advise needed

can someone give me some advice. 46 year old women here that recently had a anal fissure. I have been having all kinds of problems lately and i am worried that i may have crohns or UC. i have diarrhea, alot of pain in the anal area, black stools, weight loss about 25 pounds in 2 months, vomiting, dont feel like eating, mucous or pus in stool, mouth sores and feel tired all the time. I went back to my CRS and told her about some of these problems but she was mainly checking to make sure anal fissure has healed which it has but she didnt do anything else or testing. what should i do? go back to her or find another CRS to talk to or prehaps a gastro doc? THANKS

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Advise needed NEW
by: Annette Young

Hello there,

I read your post was some concern and felt obliged to respond really just to emphasise the comments made by others.

To have consistent diarrhoea, anal pain, black stools and weight loss, these are serious signs that there is a problem and I am shocked that your CRS is not sending you for further tests and supporting you through this.

As you know an anal fissure is a tear in the lining of the lower rectum and is actually quite common. Most fissures heal quite quickly-certainly within a six week period and if it has not healed after that time, you may need medicine to help or even surgery.

It is important that you go to see a gastroenterologist and there are some excellent ones about but do not be fobbed off. They have to rule out condition such as cancer and as you have black stools, this certainly indicates bleeding. I am concerned because my own mother who was diagnosed initially with colitis and then with chronic Crohn's did not report the fact that she had black stools and it turned out that she had been bleeding very heavily for a long period of time and had to be rushed into hospital for an immediate blood transfusion. It was a terrible shock for her and for us and we had no idea how serious it was.

It is never worth taking risks with your health and sadly many people struggle to get a correct diagnosis-mainly because the symptoms can be very similar with Crohn's and IBS for example but once you have the correct diagnosis, then it can form an excellent starting point for recovery.

At the moment the only thing that you are sure of is that you had an anal fissure which may or may not have healed correctly, so whilst pushing aggressively for more help may be the last thing you feel like doing, it is probably the most important thing too.

Please do let us know how you get on.
Best wishes,
Annette
questions and answers
by: Question and answer

Like many others visitors to this site, I am trying to get answers. I recently had a colonoscopy and upper GI and cat scan. These test only after a host of symptoms. I have had stomach/bowel issues for years. Ruptured bowel and peritonitis ten yeasts ago. many test were ran at that time and was diagnosed with ibs. The pain and cramping and constant bowel changes are something I have learned to live with until recently. Years of what I have thought were weird symptoms or getting older.The last six months the symptoms that normallys are bearable and only a few at a time have worse and I can't seem to her well . The dymptoms I have suffered in some form everyday the last threw months include Leg cramps,tounge ulcers, fever blisters ,hip pain,buttock pain, anal pressure, trouble swallowing,back pain worsened with heavy lifting and traveling, groin and arm pains,weeks of diarreah,my white blood count is slightly elevated. Two weeks ago the scopes showed 4 polups in the colon, rectum (removed), an ulcer in the colon, an inverted apppendix vs polup and gastritis in the antrum. with the distance in my polups , colon ulcers and gastritis I am wondering if these are all symptom of crohns and what I should do to further make sure I get a diagnosis. When the gasto met with my friend after my test he never mentioned crohns.
advise needed
by: LydiaD

I can only echo the comments of the previous poster. You must see a good gastroenterologist urgently.

You need to get a diagnosis and rule out such as cancer. The bleeding is serious and must be treated as such and I don't understand why your primary care physician is being so laid back. Black stool generally indicates bleeding in the upper GI and could involve the oesophagus, stomach or small intestine. However, it also happens when someone eats too much chocolate or meat, etc.

Anal fistulas can occur with child birth or straining, etc. They are not necessarily an indication of Crohn's disease, although over 35% Crohn's patients, 5% of UC patients and 1% of the general population have fistulas at some time.

Your mouth ulcers would indicate malnutrition due to an inadequate diet as indicated by your rapid weight loss. You should consult a nutritionist. In the interim, I suggest that you take a vitamin B-complex with zinc, vitamin C, fish oil, until your diet is normalised. Spread the vitamins throughout the day. You can take up to 300% RDA vitamin-B complex with no problems. Vitamin B6 has an upper daily limit of 50-100mg per day depending on which country you live in (Australia 50 mg, USA 100 mg).

Whenever I have mouth ulceration I know that I am short on vitamins. Vitamin deficiencies will not help you fight your illness. Zinc is also good for the immune system.

In addition, please cut out all sugary foods and drinks - sodas, colas, etc., avoid alcohol and check that you have not developed a lactose or fructose intolerance. Limit fruit juice to a glass of diluted juice - 50:50 with water per day.

Google diets to put on weight.

Get immediate help
by: Kit Campbell

Hi there 46 year old woman :)
Your black stools indicate blood loss from your colon at a higher level. The lower the level, closer to your rectum, the blood colour will be a brighter red.
Go and get immediate help, preferably from a gastroenterologist first, so that he/she can immediately settle the symptoms with steroids to stop the inflammation in your bowel and the bleeding. You will probably have Salazopyrin given to you too.
Eat really gentle food, little and often, nothing too hard to digest. Keep away from sugar, alcohol, citrus fruits, meat.
Try oats, soft rice, soft vegetables, pasta, fish etc.
Drink water, water, water.... as much as you can, as you will be losing fluid through your diahorrea.
And breathe. Things are just the way they are. It's going to be hard, but just accept each moment as it comes, even the pain, even the diahorrea, as there will be moments without all these. Concentrate on these moments. When the pain comes, know that this too will pass. Trust this. Seek comfort and move away from all that is vexing to you. Find people and things that will cause you to smile.
Whilst the doctors are going to help you with your symptoms, you are going to have to work on the cause.
The men in white coats will call your symptoms diseases. Don't own them. Just see them for what they are in the present moment. Something to be left behind. Not to own :)
Go through these tests in peace, not with anxiety, or your stress will continue to create the symptoms.
All the best for you in this time.
Cheers
Kit
creatingchange1@googlemail.com

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