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What does a narrowing in the small intestine feel like?
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What does a narrowing in the small intestine feel like?

I live with the feeling of cramping, bloating and lower belly pressure like I am constipated. My colon or lower small intestine gets blocked and starts backing up and my belly pushes out with cramping and lots of discomfort (not gas) until I can pass a bowl movement. But my colon while it feels full seems empty. I tried 2 enema and they came out clean. After about 5 hours finally I have a bowl movement and it is not hard. I live with this every day for many years and it just gets worst each year. Wondering if this was Crohns? I am going to do a colonoscopy very soon will that give an answer or do I need a CT of the small intestine. Can I just blood test for this??
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Avatar_f_tn
Hi crystal - welcome to our community.

I have had Crohn's for 38 yrs, and have been on various medication for all that time.  Last November my gastro ordered an MRI scan of my lower abdomen as he suspected strictures, although at that time I had no symptoms. The MRI technician told me they have only been able to do this particular test for the past 18 months (I live in the UK).  Indeed, two strictures were found in the small intestine (I have Pan Crohn's colitis - in both the colon and small intestine) but as I had no symptoms my gastro did not offer surgery.  

In the last 4 weeks I have been experiencing total loss of appetite, severe nausea, and now lower abdominal bloating. I saw my GP 2 weeks ago and he prescribed Omeprazole, 20 mg.  The nausea has eased somewhat, but the bloating has become worse and I have to force feed myself.  I am going to ring my specialist IBD nurse to ask if these symptoms could be caused by the strictures and get an appt with my gastro.

Your symptoms could possibly be Crohn's, but to definitvely diagnose, you need an upper endoscopy and lower colonoscopy, with appropriate biopsies. I have never had a CT scan for Crohn's, but many scopes.   Blood tests can help towards a diagnosis i.e. if the white cells are elevated, this can point to an inflammatory condition. I have comprehensive blood tests each month, including C-reactive protein, as I self inject methotrexate weekly and this can be toxic to the liver and bone marrow.  Also, a calprotectin stool assay test can be done to determine an inflammatory condition - this is easy and cheap to do compared to scopes. If the calprotectin level is higher than normal (norm is 20, mine is often 40) then scopes would then be considered to identify where the inflammation is.

Not sure if this helps, as you really do need to see a gastro with experience in inflammatory bowel disorders.

Hope you get some answers soon.
Take care,
Liz.
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Avatar_m_tn
Yes it explains why my one of my docs wanted to do an upper endosocpy with biopsy. I didn't know why they wanted to do it and I said no because I didn't think I'd be able to tolerate it awake. Doing the colonoscopy soon. I will ask if they can test for crohns. I never have a problem for many hours after I eat. The constipation happens about 3-5 hours later. But I thought that might just be because the food is getting backed up. Could be a narrowing in the intestine too. No clue, hard to understand, I just feel pain and the feeling like I have to poop and nothing comes out. Stomach gets packed with food and swells, if I can't poop it out I start to vomit. 15 years and still not identified. Up in till now doctors game me meds to prevent me from going, finally we figured out the problem was that I couldn't go and food was not coming through me. All I know is pain and discomfort and a generalized area where it starts from. It is visual too. You can see it getting stuck as it moves from left to right before my small intestine gets irritated and starts to bloat.
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Avatar_f_tn
Hi crystal -  with the further information you have given it looks unlikely you have Crohn's as this usually, but not always, presents with severe weight loss and diarrhea, as mine did. I only started to experience pain around the terminal ileum, next to the appendix, after 9 months of the other symptoms, which became life threatening as my weight went down to 60 lbs. and I needed blood transfusions before the laparatomy surgery (no scopes in 1970 when I was dx aged 24). The only treatment then was resection of the affected parts or steroids. As I had some 15 different areas of Crohn's, my gastro decided surgery was not appropriate and I went on to steroids. Now on weekly self injections of methotrexate which has kept the disease in remission.

The only way to find out if you have a blockage of some kind is to have both a colonoscopy and endoscopy. I have them regularly and the gastro puts me into twilight sleep. I don't remember a thing until they wake me up in recovery with a cup of tea and a cookie. I find the worst part is the preparation for the colonoscopy in order to have a clean colon.

There is definitely a problem somewhere in your gastro-intestinal tract, but I can't second guess it.

Do hope you get some testing done soon and can start to have appropriate treatment.

Take care and good luck,
Liz.
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203342_tn?1328740807
Hi crystal, I'd go ahead and have the colonoscopy and endoscopy done at the same time, if you can. You won't be awake for either and it's not a big deal, really. I had both done in January with no problems. The thing is, they're not going to be able to see the small intestines properly without the endoscopy. The colonoscopy is for the large intestine.
I had narrowing in my small intestine in the terminal illeum (where the small intestine hooks up to the large intestine). The symptoms I had where stomach aches, nausea coming in waves, usually (but not always) after I had eaten. The feeling would eventually pass but sometimes took hours. Finally, I got so bad that I went into the ER and it was with a Cat Scan that they saw the blockage. I had the surgery a few weeks later and they removed a mass that was fibrous scar tissue with ulceration. They thought I might have Crohns at that time but were unsure. I had a colonoscpy five months later and they saw several ulcers so put me on a steriod medication, Entecort. This time they weren't sure it was Crohns but maybe just ulceration. Still the treatment is the same with the steriod medication. Since the surgery and finishing the medication, I've felt great.
Go ahead and get it all checked out. It will be good for you to know for sure so that whatever is going on can be addressed and fixed. I wish you well!
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Avatar_f_tn
Hi..  I had a stricture recently repaired by a resection.  What happens when you have them will show signs of a backup.  If you treat from below you will not get any results (ie the enema).  The true test to find a stricture is a small bowel follow through.  If it is a serious enough narrowing you may have signs of an obstruction including the constipation, possibly diarrhea ( the body compensates to get through), nausea, vomiting and abdominal pain/cramping and distention.  No blood test will tell you if it is- there are 2 blood tests that are suggestive of inflammatory bowel but not definitive ( P anca/P asca).  The crohns diagnosis is by biopsy from a scope of some sort( granuloma's- which are definitive but not everyone has them).  A CT scan may show it, but mine didn't show.  
Bottom line, you need your GI to work you up.  Hang in there.  I know it is quite frustrating.
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Avatar_f_tn
I forgot to mention that I had an abdominal MRI  with contrast last November -don't know why gastro ordered it as I was asymptomatic. It showed two strictures in the small intestine.  Have had real problems this last month with nausea, no appetite, abdominal pain and bloating and after calling my specialist IBD nurse Monday have an appt this morning with him. She said I will need an upper endoscopy or repeat MRI, and possibly strictureplasty to widen those narrowed parts. Oh hum.....just want it sorted so I can eat again. She said he will prescribe some kind of nutritional drink today that I can get from the hospital pharmacy as I have lost 16 lbs in the last month. Went to GP 3 weeks ago and prescribed omeprazole for the nause and lack of appetite, but had done no good.

Take care.
Liz

PS - Apri12 - great to see you posting and helping others - we value your contribution to the forum!
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Avatar_m_tn
Thank you for this information. The description of the backing up constipation for hours then getting better is a good way to describe it. Thats the part that was confusing. Backs up nausia, gas sometimes vomiting (if you vomited from being clogged it is really scarry becuase there seems to be no end) and stuff then the constipation feeling goes away and no poop. Throws me off. Then when the enemas reveled clean water it made me think it was much higher up. There is no doubt that something is getting stuck somewhere, just where is the question. I have lots of test that I need over the next 2 months. We are ruling everything out along the way. Eventually something will show. The CT scan which is something I don't want will probably need to be done if nothing is found at either end. Thank you for your posts because I learn a lot.
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Avatar_n_tn
Hi, my girlfriend is in hospital as we speak, all the symptoms you first described, is everything that she is complaining of, they removed her appendix today, and after reading up on the internet, i dont think is gonna make any difference, as that wasnt the problem, they also did a colonoscopy, sorry my spelling and medical terms are terrible.

I just wondered if you had found out what the problem was in the end, I've got a feeling she has chrons, and i've also got a feeling being on the NHS, that they are just going to discharge her tommorow, any help would be great.

contact me at work ***@****
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Avatar_f_tn
Have you ever considered a blockage??????
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Avatar_n_tn
Yes, it does sound like you may have chrons.  Mine was asymtomatic for a long long time.  Different types of test can prove chrons or not.
One is sometimes the colonscopy shows it, mine didn't at first.
Sometime CT show
Sometimes a test where you swallow barium and the Dr. watches it go through the stomach to the colon.  This one is where they said they were sure it was chrons.  And he told me it was very bad.

My GI dr decided to do a gentic marker blood test to make sure it was chrons and I came back positive.

Within a year the symptoms started full force.  Flu like symptoms with chills that wiped me out completely the next day.  Diarrhea, cramps and then horrible pain, like someone pulled a kink out of my intestine.
And that is probably what was happening.

Started on Remicade and felt 100% better.  The had a fistula to the bladder which caused infection.  Finally had to have bowel resection to fix all of this.  My bariatric surgeon was great, he did it lapro with hand assist.  Also, stated that it was so bad he didn't know how I functioned.  I was one of the lucky ones as when they sent the test out it found a cancer in it.  It had not spread so no chemo etc.  Just see the oncologist every few months for blood test and follow up.  

So if they aren't sure you can ask for the blood test for the gentic marker.  But make sure your insurance oks it first.  It cost around $400 otherwise.
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Avatar_m_tn
Thank you, a very good post, great to hear such wonderful results you had. :)
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