Please bear with me as a I am going to go through my history (its graphic and shameful in some areas) and would like you to tell me your opinions.
My whole life I have been "regular" (2-3 normal looking bowel movements per day; 4 during bodybuilding bulking with high fiber). I also have OCD, anxiety and a number of other mental health issues which I take Lexapro and Unisom for.
For years I got into the habitat of "holding in" my bowel movements since going 2-3 times per day can be annoying while working. In October of 2014 I got really bad and was oftening holding in "turtle heading" and pushing it back in. After a while I got an odd pleasure from this so it became a disgusing private act. Sometimes so much fecal matter would get dried around my anal region ( and inside) that when I sprayed my shower head onto my anus it was like dried mud coming off.
Later that month I developed a painful lump in my perineum that turned out to be a perianal abscess. I had surgery on October 31st, 2014 and then a fistulotomy on January 7th, 2015.
open wound healed in a couple of months without incident and it never returned. I also learned that my maternal uncle had a perianal abscess/fistula a decade earlier and does not have IBD, diabetes or anything else. He did, however, have severe gallbladder issues.
Nonetheless, the abscess and my frequent flatulence and 2-4 bowel movements got me paranoid about
Crohns. So I ordered a colonoscopy with biopsies in February of 2016. The colonoscopy was normal and the biopsies (taken at the terminal ileum and colon) were normal.
In 2017 I started taking Imodium (Loperamide) every day to bring my bowel movements down to one per day rather than 2-4.
Everything was going fine for three years, but suddenly last month (two days before my 37th birthday) I suddenly was struck with bad diarrhea. Initially I suspected food poisoning or gastroenteritis, but the stool culture came back normal, as did my blood tests (normal WBC and everything else). When it did not go away for 5 days I went to the ER and they told me the CT scan revealed mild mesenteric adenitis but nothing else.
The diarrhea finally vanished after 10 days. I was using Imodium virtually the entire time. I then got the Prometheus IBD sgi diagnostic blood test. It came back "pattern not consistent with IBD" and my CRP was 0.5, although I do have a couple of the genetic alleles that increase my chance of IBD by 2x compared to the normal population, but I imagine that isnt uncommon.
Flash forward three weeks and I have another single episode of diarrhea following an intense powerlifting workout (I hadnt worked out in 3 weeks prior) and a large post-workout meal. I took Imodium throughout the illness and am still taking it. Ive been on a low fiber diet and and Imodium since then and Im have no symptoms (one bowel movement per day, sometimes hard and lumpy).
I am seeing a new gastroenterologist tomorrow.
Here are some key notes about
1.) I do not have pain in my intestines. The diarrhea is usually the "I thought I needed to fart" kind. I did have mild pain on the left side and below the naval during the first couple days of my illness, but outside of that I never have any pain with the diarrhea.
2.) No blood in stool and rarely any mucus (except some mucus during the illness)
3.) Stools are almost always a yellowish hue (regardless of solid or diarrhea), although I will sometimes gave normal brown color. In fact, they have been mostly yellowish for many years.
4.) No extraintestinal issues- no joint pain, no fever, no fatigue, I rarely get sick, no eye pain.
5.) I have NO family history of IBD or any other autoimmune diseases. I DO have a strong family history of gallbladder issues, fissures and hemorrhoids. And the aforementioned perianal abscess in my uncle (I understand 90% of them are not Crohns related, although they have a vastly higher occurrence in Crohns).
So, what do you think?
Should I get another colonoscopy with biopsies? Should I get the capsule endoscopy (my last gastro said small bowel crohns may hide beyond the terminal ileum)? Can gallbladder issues be causing my long term mild bowel issues? I tried cholestrymine and it helped....not as much as Imodium but even with Imodium I cant eat a lot of ruffage.
Im truly confused because my symptoms dont 100% mirror any of the conditions.
Post Edited (Cporosus1) : 9/29/2020 6:58:31 AM (GMT-6)