IBS or Crohn's?

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greeneyes28
New Member


Date Joined Aug 2008
Total Posts : 6
   Posted 9/9/2009 1:02 PM (GMT -7)   
Hi all,
 
I posted on the IBS pages about a year ago so all of my background info is here: http://www.healingwell.com/community/default.aspx?f=26&m=1221470
 
In the last year, I've been on the same meds. I'm still getting D after almost every meal and sharp pain sometimes after eating which is different to the abdominal cramps associated with D.
 
Since I figure my symptoms are pretty much as good as it's going to get, I haven't seen my GI doc in 9 months. Maybe not the attitude to have but I'm so tired of the tests etc.
 
In the past few months, however, I've been getting a lot of very painful mouth ulcers and this has brought me back to the question of whether it's Crohn's Disease I have since mouth ulcers can be a symptom.
 
My mother has Crohn's and has been in remission for years now. Hers was an unusual case since it was her stomach that was effected.
 
This was one of the first things that was ruled out when I first had the endoscopy/colonoscopy two years ago. I have since had another endoscopy a year ago (see link) and the dialation seems to have helped a  lot with my reflux/dysphagia.
 
Has anyone been diagnosed with IBS and later Crohns? My husband (who is a physician, but not GI) thinks that I may be experiencing symptoms of the early stages of Crohn's or a mild case of it.

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 9/9/2009 1:31 PM (GMT -7)   
With the mouth ulcers appearing I think it sounds like Crohns too. The colonoscopy is not the be all end all answer for if you have Crohns or not. Sometimes Crohns is in the small intestine where the scope can't reach. Did they take biopsies? Sometimes those will show the Crohns when the naked eye doesn't see anything. I might suggest a pill cam test. This test is a little pill camera you swallow and it takes pictures all the way down. Its one of the best tests to see if there is Crohns in the small intestine. Good luck and Big Hugs!
Gail*Nanners* Co-Moderator for Crohns Disease and Anxiety/Panic Forum
Crohn's Disease for over 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium  w/Vit D, and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia, Osteoarthritis, and Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
It's scary when you start making the same noises As your coffee maker.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 9/9/2009 10:08 PM (GMT -7)   
Prilosec is a PPI (proton pump inhibitor) and they have a bad effect on your digestion. They reduce the pH of your gastric juices to the point where your enzymes don't work and food passes undigested out of your stomach into your small intestine. Undigested food triggers sensors in the gut which brake the peristaltic action, slowing the passage of food through your small intestine. This reduces the clearing of bacteria which proceed to multiply on the undigested food in the small intestine. The braked peristalsis can also cause reflux, although with the Prilosec it would be non-acidic reflux. The bacterial overgrowth may be the cause of your diarrhea and can also cause problems with your gall bladder and pancreas. It would be difficult because of rebound acidity, but you might be well advised to try the older variety of reflux medication (H2 blockers like Tagamet) because it does not interfere with digestion.

You may have developed food intolerances as a result of gut inflammation and undigested food proteins. Food intolerances are also a common cause of reflux because the offending food triggers the mast cells in the stomach which then secrete histamine and histamine in turn promotes acid production in the stomach. The stomach is inflamed as well and the resulting swelling causes the valves controlling the flow of food/digestive juices to leak. Food intolerance can cause inflammation/pain in the gut as well as the stomach. Food intolerance testing should be the first step in controlling reflux disease.

There are a few nutrient deficiencies that can cause mouth ulcers and may result from regular diarrhea. Vitamin C, vitamin B12 and zinc deficiencies can all cause mouth ulcers.

Despite the many possibilities for other explanations, you must also consider Crohn's. There are any number of examples of people who have taken years to be diagnosed and a couple of examples of people who have switched from one disease to another (ulcerative colitis to Crohn's). This can happen as a result of treatment as well.

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 9/9/2009 10:16 PM (GMT -7)   
Crohn's disease and ulcerative colitis are 2 seperate diseases that fall under inflammatory bowel disease, one can not turn into the other, one patient can have both diseases though, but it is very very rare (aprox 2%). Crohn's colitis is still crohn's disease that is affecting the colon, there are 5 subtypes of crohn's disease (but they are all still crohn's)...
 

The symptoms and complications of Crohn's disease differ, depending on what part of the intestinal tract is inflamed. That's why it is important for you to know which part of your intestine is affected by Crohn's disease. Your doctor may also refer to your illness by various names based on the principal area involved. The following are five types of Crohn's disease, together with their presenting symptoms:

  • Ileocolitis: The most common form of Crohn's, affecting the ileum and colon. Symptoms include diarrhea and cramping or pain in the right lower part or middle of the abdomen. Often accompanied by significant weight loss.

  • Ileitis: Affects the ileum. Symptoms same as ileocolitis. Complications may include fistulas or inflammatory abscess in right lower quadrant of abdomen.

  • Gastroduodenal Crohn's disease: Affects the stomach and duodenum (the first part of the small intestine). Symptoms include loss of appetite, weight loss, and nausea. Vomiting may indicate that narrowed segments of the bowel are obstructed.

  • Jejunoileitis: Produces patchy areas of inflammation in the jejunum (upper half of the small intestine. Symptoms include abdominal pain (ranging from mild to intense) and cramps following meals, as well as diarrhea. Fistulas may form.

  • Crohn's (granulomatous) colitis: Affects the colon only. Symptoms include diarrhea, rectal bleeding, and disease around the anus (abscess, fistulas, ulcers). Skin lesions and joint pains are more common in this form of Crohn's than in others.

 

:)


My bum is broken....there's a big crack down the middle of it! LOL :)


Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 9/10/2009 10:22 PM (GMT -7)   
The notion that UC can convert to Crohn's comes from a case study published about 15 years ago. It may not be the final word, but it does appear to be a possibility and may account for some people spending years getting a diagnosis. See: gut.bmj.com

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 9/10/2009 10:36 PM (GMT -7)   
Absoultely no offence towards you keeper (I do respect you and your postings) but I just don't buy what they've written in the link, plus according to their own words it is "speculation"...I think there's a greater chance the patient was just initially misDX, or even the rare patient that does have both UC and CD...I've often been on long term corticosteroides myself over the 18 yrs that I've had crohn's (specifically crohn's colitis)...plus that is based on one patient, maybe if there were more documented cases, even so I would still lean toward believing misDX or "conversion from UC to crohn's"...again, just my opinion and nothing against you in any way...Even though I do like be as open-minded about "anything's possible" I'm just having a hard time with that one.

:)
My bum is broken....there's a big crack down the middle of it! LOL :)


medchrt1
Veteran Member


Date Joined Sep 2005
Total Posts : 517
   Posted 9/10/2009 11:20 PM (GMT -7)   
both correct. I have no problem with the leap of drug induced stricture. I actually suspect prednisone for doing just that.

Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 9/11/2009 8:28 AM (GMT -7)   
Sorry medchrt1, but I don't know anything to support the idea that pred can cause a stricture. It has a long list of other problems that it causes, but that is a new one for me... Strictures are usually the result of inflammation and pred is an anti-inflammatory.

medchrt1
Veteran Member


Date Joined Sep 2005
Total Posts : 517
   Posted 9/11/2009 1:44 PM (GMT -7)   
I imagine the doctors said something similar after publishing the article.

HM
Regular Member


Date Joined Sep 2008
Total Posts : 211
   Posted 9/15/2009 9:36 AM (GMT -7)   
I was first DXed with IBS. The doctor thought I had a bad case of IBS with GERD. He gave me librax and paxil for my anxiety issues to help with the IBS and my general wellbeing.

It wasn't until a year later when I started having blood in my BMs that they looked closer at it being more than just IBS. My GI hasn't said this, but my family doctor told me I probably have both disorders. I did go off the librax after starting the meds for Crohns.

36/f   proud single mom of 2

Diagnosed with GERD/Acid Reflex 2002

Diagnosed with IBS 2007

Diagnosed with Arthritis 2007

Diagnosed with UC, then Crohn’s 2008, now the GI isn't sure which is it exactly...he calls me a strange case.

Diagnosed with Generalized Anxiety Disorder 2008

Current medications: Asacol 2 tablets 3X daily, Imuran 50 mg daily,Endcort 3mg 2X daily, Pentasa 2 500mg caps 2X daily, Prilosec 20 mg 2X daily (if needed), Cymbalta 60 mg daily. 05 mg Zanax (if needed) Probiotics, Calcuim/Mag/Vit.D. Flinstones multi with Iron and Vit. C 500mg daily


frogeleita
Regular Member


Date Joined Jul 2009
Total Posts : 342
   Posted 9/15/2009 9:41 AM (GMT -7)   
sounds like Crohn's to me..i had the mouth ulcers too some small ones and one the size of a quarter..it took months to heal...ask about getting a colonoscopy or an MRI or a catscan..you really need more tests to see what is wrong...one suggestion is...canker sore medication will help and chloraseptic..gargling with hot salt water and also if your doctor gets u a prescription for Lidocaine..to gargle...

 

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