my other symptoms - for example, i experience gum inflammation which shows that i have symptoms from mouth to anus... and just other things seem to make it obvious it's crohn's but he couldn't be bothered asking me i guess.

so now that i got that off my chest, i am curious to know...
what type of crohn's i have ... i'm still learning...

so, my pelvic ultrasound results (prior to meds) said: "thickened loops of bowel identified. involves a good portion of large bowel, the right hemicolon and transverse colon but also the terminal ileum which is quite thickened"

then after being on prednisone for 2 weeks, my CT scan results said:
"there is significant thickening and inflammation around the entire ascending colon. The wall is thickened up to at least 1.1 cm. There is relative sparing of the cecum . The remainder of colon appears normal."

so what does this mean? is the ascending colon the same as small intestine?

when i get severe pain, my right side bothers me the most but i do get a lot of pain in the upper part of my stomach too... the cramping that comes and goes.


if anyone could explain this, i'd appreciate it... or if you have the same results, anything that you've been told, would be helpful to learn.


thanks.

 

[AIjen]

I don't know what kind I have either, but I don't have diarrhea either. I have constipation. I've always had constipation (even as a child - it was much worse then though). I don't have my colonoscopy result yet - The results are Crohn's, but I don't have the physical report in my hands yet. I have to request my records from my GI from last year. I don't have weight loss either. I do have a lot of abdominal pain. I did have an "area of infection" when I had my colonoscopy, so I'm guessing that was an abcess. I was put on Flagyl for that (allergic to Cipro). I do have inflammation from my esophogus right down to the anus though. Sometimes my gums are really sore too. And most of the time the roof of my mouth right behind my top teeth is sore. Almost always for that one.

 

[katiesue1506]

All I know is that I have mild to moderate Crohn's per what my doc said in a letter for a scholarship competition.

 

[cheeky]

I don't know what kind I have either, but I don't have diarrhea either. I have constipation. I've always had constipation (even as a child - it was much worse then though).

ya i sometimes get mild constipation, while i was flaring,but it wouldn't last more than a day or two... but i'm pretty regular and my stools are always formed... never diarrhea... and funny you mentioned problems from when you were a child, my mom says i always had a digestive problem since i was a baby, but i figure lots of babies do.

I don't have my colonoscopy result yet - The results are Crohn's, but I don't have the physical report in my hands yet.

ya they couldn't complete my colonoscopy when i went the first time, they said i was too inflamed and too much narrowing... but my GI said he'll have me do another one in the summer time...

I don't have weight loss either. I do have a lot of abdominal pain.... I do have inflammation from my esophogus right down to the anus though. Sometimes my gums are really sore too. And most of the time the roof of my mouth right behind my top teeth is sore. Almost always for that one.

i got the weight loss, but i think it was a combination of crohn's and me actually trying to lose weight (that's why i wasn't concerned when i dropped the weight) i just noticed the weight was coming off fast and easily, even when i wasn't actively trying...

i had a time when my esophogus bothered me too, and my gums get very inflamed and were bleeding easily... right now i have to see the Gum Specialist and my dentist every 3 months (alternating) which has helped a great deal... i also once got some kind of swelling/lump under my tongue at some point and my dentist said it was saliva ducts blocked but i dunno, i think it was something else.

when i had the cramping in my stomach it was terrible and the nausea... also joint pain.

 

[dayng1016]

My Crohn's is in the terminal ileum, considered moderate to severe. I've got a stricture that prevented the GI from completing my last colonoscopy. I don't have diarrhea, but I do have constipation. My stomach pains are more upper stomach, even though my area of trouble is in the lower right quadrant. I do have ulcers and inflammation in my stomach, and suffer from horrible heartburn.

I do have the weight loss problem, wishing I could put back on the 20lbs I've lost, but that's real hard to do.

 

[cheeky]

so i looked at my ultrasound results again and the impression says:

"fairly concentric bowel wall thickening involving both small and large bowel in keeping with an ileal colitis. "

then it explains more and says it is possibly inflammatory bowel disease such as Crohn's ileal colitis.

so when i looked this type of CD up, i found this:

"Ileocolitis Crohn's disease of the ileum and the first portion of the colon, which usually involves the ileocecal valve as well. - Ileocolitis is the most common type of Crohn's disease. It affects the ileum (the lowest part of the small intestine) and the colon (the large intestine). Often, the diseased area of the colon is continuous with the diseased ileum, and therefore involves the ileocecal valve between the ileum and the colon. In some cases, however, areas of the colon not contiguous with the ileum are involved. Symptoms of ileocolitis are essentially the same as those present in ileitis. Weight loss is also common."

so i guess i have this kind of Crohn's.


i always ask for photocopies of my results and look up things to help me understand.

 

[cheeky]

My Crohn's is in the terminal ileum, considered moderate to severe. I've got a stricture that prevented the GI from completing my last colonoscopy. I don't have diarrhea, but I do have constipation. My stomach pains are more upper stomach, even though my area of trouble is in the lower right quadrant. I do have ulcers and inflammation in my stomach, and suffer from horrible heartburn.

I do have the weight loss problem, wishing I could put back on the 20lbs I've lost, but that's real hard to do.

wow, i have the EXACT same symptoms as you. all of the above.

 

[dayng1016]

I also always get copies of my results also. I like to see firsthand what the results say because the doctors don't always explain things to our understanding.

 

[Jax]

x3 !
My symptoms also sound exactly like you describe and my doc asks me about D too when I have the opposite if i'm in a flare. My terminal ileum was so inflammed by the time I got diagnosed that it had just about closed up. I saw the pics and they were truly freaky!
I get pains that come in waves like contractions (or how I imagine then to be!) I think my type is called crohn's ilietis (sp?) The affected area in the LRQ but my pains seem to be felt higher up too. Part of the reson a diagnosis took so long as I was pointing to my gallbladder sometimes. When i am sick I am really sick but when i am good I am really good. I don't seem to go up and down as much as some people seem too. I think I will have long periods of remission and then be struck down out of the blue. It's early days but time will tell. Aaah the suspense of it all

 

[Sojourn]

That's a good idea to get copies of everything. I always learn more from my own research than what I learn from GI.

The worst part of my inflammation was at the cecum. I had half of that ascending colon taken out but I can't remember if they removed the ileocecal valve or not. A lot of diarrhea problems come from the ileocecal valve because it is a sphincter muscle.

The ileocecal valve is important to gut function. The ileocecal sphincter extends over a 4 cm length of distal small intestine and produces a high- pressure zone of about 20 mm Hg. Distention of the ileum results in a decrease in the ileocecal sphincter pressure, whereas distention of the colon results in an increased pressure in this area. The ileocecal valve slows down intestinal transit and prevents backwash from the colon. By this mechanism the ileocecal valve is important in regulating intestinal transit. Removal of the ileocecal valve during surgery will result in marked intestinal hurry as well as the potential for bacterial overgrowth from fecal "backwash." Disorders that impair peristalsis in the small gut allow bacterial overgrowth, resulting in diarrhea.
http://www.gastroresource.com/GITextbook/En/Chapter7/7-11.htm

 

[pb4]

Cheeky, with all that you've described, you have crohn's not ulcerative colitis...UC does not affect the TI, it's limited to the colon/rectom (the lower part of the GI tract) and does not affect the anus as it does with crohn's (perianal crohn's skin tags, or fistulas).

CD can affect the many layers of the intestinal lining, UC is limited to affecting the surface of the lining only (reason why fistulas don't occur with UC)...

Also, with CD there are skipped patterns of inflammation (healthy tissues in between inflammed) with UC the entire area will be inflammed with no skipped patterns (a doc should be able to determine this via colonoscopy).

crohn's colitis is CD affecting the colon, that's the general term used to describe CD just as ileitis is the term used to describe CD affecting the ileum...proctitis is simply inlfammation of the rectom which could be from either CD or UC.

And as you can see by sojourn's reply the ascending colon is not the same as the small intestine.

Don't get too caught up in the "type" of CD you have, although different meds are used to target inflammation in different areas, so long as your doc knows where all your inflammation is and he's treating you accordingly that's the main thing.

 

[pb4]

Here's a description of the 5 subtypes of crohn's...

There are five subtypes of Crohn's disease, distinguished by the gastrointestinal area in which the disease occurs. While Crohn's disease lesions can appear anywhere in the digestive tract, lesions rarely occur in the mouth, esophagus, and stomach unless there are also lesions in the lower parts of the tract (intestines).

Gastroduodenal CD - Gastroduodenal Crohn's disease, which affects the stomach and the duodenum (the highest, or beginning, portion of the small intestine), is often misdiagnosed as ulcer disease. The correct diagnosis frequently is not made until various ulcer treatments have failed, or until Crohn's disease is identified farther down the gastrointestinal tract. Symptoms of gastroduodenal CD include loss of appetite, weight loss, nausea, pain in the upper middle of the abdomen, and vomiting.

Jejunoileitis - Jejunoileitis is Crohn's disease of the jejunum (the longest portion of the small intestine), which is located between the duodenum and the ileum. Symptoms include mild to intense abdominal pain and cramps after meals, diarrhea, and malnutrition caused by malabsorption of nutrients. (The majority of nutrients are absorbed in the jejunum.) Fistulas (abnormal openings in the intestinal tract) may form. These can link a diseased area of the small intestine to another area of the intestine or another organ, such as the bladder. Fistulas may increase the risk of developing infections outside of the GI tract.

Ileitis - Ileitis affects the ileum (the lowest, or last, part of the small intestine). Symptoms include diarrhea and cramping or pain in the right lower quadrant and periumbilical (around the bellybutton) area, especially after meals. Malabsorption of vitamin B12 can lead to tingling in the fingers or toes (peripheral neuropathy). Folate deficiency can hinder the development of red blood cells, putting the patient at higher risk of developing anemia. Fistulas can develop, as can inflammatory masses.

Ileocolitis - Ileocolitis is the most common type of Crohn's disease. It affects the ileum (the lowest part of the small intestine) and the colon (the large intestine). Often, the diseased area of the colon is continuous with the diseased ileum, and therefore involves the ileocecal valve between the ileum and the colon. In some cases, however, areas of the colon not contiguous with the ileum are involved. Symptoms of ileocolitis are essentially the same as those present in ileitis. Weight loss is also common.

Crohn's Colitis (Granulomatous Colitis ) - Crohn's colitis affects the colon. It is distinguished from ulcerative colitis in two ways. First, there are often areas of healthy tissue between areas of diseased tissue; ulcerative colitis is always continuous. Second, while ulcerative colitis always affects the rectum and areas of the colon beyond the rectum, Crohn's colitis can spare the rectum, appearing only in the colon.

 

[teeny5]

I have Crohn's Colitis.

 

[fenway1971]

I also have Crohn's Colitis. Last Wednesday's colonoscopy confirms mild inflammation down from moderate/severe last July. Yay, Prednisone!