Sunday, September 13, 2009 annsplash asks

Q: can irritable bowel coexist with Crohn's and if so how do you tell if a flare is occurring from the

I have been diagnosed with Crohn's and the area affected is the sigmoid area of the left colon

Last night I had intense pain had to get out of bed and try walking a little

The pain was in the area of sigmoid and then radiated to the right side and up into the stomach and though the shoulder blades up into each jaw.

I have never had anything like this before.

I no longer have a gallbladder, removed 20years ago.

The sigmoid area has a mass which was very painful to touch

My doctor and a consulting surgeon found this mass.

The GI consultant, at colonoscopy said he did not find it, although I had the pain there.

Now I am wondering what is happening and afraid to go to bed tonight.

Many years ago I was diagnosed with irritable bowel but have controlled this by eating high fibre foods, both soluble and insoluble.

I have not been eating very well for a while with the Crohn's, had nausea and pain some bloody stools which seems now controlled with cortifoam enemas one nightly.

Hoping you may be able to help me

annsplash

Answers (1)

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Elizabeth Roberts

9/14/09 6:46pm

Hi Ann,

I have ulcerative colitis and IBS, so yes they can coexist. Typically I can tell a UC flare because it causes a distinct feeling in my lower colon and rectum, I get severe diarrhea, sometime bloody, a low temperature, achy joints, and I lose my appetite.

An IBS issue on the other hand usually comes on when I'm under stress and is marked not necessarily by diarrhea but by urgency and lots of BMs.

What you've explained sounds more Crohn's related to me than IBS related. Typically IBS doesn't wake people up at night. And since you know the affected area for you is your sigmoid colon and that's where the pain is it really seems more Crohn's to me. I think you need to call your GI and make an appointment to see him or her, or minimally to talk to their nurse to discuss your pain and how you might be able to better cope with it. As I'm sure you know lack of sleep can only make IBD worse, so it's not good that you're scared to sleep at the moment.

Also, if you know you're not eating a balanced diet then change it, today. If need be go to the BRAT diet for a day or two - bananas, rice, applesauce, and toast. And then add in other easy to digest foods like yogurt, eggs, white fish, chicken breast, etc.

But, really, talk to your doctor. Pain that severe is something to be checked out, especially with your history.

Best of luck,

Elizabeth

annsplash

9/14/09 8:21pm

Thank you so much for the helpful reply.

I am feeling better today, although I still have some pain,which is dull, smouldering on.,aching when I walk.

Incidentally, I also get achy joints and I have a few scaly red patches on my hands..

This Thursday, Sept 17th, I will be having an endoscopy,for upper GI symptoms.

Since some of these pains are similar to Sunday, I now wonder if the scoping should be elsewhere?!!

The GI specialist has diagnosed the Crohn's from the colonoscopy appearance and the pathology reports.

When I see him, twice now, he does not examine me, even though I mentioned the mass in the colon,which I can certainly feel more times than not,but insists I use the cortifoam enemas, which do help a lot with the bleeding,but does cause some constipation.

I have to use them for two months once daily for two more months (adds up to 3 months altogether)

and then he says if symptoms return he will have to use immunosuppressants.

He also said at that time he will do either colonoscopy or flexible sigmoidoscopy.

He has never ordered any bloodwork.Maybe it is not necessary.He is a very well qualified and respected gastroenterologist and pleasant to talk to.

Maybe my age is against me for complete treatments, I don't know,but before all this I was a very healthy senior, walking at least 6 miles a day. Too tired to try that yet., but every day I have a walk of some kind in the park or to the shops.

I do find everything that has happened to me a bit worrying.

Foodwise, I have been off foods and eating very little,and had hoped it might help

the healing process.Prior to all this I had followed a high fibre diet, and I do not eat meat or fish.

There is no GI nurse at the university hospital I attend, and it is extremely difficult to get in touch with the specialist.I am afraid to bother him in case he gives up on me.

It is good that I will see him Thursday, but I doubt if I will be able to talk about all this at that time.

It is so depressing.

I am grateful that I have been able to have my question answered

Thank you

annsplash

9/17/09 4:06pm

Hello Elizabeth,

Thank you for the reply it is a big help.

Today I had endoscopy and the GI found three duodenal ulcers and stomach inflammation for which he has prescribed nexium 40mg once a day.

He did say that these ulcers might be Crohn's but have to wait for the biopsies.

He has also ordered a CAT scan of the abdomen because he said there are other areas he wants to look at to explain other pain issues.Previous ultrasound did not show anything of interest.

Then he will see me again after all test results are in..

It is a bit depressing to think that the Crohn'c has migrated from the sigmoid colon area.Just have to wait and see when the full picture is available.

I am startin gtheBRAT diet on your advice, since I find it difficult to eat anything at all.,certainly worth a try.

Thank you for all your help

annsplash

Elizabeth Roberts

9/17/09 6:49pm

Hi Ann,

This can all be such and up and down rollercoaster ride, can't it? But, the good thing is that you've been checked out and will know in fuller detail when all biopsies and scans come back what you are currently dealing with.

There are many more treatment options for both Crohn's and Colitis today than even 5 years ago which is rather helpful and daunting all at the same time.

I'd say for the moment focus on getting yourself some good nutrition. And at this point, if eating just isn't setting well, then anything that stays in is "good" in my book. When at my worst about 10 years ago I even found that grilled cheese sandwiches were something I could tolerate. Others said, oh no, don't eat that it's too harsh with the fat, etc. But, my gut liked them as well as white rice with a dash of olive oil and salt, scrambled eggs, potato bread, baked chicken, and yogurt, natural not anything like Yoplait that's full of sugar and junk. I lived on this weird little diet for a month or so and was glad to have found it.

I wrote a book about my experience of figuring out some of this, it's titled Living with IBD & IBS - www.ibdandibs.com - and you might find it helpful even though I have colitis.

Let me know how you're doing. I'm really glad you found our site.

Peace,

Elizabeth

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