Is it Chron's or IBS?

by Kira
(Canada)

Hello! I am a 22 year old female, who weighs 115 pounds and is 5'3". I try to stay healthy and eat right. I avoid fatty, red meats, eat plenty of fruits and vegetables and try to lead an active life. I work a full time job, and I go to the gym 3 times a week, and my main form of transportation is buses and walking.


Three years ago I began to exhibit symptoms such as: bloating, cramping, straining to go the bathroom, diarrhea, mucus in stool, pain so severe I would wake up in the night crying etc. My doctor (without performing any tests) concluded that I had IBS and prescribed me with 50mg of Dicetel 3 times a day with meals, as well as some antacid for some recurring acid reflux. After a few months my doctor increased my dosage of Dicetel to 100mg, which still seemed to have little to no affect on my symptoms, while also causing side effects like extreme nausea and vomiting. Eventually, I stopped taking Dicetel on my own, and began to self medicate with Imodium, Gas-X, and generic over the counter antacid for my acid reflux. I took and still take on nearly a daily basis Imodium for the diarrhea and cramps.

Three years later: and still no improvement in my symptoms. In fact, I would say they have worsened. I vomit in the morning between 1 and 3 times a week. The vomit is usually nothing but a sweet tasting, white mucus, and I usually wretch for a while until I can't throw up any longer. I wake up with severe cramping and diarrhea, which has me rushing to the bathroom the second I open my eyes. I have on a few occasions noticed dark red parts in my stool, but upon collection of a stool sample, my doctor found no blood. I have lessened my intake of imodium to 1 capsule a day and try not to take any on the days which I don't work, because I really do not want to become dependent on it. In addition to these symptoms, I am almost always extremely fatigued, and I suffer from a lot of muscle and joint pain in my knees, legs, wrists, and back. I also have dry patches of skin all over my body, and sometimes I get clear fluid filled bubbles on the inside of my mouth which get bigger until they burst on their own.

Currently, my doctor says that since Dicetel doesn't work, that there are no other treatment options available to me, and he does not have any reason to believe it is anything other than IBS so I can just "live with it." He refuses to refer me to a specialist, which I have asked for on multiple occasions, will not refer me to have a barium swallow tests or colonoscopy. He has done blood tests and taken stool samples, and nothing more. What could this be? And what could be done about it? It has been a plague on my life and I need some definite information!

Comments for Is it Chron's or IBS?

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Is it Chron's or IBS? NEW
by: Annette Young

Hello Kira,

Thank you for taking the time to write in.

I was appalled to read about the lack of interest and professionalism displayed by your doctor. You have every right to receive full medical support and if I were in your situation, I would find myself another doctor and get referred to a specialist.

You are not alone in receiving little help from the medical profession and it makes me very cross when I hear about such situations. At the end of the day you go to see a doctor because you are unwell and you shouldn't have to battle for support and guidance.

It sounds like you are doing all you can to have a healthy diet but of course until you receive an accurate diagnosis you're not quite sure what you're dealing with. I was diagnosed with IBS for many years myself and I tried every remedy under the sun without help because it was a misdiagnosis, sadly, doctors seem to diagnose IBS quite quickly but do not provide alternative tests to ascertain whether there are other causes such as Crohn's. I understand that the symptoms can be similar but having endured chronic pains in my teenage years, I can fully understand what you're going through.

If you have Crohn's for example, this is a very serious condition and it can be aggravated by intolerance to foods such as dairy, too much fibre, stress, smoking and alcohol. Even foods that you have been eating for years can certainly cause an acute attack which may result in feelings of nausea, diarrhoea and abdominal pains.

I would keep a food Journal to see if certain foods are acting as triggers and I would make note of everything possible that relates to you on an individual level - including stressful situations, emotional or social pressures, because triggers are not just the foods that you eat and you have to tackle these types of conditions with an intuitive approach.

Mouth ulcers or sores within the mouth is often associated with undiagnosed Crohn's and you may be deficient in certain vitamins and minerals. If you're able to go and see a nutritionist, they would be able to offer you a great deal of support and advice at this time. If you can find one who has a lot of experience with IBD, then this would be useful.

I hope this helps,
Annette

Some doctors are just useless NEW
by: Anonymous

You need to see a new doctor, and then a specialist. I can't believe your doctor won't do further testing or refer you to a specialist. This is unacceptable.

Get a new Dr. asap!!!
by: Anonymous

Then get checked for celiac disease as well. I went wheat gluten and dairy free 8 months ago. I am not on any more meds and have been in remission since April.

Change doctor
by: Helen

I agree with Marys comments, change your doctor NOW!!! also I find that fruit and some vegetables irritate me a lot, so avoid them where possible - I only eat fruit when I am constipated which unfortunately happens too - hope you get help very soon

Is it Chron's or IBS?
by: Anonymous

When I get mouth ulcers, it is a sign that I am deficient in one or more vitamins. It would do you no harm to take a vitamin-B complex tablet, supplementary vitamin C and fish oil for the fat-soluble vitamins.

The FDA has stated that over 3 g of fish oil a day can be harmful due to the mercury content.

The B vitamins and vitamin C are water soluble and it is difficult to overdose on them. If you can find a sublingual tablet or powder then the absorption is far better.

The joint pains may be due to B vitamin deficiency particularly B12 and mineral deficiencies, e.g. magnesium, copper and zinc. Joint pains may also indicate Crohn's extra-intestinal arthralgia or arthralgia associated with another disease (there are over 100).

When Crohn's is located in the terminal ileum, this can lead to deficiencies in vitamin B12 and the fat-soluble vitamins. This is where vitamin B12 is absorbed. However, vitamin B12 requires stomach acid and if you are taking PPIs (proton pump inhibitors - acid inhibitors) or similar for reflux you may end up deficient in vitamin B12, magnesium, calcium, vitamin D and zinc.

However, there is a phenomenon that is called backwash ileitis - where colon bacteria wash back into the ileum and cause inflammation in the terminal colon. Antibiotics can cause inflammation of the gut as can other medication.

The dry skin could indicate deficiency of the fat-soluble vitamins (vitamins A, D, E, K). Here you have to be very careful because you can overdose easily and, in certain cases, too much can trigger certain cancers. Dry flaky skin can also indicate psoriasis, which is occasionally associated with Crohn's.

Doctors do not consider vitamin deficiencies because it is not something that happens in our part of the world. Unfortunately, I think that it is more frequent than they would like to believe. Cravings are a sign of undernourishment and a lot of obese patients are severely undernourished with respect to their vitamin and mineral intake.

The vomiting would indicate to me that you have frequent intestinal blockages. This happens in Crohn's, but also happens in other diseases such as Coeliac disease, cancer, etc. However, the Imodium and any opiate painkillers you are taking will cause severe blockages as do most street drugs.

Vomiting is also a sign of dehydration. Could you be overdosing on the Imodium - this will cause severe dehydration if you do not drink the required 1.5-2 litres water a day.

You need to keep a mood, food and symptoms diary (Google for support) and go armed with that to a new doctor. Use the CDAI as a guide to what information to collect: http://www.ibdjohn.com/cdai/

DL - see Part 2

Is it Crohn's or IBS?
by: Anonymous


Part 2

Also keep a record of what you drink and make sure that it is at least 1.5l a day. A word of warning coffee, aniseed, nettle, sugar, chocolate all exacerbate diarrhoea and/or reflux. Other foods are constipating - do your research here. You might have to start pureeing food to try to reduce the blockages and the resulting pain.

I suggest that you make appointments with a new gastroenterologist, a rheumatologist and a dermatologist. One of them must be able to help you. Take along the results from your diary. Taking vitamins and mineral supplements will not harm you if you are sensible about it (see above). Buy a medical copper bangle, which will supply you with copper - important for joint health.

Look up the side-effects and interactions of the medication and supplements that you are taking at www.drugs.com or www.rxlist.com

I can't answer your question, you need to see a team of doctors to obtain a proper diagnosis.

Be wary of treating yourself without medical supervision because the side-effects of medication can mimic a plethora of diseases or hide symptoms. Be completely upfront with the doctors and write everything down in a structured manner prior to the appointment.

DL


crohns
by: mary

my advice to you is to change your doctor, immeditly, what you have described, there, isnt normal, i have crohns, and i wouldnt tolarate, his behavior, not for a second, its your right to see another doctor, and make sure you do ,

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