Posted 9/19/2007 2:35 PM (GMT -6)
Hi, I'm new to the board and wondering if anyone out there has had a similar experience to me. Here's my story.
I have always tended toward constipation, and off and on since college I've experienced occasional bleeding that a GI in college labeled as hemorrhoids. I never really thought twice about it... just applied some Anusol-HC and bulked up on the fiber whenever I started to bleed, and eventually things would be fine again. During my first pregnancy 9 years ago, I developed what I thought was a small external hemorrhoid, which grew enormous after giving birth. My OB/GYN tried several times to refer me to a colorectal surgeon to have it removed, but I never followed up because it was more a nuisance than anything else.
Finally, after years of intermittent bleeding and itching, I went to the surgeon. She immediately told me it was not a hemorrhoid but a very large skin tag, with a very large and abnormal looking anal fissure. She recommended surgery due to the chronic nature of the fissure and also suggested that the visible characteristics of the fissure made her suspect Crohn's, so she wanted to biopsy it and also do a flexible sigmoidoscopy. What??? I have no other symptoms of Crohn's whatsoever (no diarrhea or abdominal pain), and no family history of IBD. Just one family member with IBS. My dad, who is a retired GI himself, was also very skeptical that it could be Crohn's since I've never complained of any symptoms that are remotely associated with Crohn's.
I proceeded with the surgery to remove the skin tag and repair the fissure, at which time the surgeon noted and repaired two additional superficial fissures as well, also with small tags. Sigmoidoscopy looked normal, but surgeon thinks the large fissure in particular looks very suspicious for anal Crohn's. I have also read that multiple fissures as well as fissures in a lateral position (which one of the smaller ones was) should also be considered suspicious for Crohn's.
Biopsy result from the base of the main fissure says "focal ulceration and focal granuloma formation" but that the granulomas are "of unknown clinical significance." It further says that IBD is considered and is a possibility, but recommends obtaining rectal biopsies for further evaluation. It's apparently not conclusive for Crohn's but it can't be ruled out either. My dad (retired GI) looked at the pathology report and noted that it states that "foreign body giant cell reaction is favored," which he says could mean anything.
Other things that have my surgeon still very much leaning toward Crohn's are that she specifically asked about mouth sores, and I did indeed have a period of several months where I experienced constant canker sores in my mouth, one after another. But that was several years ago. It was very troublesome at the time, but they finally stopped, I haven't had another episode since. Also, at my 1 week post-op appointment, the surgeon was concerned that I was healing slowly and still very inflamed. She says this is very characteristic of Crohn's. My next appt. is in 3 weeks and she's talking about putting me on Flagyl if there are still healing concerns at that time.
What I'm wondering, as I wait on pins and needles for my next appointment, is does this sound ANYTHING like any Crohn's experience anyone else here has had? It it just a fluky collection of things that are coincidentally associated with Crohn's, or could it really be Crohn's with chronic constipation instead of diarrhea?
I just don't know what to think. Thanks for any insights!