Resolved question:
Hello
I am 55 years old,, female. Have suffered with bowel troubles all my adult life. Until a few years ago, I had IBS-D. Changes in bowel habits led me to find a new gastro doc. I went to him with the following symptoms:
IBS-D and C
often feel like my bowels are not completely empty
sometimes bleed
frequently pass mucous
losing weight (I am 113, down from 122. In the past, I have gone down to 95)
can't eat a "normal" diet without suffering stomach pains or diarrhea
eat mostly bland food, chicken, potatoes...
The main reason for seeking a new doc are the "stomach attacks" I suffer about once a month. These spasms are not your usual stomach ache. I will have excrutiating spasms centered lower left side, so severe I have feinted. Also occasionally vomit. Episode will last a few hours until I progress from severe cramping to watery diarrhea. For about a week afterward, I will be unable to eat anything without running to the bathroom or feeling as though I have to. I will feel weak. Will pass mucous for days. Have had a few occasions where I didn't make it to the toilet. I will have what I call an interior soreness; my left side feels completely different than my right after one of these episodes. I rarely go out - have no social life and don't travel - because I am afraid to be away from a bathroom if one of these episodes suddenly occurs. Sometimes, these spasms wake me up during the night. I can't always find an offending agent, like food. I can't determine a reason for these attacks.
Doc sent me for cat scan, colonoscopy. His diagnosis was IBS and he gave me Bentyl prescription. Bentyl does absolutely nothing for me. According to him, IBS causes these episodes I experience. I have friends with IBS; they do not suffer as I do.
Recently, doing ancestry research, I had my genetics tested. Part of the test reveals health issues in your genes. When my report came back as "high risk for ulcerative colitis", I sent for my cat scan and colonoscopy results (should have done so sooner) and was surprised by what I read. (My niece has colitis, so it is in my family.)
My cat scan results say: "There is evidence for bowel wall thickening involving virtually the entire colon with relative sparing of the ascending colon. The bowel wall thickening seems to be contiguous with the rectum. Therefore this could indicate ulcerative colitis. Other forms of colitis could also give this appearance including Crohn's colitis although this is usually more segmental in appearance. Pseudomembranous colitis can also cause bowel wall thickening. Ulcerative colitis should certainly be considered but other forms of colitis could also cause this appearance."
My colonoscopy results were normal except for diverticulosis and the following:
Rectum - "Multiple biopsies taken from aphthoid erosions in rectum (prep?)
Diagnosis - Minimal focal acute inflammation, probably related to bowel prep, otherwise unremarkable.
Microscopic description: colonic mucosa shows normal histological features except for a single crypt with acute inflammatory cells.
My question is this: is there a possibility I have been misdiagnosed with IBS? Is there a possibility I have some form of colitis? I am considering going to yet another doctor, but I have been to so many doctors in the past that I hesitate to do so again. But I certainly would like to know if I have colitis. I can't believe the severity of my pain during my frequent "stomach attacks" is IBS or diverticulosis related. Or do I have IBS and the bowel wall thickening shown on Cat scan and inflammatory cells from colonoscopy biopsy is related to the bowel prep barium.
In your opinion, then, is there a possibility I have colitis and should I have a new gastro doc take a look at me?
Thank you for your consideration. I look forward to your opinion.
Sincerely,
Anne
Submitted:
4 Days
Category:
Gastroenterologist, Medical
Hi,
Thanks for posting your query at DoctorSpring.com. I am Dr Kini and I am pleased to assist you.
You have given a good description of your symptoms.
This does not look like IBS at all for me for three reasons -
1. You have blood in stools at times
2. The pain wakes you up from sleep
3. You have lost significant weight.
These three do not occur in IBS.
Yes colitis is a possibility give the fact the CT scan showed thickening of the colon for a significant length.
I would advise you to get a second opinion. You can approach medical college hospital where the doctors would be more experienced including the pathologist. A repeat colonoscopy with biopsy by a different Doctor is the next thing to do.
I hope that answers your question. Please feel free to discuss further.
Regards,
Dr. Kini
Consultant Gastroenterologist
Doctor Kini, thank you for your opinion. My current gastro-doc seems to think the bowel wall thickening on the cat scan is nothing more than the prep clinging to the bowel wall. Couldn't that be so? I am confused. If I have colitis, how could he have missed it? I'm afraid to go to yet another doc.
Hi,
Bowel thickening occurs if there is inflammation or malignancy.
Inflammation occurs if there is infection or could be part of inflammatory bowel disease or if there is exposure to certain medications and chemicals. Yes bowel preparation can sometimes cause some degree of inflammation.
So even if the thickening is considered to be due bowel preparation, there is no explanation for the blood in stool which occurred before the bowel preparation and other symptoms like pain waking you up from sleep and loss of weight.
So it is prudent to get a second opinion. Do not hesitate !
Let me know if I can assist you further.
Regards,
Dr.R.K