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Why on earth can't they just do the pill cam first?

Hi all, new here. Just had colonoscopy and gastroscopy which I was sure would diagnose Crohns. Alas, all was negative. Don't get me wrong, it's not that I want Crohns, but I'm so sure I've got it that I would bet my last dollar on it. Here are my symptoms.

October 2012 - sudden onset of lower right abdo pain lasting six hours resembling early labour pains, you know the type of pain you have when you're around 4 cm dilated. Same pain returns on and off for next 3 months lasting usually 6-8hrs each episode, usually starts around 3am and wakes me from my sleep. So I go and see my OBGYN as I have a history of endometriosis - 2 ultrasounds, 1 MRI and nothing to be found.

Pain returns in March 2013 and settles in for a 3 week stint. I take nurofen plus on a daily basis, in a dismal attempt to take the edge off the pain. It's always the same pain and I can literally pinpoint the exact location of it, in fact I can even recreate the pain by pressing down on the spot.

Pain returns Early August for another 4 weeks or so, during which time I have increased bowel activity, usually I go once every 1-2 days, but now I'm going 3-5 times a day. Then one evening in early September I am woken a 1am by the pain which increasingly gets worse, to the point where I'm now writhing in agony. If I lay on my left side the pain goes down a notch, if I lay on my right the pain goes up a whole lot. Pain relief is an utter waste. Hubby gets me a hot water bottle and watches as i cry and wait for some relief. Relief comes at around 5 am, but doesn't last long. That was my last big episode and I'm so afraid of it happening again, I'm anxious just thinking about it.

I also have gut pain during intercouse, which is on the same spot and also shoots up my abdomen to the upper right area. I have also had 2 episodes of spontaneous bloating, making me look like I'm 5 months pregnant within an hour of eating (last time it was fish stew).

I weigh a healthy 55kgs, I'm 33, active, 2 kids, ex smoker, 4 previous endometriosis surgeries, 1 appendix out, tubes tied 3 years ago, endometrial ablation. I've also had a problem with back acne since I was 14, it comes and goes but has left my back moderately scarred.

My grandmother had crohns and eventually bowel cancer.

I know I have crohns , and I'm pretty sure it's in my ileum. I thought the gastroscope would go all the way down the small intestine, but it apparently doesn't.

Any advice from the experienced folks would be very much appreciated.

Cheers, :yrolleyes:
 
:welcome:! Sounds like it could be crohns, but could also be endometriosis on the intestines. I was also diagnosed with endometriosis and for years and years, docs just blamed that for my pain. I had a hysterectomy in Jan 2011 and they took everything. Now my pain is back :( I am currently sitting undiagnosed until I can get in for a scope. I hope you can get answers soon. Don't let the docs slough you off as having IBS.Get answers :)
 

Trysha

Moderator
Staff member
Hello Phoebe
Welcome to the forum.
The probable reason for holding back on pill cams might relate to the expense of such a tool.Also the hazards have to be weighed as much as the cons.
Usually a colonoscopy will give loads of information, but that does not appear to be the case for you.
It certainly looks as though you require more extensive exams, and pill cam may be one of them.
Also the gynaecological aspect is deserving of attention, there are things to rule out there.
There is also MRI enteroscopy which can be a very revealing diagnostic tool.
Has your GI discussed any of this with you---especially since you have a family history of crohn's.?
If not I think I would be asking for further investigations.
Feel better soon
Hugs and best wishes
Trysha
 
Thanks for your help, I will be asking for a MRI of the small bowel next, I think.

Also, just quickly my doc said that she has only seen 3 patients in the last 10 years with Crohns in the small bowel, but everything i have read suggests that it is a lot more common than that! Is this an indication that I should change doctors?
 

Trysha

Moderator
Staff member
It seems to be more common in the terminal ileum from what I have read.
However crohn's can affect the whole of the GItract from mouth to anus., and anywhere in between. Gives it a broad scope.
Mine is in the left colon just above the sigmoid area and was diagnosed with the first colonoscopy I ever had because of bleeding and loose stools. I was quite shocked at the diagnosis..After reading of all the difficulties people encounter in achieving a correct diagnosis I suppose I must consider myself lucky to some extent.The GI has a crohn's clinic several times a week.
The diagnosis can be quite elusive and it is best to be with a GI who sees lots of crohn's patients.
It never does any harm to get a second opinion though.
Doctors should be made aware that you have a history of crohn's in a close relative.
Just because it has not been found does not mean you don't have it.
Hugs
Trysha
 
Unfortunately there are many many things which can cause the same symptoms besides Crohn's. You can't really know you have Crohn's based on symptoms, especially with the main symptom being pain, which so many different conditions can cause.

I know it's frustrating when you want answers. Unfortunately diagnosis can take a long time, and further testing is the only way your doctors may reach a correct diagnosis - and you're right that gastroscopy and colonoscopy do not detect everything.
 
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