I am a 26-year-old female and recently underwent tests at the Mayo Clinic to pinpoint the cause of a nearly year-long bout of chronic diarrhea, weight loss (>20 pounds), abdominal pain, episodic mouth ulcers, and intermittent fever. I also experienced symptomatic gallstones and had laparoscopic surgery about 10 weeks ago. At the Mayo, I had innumerable stool studies for parasites and bacterial infections, and all were negative. Upper endoscopy showed mild gastric erosions; biopsies showed no evidence of H. pylori. Colonoscopy with terminal ileal exam and biopsies was completely normal. CT w/ contrast was normal. I had a positive fecal occult blood test and positive fecal leukocyte test. Previously, I had a small bowel follow-through that showed prominent folds in the duodenum. Also previously, a wireless capsule study was done and read as normal. I was told that I had post-infectious IBS and to continue taking Lomotil and hyoscyamine.
I have been back for two weeks and have had a nearly constant low-grade fever of about 100 degrees. My diarrhea has been consistent despite regular doses of Lomotil and Levbid. The Mayo docs agreed that weight loss, fevers, and positive FOB and leukocytes should not occur with IBS, but didn't have other answers for me.
I am working with a wonderful PCP now who is very helpful and has been doing some research for me. I thought I might give her a hand. We know that my symptoms seem consistent with IBD, but the test results are vague. My questions: could these findings - gastric erosions, bowel wall thickening, positive FOB/leukocytes - indicate Crohn's disease despite the otherwise negative endoscopy findings? Is it unheard of to start empiric treatment for Crohn's despite no physical evidence of the disease in the intestine? I know some treatments can be tough on the body, but this illness is driving me up the wall.
Thanks in advance for your response!