26 years of bowel problems...

[cindy27]

I'm 37 yrs old and "bowel issues" started at age 11. Bloody diarrhea & weight loss mostly. Some bouts severe enough that I was hospitalized. At age 11 we were told it was colitis likely from my parents' diverse 2 yrs prior (?!) At age 14 we were told it was due to food allergies. At 19 they said it was food poisoning. At 23 I was told it was bleeding hemorhoids from the pregnancy. In 1997, at age 28 I had a severe G.I. hemorrhage landing me in the hospital for 5 days. They thought it might be salmonella but all cultures were negative. Sigmoidoscopy indicated "significant inflammatory changes, most markedly from 40-60 cm...severe edema and hemorhagic changes...many areas of erythema and edema... continued to worsen from 40 cm up to 60 cm where it felt further passage of the scope was not necessary(!)...diffuse hemorrahgic changes, hemorrhoidal disease." Biopsy report: "focal recent mucosal hemoorahge, prominent submucosal lymphoid nodules."  After 2 wks of Cipro,Flagyl and Prednisone, the episode resolved. By the way, over the last 15 yrs, I have only one bowel movement every 10 to 14 days. Then, when I am able to "go," it's as if a dam breaks and I spend the entire day in the bathroom. So, I'm CHRONICALLY CONSTIPATED. 6 mths ago I started running a low-grade fever between 100 and 101 EVERY afternoon. Sometimes night sweats too. I've unintentionally lost 25lbs in the last 6 mths. I have a CONSTANT dull ache on my rt side directly level with my navel. Sometimes the pain is severe. Infectious disease specialist ordered a Gallium Scan with scans at 24 and 48 hrs. I was called back at 72 hrs and then again at 96 hrs and wanted me back for a 5th day but I couldn't go. The findings: "persistent colonic activity particularly in the right lower quadrant. Differential includes normal excretion or the prescence of inflammatory infectious disease..." Colonoscopy: Nov 2005: "very tortuous colon making entrance to the cecum very difficult" and random biopsies including: "Terminal Ileum: mucosa with lymphoid formation" and "Colon: increased number of intramucosal lympocytes." Upper endoscopy:  "scattered erythema in the stomach and scattered punctate erythematous lesions in the duodenum."  New pathologist offered "2nd opinion" on biopsies from 1997 and found "Colonic mucosa with focal areas of CRYPT ATROPHY and Lamina Propria FIBROSIS consistent with iscehmic change." The SBFT was a bad experience. I hadn't had a bowel movement for 5 days prior to the exam but they had me drink the barium anyway.  It got "stuck" and they sent me to eat soup! After several hrs they did the flourscopy (resident did it) which took over an hour but couldn't see T.I. Report: "Terminal ileum is not visualized due to position in low pelvis...mucosal pattern of cecum is irregular probably due to residual fecal material."  My question: Could this be Crohn's?  Fever, weight loss, pain, skip areas, biopsies, pink eye, positive Gallium scan? Also, can Crohn's cause constipation? THANK YOU!

[Kevin Pho, MD]

You clearly have been through a comprehensive GI evaluation.  

The diagnosis of Crohn's can be difficult, and pathology sometimes cannot give a definitive diagnosis.  To help compliment the biopsies, you can consider some serum antibody levels to pin down the diagnosis of Crohn's.

This can include the anti-OmpC antibody which has a specificity in the mid 90-percent range.  Also, the antineutrophil cytoplasmic antibodies (P-ANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA) can also be obtained to further cement the diagnosis.  

Although possible, Crohn's typically causes diarrhea rather than constipation.

To further evaluate the chronic constipation, you can consider anorectal manometry studies or motility studies.  

These options can be discussed with your GI physician.

Followup with your personal physician is essential.

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, M.D.
kevinmd_b

[NickyIsHere123]

Sounds like you are deficient in Magnesium. You may need to start taking a highly absorbable supplement. This will also help the constipation. Good Luck

[MichelleH.]

Symptoms of Chron’s Disease

  

The most common symptoms of Chron’s disease are abdominal pain, often in the lower right area, and diarrhea.  Rectal bleeding, weight loss, and fever may occur.  Bleeding may be serious and persistent, leading to anemia. Other symptoms may include anal pain or drainage, skin lesions, rectal abscess, fissure, and joint pain (arthritis).

http://www.daytoncolonrectal.com/Conditions_Chrons.htm

http://www.geocities.com/rosemarie_bravo/

[lestye]

My husband (48 yo) had shoulder surgery in August 2005.  Two days after surgery he developed neurological problems that lasted for about 3-4 weeks, undiagnosed. In September he developed severe abdominal pain, RLQ and about the naval, so terrible he was on the floor rolling in pain.After about 45 minutes they subsided. This has since happened 20-30 times, he has had workups with 3 GI docs, colonoscopies, endos, ERCP, hepatology with liver bx (liver functions were quite elevated as well), CAT scans, MRI, bloods galore. He has been ruled out for gallstones, gallbladder, liver disease, hepatitis A,B,C,E, pancreatic insufficiency, stroke, etc.  Associated with the abdominal pain, he gets immense bowel gas and has anywhere from 5-10 bowel movements a day. He was put on Creon for pancreatic insufficiency which did make a dent in the bowel movements but not the symptoms.  He is down 19 pounds since August, no diagnosis in sight, have visited 4 major Boston hospitals, hepatologist, pancreas specialist, GI.  They keep mentioning some underlying Crohn's but no on is able to find anything.  We are truly scared.  Does anyone have any help for us?

[fgc236str]

I was diagnosed with Crohns disease at Cedars in LA.  I have given up on Western Medicine.  I have been to both Cedars in LA and UCSF in SF as well as multiple gastro doctors.  All they want to do is shoot you with steriods and pump medicine.  I have moved to Eastern medicine and had great results.  I travel, take clients out to lunch, take public transportation and I am not always looking for a bathroom.  All the doctors told me there is no cure for Crohns.  Well, I feel much better.  Good luck to you.