Something serious

Dear Doc:

I have been having intestinal problems for about a year and a half now. 9 months ago, at a time when I was having diarrhea and some bright red blood in my stool I had a gastroscopy and colonoscopy done, both were clear. Problems have persisted ever since, but diarrhea stopped and now I am actually constipated, however, bright red blood accompanies very painful bowel movements (pain is in the anus) and now I have got cramps all over the abdomen area, a little loss of appetite as well.

Is it possible that we missed something in the colonoscopy, could Crohn's disease or UC (these are the two that I am most concerned about) not have matured enough to be visible, I was having symptoms at that time though of the tests. I am terrified of Crohn's disease and UC. I am going to follow up for certain with my Gastroenterologist who originally said that all that I was suffering from was pretty bad constipation, could the constipation still be the cause.

please help

[Kevin Pho, MD]

I agree with the testing thus far.  The colonoscopy would exclude most cases of the diarrhea as well as look for possibilities leading to blood in the stool.

I would test the stool for causes of malabsorption, and obtain breath tests to exclude lactose intolerance.  

Celiac disease can be considered, and evaluated with the appropriate blood tests.

If the tests remain negative, irritable bowel can be considered - and treated appropriately.

If Crohn's disease continues to be suspected, a small bowel series, or MRI enteroscopy, would be the tests to further evaluate for this.

These options can be discussed with your personal physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd