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Gastroenterology (Expert Forum)
Chances of it being Chron's?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Chances of it being Chron's?
by jfem, May 30, 2006 12:00AM
I am a 40 female with a 9 month hx of stomach problems.
It began with diarrhea for about 2 weeks,( AUgust) that stopped, then about 2 months later it was horrible bloating, feeling like there was a brick on my stomach, as well as nausea.
Had an endoscopy-negative
Had stool cultures for O and P- negative
ABd x-ray -negative
Complete blood test, CA 125, Celiac Disease profile,Gliadin Antibody,IgA, all negative. THe only out of limit was the A/G ratio-it was 2.2 normal was 2.0
Had an ESR in AUgust-it was 4.
That lasted for about a month, then just stayed with an ittirated stomach after a BM ( which was only in the AM), then progressed to nausea, or bloating.
I began VSL #3,Culterelle, and Citrucell for about a month and things got better, so I stopped the Citrucel, and started to increase my soluble fiber.
The symptoms that continued were rectal bleeding with a formed stool or with straining,some slight rectal pressure ( similar to hemorhoid pressure), some bloating ( 2-3 times /week), and some nausea ( 1 -2 times/week).
Had a colonoscopy, biopsy revealed UC/IBD, and the GI treated me with Rowasa suppositories because he said it was confined to the rectum and was treating it as proctitis.
Since taking the suppositories, the symptoms have gone away almost entirely ( it's been 2 weeks). THe bloating is significantly better, I think there has been only one tiny strain of blood in 2 weeks .
I've never had more than 1-2 BM's per day, only had that diarrhea once in August ( that was after a dose of CLindamycin)and that only lasted 2 weeks.
I have normal stools now, once a day, sometimes twice.
No weight loss, no appetite change ( except when I have bloating, and my stomach hurts, )
SO the MD called and was concerned because his partner who did the colonoscopy. didn't go it to the ilieum, and he wasn't to make sure it's not CHron's.
He said he's just being academic, and that I present with classic proctitis, but he wants to be sure.
SO he oredered some blood test?
Can you tell me your thoughts on this?
What chance do you think it is that I have CHrons, and what is the blood test that he's talking about?
Wouldn't it be seen on the other tests that I had?
WHat are the chances if all those major onles were negative, and the symptoms that I ma having, of it being Chron's??
Thanks
JM
It began with diarrhea for about 2 weeks,( AUgust) that stopped, then about 2 months later it was horrible bloating, feeling like there was a brick on my stomach, as well as nausea.
Had an endoscopy-negative
Had stool cultures for O and P- negative
ABd x-ray -negative
Complete blood test, CA 125, Celiac Disease profile,Gliadin Antibody,IgA, all negative. THe only out of limit was the A/G ratio-it was 2.2 normal was 2.0
Had an ESR in AUgust-it was 4.
That lasted for about a month, then just stayed with an ittirated stomach after a BM ( which was only in the AM), then progressed to nausea, or bloating.
I began VSL #3,Culterelle, and Citrucell for about a month and things got better, so I stopped the Citrucel, and started to increase my soluble fiber.
The symptoms that continued were rectal bleeding with a formed stool or with straining,some slight rectal pressure ( similar to hemorhoid pressure), some bloating ( 2-3 times /week), and some nausea ( 1 -2 times/week).
Had a colonoscopy, biopsy revealed UC/IBD, and the GI treated me with Rowasa suppositories because he said it was confined to the rectum and was treating it as proctitis.
Since taking the suppositories, the symptoms have gone away almost entirely ( it's been 2 weeks). THe bloating is significantly better, I think there has been only one tiny strain of blood in 2 weeks .
I've never had more than 1-2 BM's per day, only had that diarrhea once in August ( that was after a dose of CLindamycin)and that only lasted 2 weeks.
I have normal stools now, once a day, sometimes twice.
No weight loss, no appetite change ( except when I have bloating, and my stomach hurts, )
SO the MD called and was concerned because his partner who did the colonoscopy. didn't go it to the ilieum, and he wasn't to make sure it's not CHron's.
He said he's just being academic, and that I present with classic proctitis, but he wants to be sure.
SO he oredered some blood test?
Can you tell me your thoughts on this?
What chance do you think it is that I have CHrons, and what is the blood test that he's talking about?
Wouldn't it be seen on the other tests that I had?
WHat are the chances if all those major onles were negative, and the symptoms that I ma having, of it being Chron's??
Thanks
JM
Doctor's Answer
by Kevin Pho, MD, May 31, 2006 12:00AM
, May 31, 2006 12:00AM
Crohn's disease is one type of inflammatory bowel disease - the other being ulcerative colitis. Most cases of Crohn's disease would extend up to the ileum. If the disease is restricted to the rectum, ulcerative colitits is more likely.
There are various antibody tests that may suggest Crohn's versus UC. Imaging the terminal ileum with a small bowel follow-through or an endoscopy can appropriate evaluate the ileum for Crohn's disease.
If these tests are negative (i.e. both an endoscopy and/or the small bowel follow-through, as well as the antibody testing), the chances of Crohn's disease is less likely.
These questions should be discussed with your personal 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_
There are various antibody tests that may suggest Crohn's versus UC. Imaging the terminal ileum with a small bowel follow-through or an endoscopy can appropriate evaluate the ileum for Crohn's disease.
If these tests are negative (i.e. both an endoscopy and/or the small bowel follow-through, as well as the antibody testing), the chances of Crohn's disease is less likely.
These questions should be discussed with your personal 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_
I believe this test was forumlated in England (where (I live) and when I had it 2 years ago showed elevated levels, which were confirmed by colonoscopy. Prolactin levels can be done at any time, whereas there are risks with colonscopies (perforating the bowel etc.). You might like to ask if you gastro can get this test done.
Liz.