Bloody stools with changing constipation, diaarhea. CHRONS DISEASE?

Resolved question:
Hello!

I think that I have Crohn's Disease. I have not yet gotten diagnosed, but all the symptoms are there.

It started in october last year and has since that escalated. My symptoms have, till today, been; bloody stool, switching diarrhea and constipation, abdominal pain, bloating, gas, nausea and weight loss(total of 9 kgs lost). This started short after I finished my course of accutane.

Today I noticed black pieces in my stool, when looking at the used toilet paper, which I have never seen before. Attached is a picture of it.

My diet contains of oatmeal, bananas, rice, salmon, codfish, avocados, cooked broccoli, zucchini, protein shakes, eggs, shrimps, asparagus, spinach, little chicken, smooth peanut butter and supplements.

Could this be anything else than Crohn's disease? If so, what?

Best regards

Submitted: 4 Days
Category: Gastroenterologist, Medical

Expert:  Dr. Ratnakar Kini replied 4 Days.

Hi,
Thanks for posting your query at DoctorSpring.com.
I am Dr.R.K and I am pleased to assist you.
I went through your post.
Your symptoms are very much suggestive of inflammatory bowel disease.
Ulcerative colitis and Crohn's disease are the types of inflammatory bowel disease.
Ulcerative colitis is more likely in your case.
A colonoscopy needs to be done.
Biopsy should be done if any lesions found during the colonoscopy.
Consult a gastroenterolgist for colonoscopy.
I hope it was helpful
Let me know if I can assist you further. Feel free to discuss further
Regards,
Dr.R.K.

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Patient replied :

Hello!
I did colonoscopy for about 3 months ago, and they didn't find anything. The difference from that point compared to now is that I have a bit more pain now in addition to those black things in my stool.
For a week ago I did ultra sound to check my liver and gallbladder, and they looked normal too.
Why is it more likely to be Ulcerative colitis?
How do you think I should proceed?
Best regards


Expert:  Dr. Ratnakar Kini replied 3 Days.

Hi,
Thanks for getting back to me with more questions.
Ulcerative colitis presents with bloody diarrhea and abdominal pain as the disease involve the colon
Crohn's disease can involve any part from mouth to anus. The most commonly affected part is junction of the small and large intestine. The common symptoms being abdominal pain, weight loss and diarrhea.
That's the reason why I said ulcerative colitis is more likely.
I would suggest a CT scan of the abdomen for evaluation of your symptoms since the recently done colonoscopy did not reveal anything abnormal.
A normal colonoscopy virtually rules out ulcerative colitis.
So other causes including Crohns has to be ruled out and you can start with a CT scan of the abdomen.
I hope that answers your query.
Let me know if I can assist you further.

Regards,
Dr.R.K.

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Patient replied :

Hello!

I still do not understand why UC is more likely than Crohn's in my case.
You mention that weight loss is a common symptom of those with Crohn's, but not UC.

As said I've lost alot of weight, and I am struggling with constipation probably more than with diarrhea.

I feel my symptoms lines up better with Crohn's. Please explain further why you think UC is more likely.

Best regards


Expert:  Dr. Ratnakar Kini replied 2 Days.

Hi,
All the symptoms that have been mentioned are nonspecific only.
Diagnosis should be confirmed with appropriate tests.
The reason why I have mentioned ulcerative colitis is more likely because in your first post you have mentioned you have bloody stool.
Bloody stool occurs when colon is involved. Crohn's disease commonly affects the junction of small and large intestine and bloody stool is not common.
Crohn's can cause bloody stool only if it involves the colon.
But ulcerative colitis always involves colon and presents with bloody stool.
Having said that final diagnosis is only with appropriate tests.
Regards,
Dr.R.K

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