Small bowel Crohn's vs colitis

Has anyone been informed that there is a difference between small bowel Crohn's and large bowel Crohn's, specifically regarding dietary recommendations?

Last week while I was waiting to see my gastro to schedule my next routine endo, I was watching a video in the waiting room. The topic was the difference between what to avoid eating if you have small bowel Crohn's or large bowel Crohn's. The small bowel Crohn's sounded just like me. I was called back before the rest of the video.

I have never been diagnosed with Crohn's, but have Barrett's esophagus plus radiation colitis and now sclerosing mesenteritis, for which I use lansoprazole and cholestyramine. While discussing the BE and RC with my gastro, he perked up when I mentioned what I can and can't eat, and when I have 'episodes' and what can I do about it.

Most doctors are unfamiliar with SM and just say they "have to read up on it". But the low residue diet which I must follow is very much like what is recommended for small bowel Crohn's. I developed problems with frequent diarrhea after my second small bowel resection, though it was supposed to have improved with time, as was the radiation colitis.

The sclerosing mesenteritis (aka mesenteric lipodystrophy or panniculitis) is much like recurrent SBO's. I've asked about this in other IBD groups and no one has ever responded. I realize it's a lot of info to 'digest' and most others don't have this combination of conditions... but really all I'm asking is if anyone has had to deal with recurrent diarrhea due to any small bowel condition so I maybe don't feel so all alone.

RobLee, I had severe uncontrollable diarrhea after a small bowel resection for crohns. This went on for years every day! Even drinking water kicked it in. I started getting afraid of eating & drinking anything which was not healthy at all. I was the bile salts medications, plus Lomotil which gave very little relief. I have a great gi dr & he referred me to UTSW for a consult to the first dr that wrote a book on diarrhea. This guy did not have an explanation either. I literally became housebound. Now, things has calmed down compared to then. However, I still have problems with it. There are so many foods that I avoid for sure. The crazy part of it is, I can eat something one day & a week later eat the same thing & be stuck in the bathroom for a couple of days.

If you feel the medication is not giving you a lot of benefit, perhaps discuss Welchol with your dr. A lot of crohns people here had better luck with it.

Take care.

Thanks Straydog. Mine also occurs in 'flares' of a week or two, even though I maintain a strict diet and don't dare eat fried foods or too many fruits and veggies.

The Welchol sounds a lot like Questran, which I get it free from the VA, so it's probably not worth changing as I do not have diabetes or high cholesterol. There is supposedly a specialist at Mayo but my family (and myself) have so much going on medically that I couldn't make a trip there as long as I am able to control with diet. But I've had to give up a LOT of favorite foods.

Yes, thanks, I take the light version. about a year now, and it really does help. And once a day with evening meal works best. It has in fact been a godsend. But I don't want to use it every day as it does interfere with absorption of nutrients and other meds. Generally I only need it when we eat out, but sometimes even my wife's home cooking can do it to me. Thanks for the input and hope you are doing well.