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IBD Disguises:Diseases That May Mimic Crohn's Disease and Ulcerati...
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IBD Disguises:Diseases That May Mimic Crohn's Disease and Ulcerative Colitis


Rather than a question, this is some information that may answer several questions here. My disclaimer is that I am not a professional or doctor but mom of a Ulcerative Colitis patient and family member of Colon Cancer surviver.

NL


http://www.ccfa.org/news/previous/news1201b.htm

IBD Disguises:
Diseases That May Mimic Crohn's Disease and Ulcerative Colitis

Ulcerative colitis and Crohn's disease are inflammatory conditions of
the intestinal tract. Each of these inflammatory bowel diseases (IBD) is
characterized by certain symptoms.

On the basis of your medical history and the physical examination, the
physician embarks on a series of investigations (endoscopy with
biopsies, x-ray tests, blood and stool tests) in order to determine the
cause of your illness.

No single symptom or test result "makes" the diagnosis of IBD. For
example, bloody diarrhea occurs not only in IBD, but also in certain
types of infectious colitis.

In fact, ulcerative colitis and Crohn's disease are sufficiently rare
that most patients will turn out to have something other than IBD.

Instead, it is the combination of all the elements of the history,
physical exam and the diagnostic tests that, together, exclude other
conditions and lead to a diagnosis of IBD. For example, when seeing a
patient with bloody diarrhea, the clinician raises the question of
possible IBD, rules out other conditions that may cause bloody diarrhea,
and finally concludes that the patient most likely has IBD.

Even in a person with a well-established diagnosis of Crohn's disease or
ulcerative colitis, any aggravation of symptoms does not necessarily
imply a flare-up of IBD.

An unrelated infection, a medication-related side effect, or an attack
of underlying irritable bowel syndrome (IBS), which can co-exist with
IBD, can all mimic the symptoms of IBD.

Very frequently, the patient "knows" whether the symptoms reflect an IBD
flare or not. Careful evaluation is nevertheless necessary in order to
determine the exact cause of the symptoms and institute the appropriate
treatment.

To complicate matters, infections and medications, such as aspirin and
non-steroidal anti-inflammatory drugs (NSAIDs), can sometimes "trigger"
the onset of IBD, or expose pre-existing but silent IBD. (NSAIDs include
many common over-the-counter pain medications, such as Advil
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I am a 35 year old marathon runner with a best time of 2 hours and 57 minutes. I have run 37 marathons during my recreational running career.

I recently discharged again from hospital and have been in and out since May 2000 with lower abdominal problems.

For any other sufferers out there who have had gut problems that mimic Crohn's or Ulcerative Colitis this may be a possible diagnosis.

As I mentioned I am a runner - specifically marathons and ultra races and since last year after lengthy training sessions in high humidity and heat I succumbed to severe lower left abdominal pain. Initially I used to "Knuckle" it out and like most endurance runners I'm used to the ups and downs of gut and stomach discomforts. However after experiencing sharp stabbing pain in my abdomen and passing explosive black diarrhea after one long hot and humid run session,which also showed indications of fresh streaks of blood, I knew all was not well.

On admission pain was relieved with analgesic injections and I was on an IV for 48 hours to rest the gut. A colonoscopy revealed about 30 small apthous ulcers in the sigmoid region of the colon.

A week later and after bed rest a further scope revealed no major changes. However 3-4 weeks after rest and reduced activity a further colonoscopy revealed that I had made a full recovery with all ulcers having disappeared.

Then again it happened this year again after a long run. This time There was explosive foul smelling black stool with traces of fresh blood. I also experienced abdominal distension and really bad gas. The pain and discomfort was horrible. On admission I was administered with IV and again intra muscular analgesic injections. 48 hours later I was colonoscopied and it revealed an almost complete colonic stricture in the same area  as before, accompanied by inflammation and several ulcers - the doctor said it was visibly like "classic Crohns disease".

However histology of biopsies revealed non specific inflammation which was not typical Crohns or Colitis. Further tests for amoeba were negative but I did test positive for aeromonas bacteria. Anyhow 5 days later pain subsided and about 7-8 days later so did the distension and general discomfort. A further colonscopy revealed I had made an astonishing full recovery and there was no evidence of inflammation, stricture or ulcers. The doctors were baffled somewhat, particularly with the speed of my recovery which is atypical of ulcerative colitis or Crohns.

After discussions the doctor decided to test for ischemic bowel. However this was then rejected when it was evident I had to have a Foley catheter inserted during the angio - no thanks I've had enough discomfort during one admission!!!

Anyhow a bit of research by the GI Doctor revealed that as a runner I could be suffering from endurance athlete's colonic ischemia. Read American Journal of Gastroenterology Vol. 93, No. 11, 1998 by Lucas . W and Schroy. P.

The cure - reduce running duration in high humidity and temperatures. Limit long runs of over 2 hours to once per week (especially summer). Spend more time in the summer on treadmills in the airconditioning. Hydrate well pre-exercise, during exercise and after exercise. Rest well at least once and possibly twice per week.

I hope that this input goes a step further in helping  doctors and patients also consider exercise habits as a factor when diagnosing gut complaints.
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Avatar_n_tn
I am a 35 year old marathon runner with a best time of 2 hours and 57 minutes. I have run 37 marathons during my recreational running career.

I recently discharged again from hospital and have been in and out since May 2000 with lower abdominal problems.

For any other sufferers out there who have had gut problems that mimic Crohn's or Ulcerative Colitis this may be a possible diagnosis.

As I mentioned I am a runner - specifically marathons and ultra races and since last year after lengthy training sessions in high humidity and heat I succumbed to severe lower left abdominal pain. Initially I used to "Knuckle" it out and like most endurance runners I'm used to the ups and downs of gut and stomach discomforts. However after experiencing sharp stabbing pain in my abdomen and passing explosive black diarrhea after one long hot and humid run session,which also showed indications of fresh streaks of blood, I knew all was not well.

On admission pain was relieved with analgesic injections and I was on an IV for 48 hours to rest the gut. A colonoscopy revealed about 30 small apthous ulcers in the sigmoid region of the colon.

A week later and after bed rest a further scope revealed no major changes. However 3-4 weeks after rest and reduced activity a further colonoscopy revealed that I had made a full recovery with all ulcers having disappeared.

Then again it happened this year again after a long run. This time There was explosive foul smelling black stool with traces of fresh blood. I also experienced abdominal distension and really bad gas. The pain and discomfort was horrible. On admission I was administered with IV and again intra muscular analgesic injections. 48 hours later I was colonoscopied and it revealed an almost complete colonic stricture in the same area  as before, accompanied by inflammation and several ulcers - the doctor said it was visibly like "classic Crohns disease".

However histology of biopsies revealed non specific inflammation which was not typical Crohns or Colitis. Further tests for amoeba were negative but I did test positive for aeromonas bacteria. Anyhow 5 days later pain subsided and about 7-8 days later so did the distension and general discomfort. A further colonscopy revealed I had made an astonishing full recovery and there was no evidence of inflammation, stricture or ulcers. The doctors were baffled somewhat, particularly with the speed of my recovery which is atypical of ulcerative colitis or Crohns.

After discussions the doctor decided to test for ischemic bowel. However this was then rejected when it was evident I had to have a Foley catheter inserted during the angio - no thanks I've had enough discomfort during one admission!!!

Anyhow a bit of research by the GI Doctor revealed that as a runner I could be suffering from endurance athlete's colonic ischemia. Read American Journal of Gastroenterology Vol. 93, No. 11, 1998 by Lucas . W and Schroy. P.

The cure - reduce running duration in high humidity and temperatures. Limit long runs of over 2 hours to once per week (especially summer). Spend more time in the summer on treadmills in the airconditioning. Hydrate well pre-exercise, during exercise and after exercise. Rest well at least once and possibly twice per week.

I hope that this input goes a step further in helping  doctors and patients also consider exercise habits as a factor when diagnosing gut complaints.
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