Conflicting information on bowel issue

[GassyGuy]

I was diagnosed with IBS 10+ years ago but recently learned that a number of other things should have been ruled out first.  Over the past few months I've had a number of tests...

Symptoms:  I often go for 2-3 days with no bowel movement, and will then, with some urgency, pass a *large* quantity of stool that resembles soft mud.  I also have a *lot* of gas most all the time.  A stressful event or a large coffee will usually result in cramping and urgent evacuation of bowels. Occasionally mucous is visible.  It often takes several trips to the washroom over a period of 2-3 hours for bowels to be empty. I have, on occasion had firmer stools, almost "normal", followed by mud-like excrement within an hour or so.

I was advised by my former doc to take fiber suppliments.  This essentially resulted in the same issue but larger quantities.

- 40ish male

- Excluding dairy and gluten for 10 days made no difference

- Bloodwork all within normal limits

- No meds, no conditions

- No evidence of blood in stools

- Urea breath test negative

- Stomach biopsy is negative for celiac

- No issues noted during upper endoscopy

- Small bowel follow-through went fine and verbal report from radiologist was that it was normal.  However, his report indicated inflammation of the terminal ileum and thickened folds suggestive of Crohn's

...but...

- Colonoscopy, including entry several inches into the terminal ileum was normal (other than two polyps were removed much lower in the colon.  Both biposies negative.)

So the radiologist sees inflammation in the terminal ileum, but the very experienced doc who did the colonosopy says it looks perfectly normal.

Any thoughts?

[GassyGuy]

Thank you both -- much appreciated!

[coughting]

Your symptoms do sound like tiypical mild chrons.  Ask the dr. if there are other tests including blood test that could see if you have the gene for chrons.  
CalGal is correct in asking to read the report yourself.  Then ask the dr. questions and ask him what the inflamation and folds would suggest.

Good luck

[CalGal]

Were biopsies taken from within the terminal ileum? "Looking" inside the terminal ileum may not be enough to render an everything is fine statement. There can be things going on under the surface that can't be seen with the naked eye. You said both biopsies were negative, but you didn't state where the biopsies were taken from.

Also, have you seen the written copies of both the doc's report and the pathology report? Always get physical copies of all test and read through them yourself. I don't care how much experience those in the medical profession have, things can be overlooked.

Were the intraepithelial lymphocytes counted in the celiac biopsy? If so, what were the counts? In most cases there's a standard. Up to 20 is negative. Over 40 is positive...........but what about from 20 to 40???? Most gastro docs call that negative, but it's not. It can mean that there is something going on, but the patient often doesn't hear about it.