IBS or IBD?

[SCR]

I am a 32 yr. old female who has been experiencing bouts of sometimes extreme abdominal pain for almost 3 yrs now. The first time I experienced the pain which was intense, I was 6 months pregnant and spent a night in the hospital. After which I had an ultrasound of my gallbladder, which was fine. Sometimes the pain is moderate, and other times it is a severe cramping, and usually (but not always) located in my upper middle abdomen which is comparable to labor pains. I also usually have explosive diarrhea and some nausea, however this does not relieve the pain which usually is intense for one day and lingers for 3 or 4. Finally after 6 or 7 episodes in 3 yrs I went to a gastro doc. I never have constipation. I also have muscle and some joint pain in my legs. Also twitching of the muscles in my legs usually when I try to sleep. Doc did a fecal occult blood test, which was positive. The doc ordered a series of tests, sed rate, h. pylori, RH, ANA Titer, and A/BC igG (<---I think that was it-doc's handwriting was hard to read as I was taking the orders to the lab.)All my test turned out in the normal range except for the sed rate which was high (exact number I do not know.) He also scheduled me for a colonoscopy and an endoscopy, and he found "colitis and gastritis." My husband remembers the pics: pics of my stomach showed a red stripe, however colon pics were just pink with no ulcerations. Doc did find and removed a polyp and took several different biopsies. I also had to give stool samples, which were all ok with no parasites. A nurse called back to say that my biospies showed no bacterial infections, and stool samples showed no parasitic infections. I have a follow up visit scheduled for next week, which hopefully the doc will have some answers by then. Also my mother has Still's Disease, and my father has had a milder form of digestive episodes himself. However he has had 2 ano-rectal abscesses, which required surgery. Other than that he has not sought a diagnosis for his gastro troubles. I was hoping for feedback from this forum. Specifically on the difference between IBS and IBD, and ideas on a diagnosis.Thanks!

[Kevin Pho, MD]

Irritable bowel disease and inflammatory bowel disease are two seperate disease.  Inflammatory bowel disease consists of Crohn's disease and ulcerative colitis.  Normally, an endoscopy (either colonoscopy or upper endoscopy) would be needed for the diagnosis.  Specifically, in Crohn's disease this can affect the small bowel, so some imaging of the small bowel may be needed.  Treatment would involve steroids and other anti-inflammatories.  

Irritable bowel syndrome is caused by a spastic colon.  It is not normally associated with inflammation.  This is normally a diagnosis of exclusion - meaning it can be considered if other causes of the symptoms are ruled out.  Treatment would involve increasing the fiber in the diet, and possible antispasmodic agents.

More can be found here -

IBS:
http://www.nlm.nih.gov/medlineplus/irritablebowelsyndrome.html

IBD - Crohn's:
http://www.nlm.nih.gov/medlineplus/crohnsdisease.html

IBD - ulcerative colitis:
http://www.nlm.nih.gov/medlineplus/ulcerativecolitis.html

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

[nelsonchatham]

any depression, fatigue, low body temp, etc?  IBS is one of the most common hypo symptoms...so you might want to rule that out.  ask for thyroid antibody testing too.

[SCR]

I do not have depression symptoms, and actually I have always had a slightly lower body temperature. My temp is usually 98 degrees or lower. I do have some fatigue, but I have always attributed that to having a busy lifestyle. I have 2 toddlers, and work partially from home. I have not had any thyroid function tests. I will mention that to my doc. Thank you for your input.

[sick for 22 years]

And thyroid problems can cause all kinds of muscle aches and pains.Please see my earlier thread GET YOUR THYROID CHECKED.

[nelsonchatham]

I highly recommend that you get more than the standard TSH test.  Ask for thyroid antibodies and Free T4 and Free T3 (the actual thyroid hormones).  if those labs are in the lower 1/3 and/or you have thyroid antibodies - i think you will have found the origin of your problems.

[SCR]

I am a little confused? I do not have many of the symptoms of a thyroid problem. Could a thyroid problem cause inflammation of the colon (colitis) and my stomach (gastritis), severe abdominal cramping, diarrhea, and nausea, and blood in the stool?  I would not think so.

[indian1]

visit this blog to get very in depth information abot ibs.

Visit as many links as possible.

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http://ibsindia.blogspot.com

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If you think candidiasis is related to your ibs, then visit this one

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[sick for 22 years]

Yes, it sure can! I suffered for years with bouts of vomiting, all kinds of abdominal pain and digestive problems. I suffered through colonoscopies, endoscopies, gi series, etc, before anyone realized what was wrong.I took enough medicine to fill a pharmacy.Thyroid disease can take many forms and should be eliminated since it can cause circulatory and reproductive problems as well.Just your low body temperature and peculiar aches and pains should be warning enough.Please visit some internet websites on the thyroid. I wouldn`t be surprised to find out you have other symptoms you never dreamed could be a sign of a thyroid problem.Remember, if you get tested you will know what you  DON`T have, and your doctor will have a clue to go in a different direction. Thyroid problems rarely heal themselves.Hope you get some relief!

[hashi]

My first symptom of thyroid disease was feeling tired. I went on very low dose of synthroid and felt better. About middle of this year I started feeling yucky again and went to dr. he took me off synthroid and put me on straight t3 medication because he felt I was converting my t4 into t3 and because of my low body temperature,below 98.0. I took it and got my temp. up and weaned off of it and now My temp. is still up and other than having suspicions of I.B.S., I'm feeling fine.I also had an antibody test for my thyroid and found out that I have Hasimotodisease which destroys your thyroid.My symptoms of suppsedly I.B.S. are constipation, abdominal cramping, and bloating.My dr. said it sounds like I.B.S. from your symptoms and told me to take a fibre supplement, start taking my flax seed oil again which did keep me regular and is good for thyroid and left it at that. I'm going to call him and deman a proper diagnosis. So please go get your thyroid checked. You feel better about things if you do. Like I said my symptoms were mild at first with just fatigue for years. Please go.

[hashi]

My first symptom of thyroid disease was feeling tired. I went on very low dose of synthroid and felt better. About middle of this year I started feeling yucky again and went to dr. he took me off synthroid and put me on straight t3 medication because he felt I was converting my t4 into t3 and because of my low body temperature,below 98.0. I took it and got my temp. up and weaned off of it and now My temp. is still up and other than having suspicions of I.B.S., I'm feeling fine.I also had an antibody test for my thyroid and found out that I have Hasimotodisease which destroys your thyroid.My symptoms of suppsedly I.B.S. are constipation, abdominal cramping, and bloating.My dr. said it sounds like I.B.S. from your symptoms and told me to take a fibre supplement, start taking my flax seed oil again which did keep me regular and is good for thyroid and left it at that. I'm going to call him and deman a proper diagnosis. So please go get your thyroid checked. You feel better about things if you do. Like I said my symptoms were mild at first with just fatigue for years. Please go.

[SCR]

Well throid tests are back, TSH, T3, and T4 are all normal. I also had a calcium test, also normal. My gastro doc said that the nurse told me wrong on the phone, I do not have colitis, but do have gastritis. He prescribed Donnatal one or two pills per day depending on abdominal cramping/pain. So far I only notice a slight difference in how I feel on the med. My gastro doc also wants to send me to a neurologist because of the "fasciculations," he calls them, or what I have always called muscle twitching which is especially bad in the evenings and at night while I am trying to sleep. My legs feel like they have a life of their own, and if you laid your hand on my legs you would feel the twitching too. Also these twitches are accompanied by muscle pain usually of my thighs, which can feel as bad as a cramp. I also have mostly facial or finger twitches during the day. I am at a loss, I really thought you all might be right with the thyroid stuff.

[HEARTSMART0925]

I am experiencing very similar issues.  I am having more problems with constipation.  I have always had normal Thyroid levels on prior blood tests.  In a recent blood test, my levels were slightly elevated.  I will begin taking medication at the end of the month, once another blood test is done.  I am at the point that I am afraid to eat complex carbs, therefore dieting is not a good thing right now.  Which makes me tired and not feel like exercising.  So, I feel your pain.  I think I would find a doctor that has more of an understanding about the hormone levels and can give more of an answer about the thyroid.