Diet and Health FAQ

Tagged As: Change In Bowel Habits

Question:
Of course I'll ask my doctor! But after looking up small bowel inflammation in the Merck Manual and getting referred to the Crohn's section, I'm beginning to wonder if a negative colon biopsy really ruled it out for me. Do these symptoms sound familiar? Chronic diarrhea Flattened, thin stool Occasional bloody stool Severe right sided pain (sometimes so severe I am unable to stand or walk) Normal colonoscopy; normal sig; normal colon biopsy Inflammation of the small bowel near the cecum imaged by CT Near chronic fever from 99.7 to 103.2 Many things, like peas and lettuce, reappear little changed by the digestive process Elevated ESR 28-44 Nephrotic syndrome, possibly caused by secondary amyloidosis (waiting for abdominal fat pad biopsy result - test is not 100%, though) Plus, according to Merck, I'm partially the right ethnicity (Ashkenazic Jew). In December, I was told I probably had Familial Mediterranean Fever. My test was negative, but the test is designed for those of Armenian and Sephardic descent, and was told I probably would test negative, even if I did have it. I have been taking colchicine since November, and despite now taking a huge dose (2.4 g per day) I still have attacks of severe right sided pain, like appendicitis, and still am feverish. No change in bowel habits, either.  Additionally, FMF is supposed to cause peritonitis, not small bowel inflammation. They know something is wrong with me, but can't figure out what. Is Crohn's with only small bowel involvement unusual? It can't be as rare as the FMF they think I may have! I don't care what it is as long as it can be made to stop hurting!

Answer:
You really need to see a GI Specialist. Yes, your symptoms are very common in Crohn's Disease, and yes, the majority of cases primarily involve ther terminal ileum. I won't say that they ONLY involve the terminal ileum, because the disease can spread to any part of the digestive tract, and those of us who have had the disease for a number of years usually have several problem areas. But a negative colon biopsy means only that there is no Crohn's Disease in the area that they tested. BUT am not a doctor. I don't want to tell you that you have Crohn's, because it is possible that there is some other problem causing these symptoms. All the same, I really suggest you see a GI specialist for further testing. Please keep in mind that there can be other reasons that doctors are reluctant to give a diagnosis of Crohn's Disease. Insurance companies don't like to see it, for one thing. It's like a good friend of mine who is a Viet Nam vet -- he was told, You have every symptom of Post-Traumatic Stress Disorder, but we don't think you have it. Try to be patient, but be insistent on getting a valid diagnosis and treatment. These diseases (Crohn's, Ulcerative Colitis, etc) are a lot more dangerous than most people realize -- especially if they are not treated properly. it does sound like Crohn's to me.  A small bowel follow through test would be in order.  Crohn's is notoriously hard to diagnose.