What to do next ?

[Marz1946]

I am retired and living in Crete.  I am 66 next month and was diagnosed with Crohns when I was 27.  I was suffering with ileo-caecal TB and eventually had a hemi-colectomy and the Crohns was in the ascending colon.  Yes it was TB as the sample was sent away to London for the culture to be grown.  I had a further resection in my 30's followed by pancreatitis and then gall bladder removal.  Had bad flare-ups from time to time which anti-inflamatories did little to help.  I found that sleep under the duvet was the best cure.  In 2005 I was diagnosed with Hashimotos and have been on treatment since then with a T4/T3 combo.  I now realise that if you have one auto-immune disease you are likely to have another !...and yes a healthy gut is oh so important.  So with the T3 receptors in the gut lining it makes sense that when thyroid hormones are low things start to go wrong.  Have been in remission for over 13 years.  However for the past week or so I have a funny feeling in my gut - probably near the last surgery.  It feels like a  tickle which I recognise as the beginning of problems.  My bowel habits have also changed.   In the past when busy with a career I used to leave things too long and then usually had the added complication of an abscess.  Of course I was admonished !

I am so nervous about having further interventions.  Would it be best to have a CT scan or a colonoscopy....I can arrange both here privately and quickly even though I do not have medical insurance it is affordable.  Am also nervous of further surgery .

Thank you.

[Marz1946]

Yes it does - thank you.

[S. Kaul, MD]

Hi there!

Well, without a clinical evaluation it would be difficult to comment specifically on the situation, though the symptoms could be related to a flare. Aut0immune conditions often tend to be related while thyroid itself could affect GI motility. It is difficult to compare a CT over a colonoscopy since both may be useful investigations. While a colonoscopy would be the gold standard for lower GI lesions it may not be preferred being invasive while CT may often be helpful. I would suggest considering a review with your gastroenterologist for an accurate diagnosis and suggestion of an appropriate management plan.
Hope this helps.

Take care!