Doctors Lounge - Gastroenterology Answers
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Forum Name: Gastroenterology Topics
|shaunmichelle - Tue Jul 12, 2005 10:55 pm||
someone close to me was diagnosed with Crohn's Disease over three years ago, when he was 16. Since then he has had colonoscopies, endoscopies, CT scans, the works. No medication has helped. he has visited natropaths GP's and specialists and been on numerous diets, none of which worked. recently he visited a different specialist who thinks he was mis-dagnosed but doesnt know whats wrong. 3 years, several doctors, thousands of dollars later he is still getting sick. he has terrible cramps and diarhea most days of the week. his apprenticship is suffering cause he has so much time off we need help, something has to be wrong and there must be a way to help him get better. does anyone have any information that may help?
|Dr. Safaa Mahmoud - Wed Jun 28, 2006 7:11 pm||
Ii would be of great help if you have mentioned the results of his studies and whether a biopsy was done or not.
Crohn's disease and ulcerative colitis are very difficult to be differentiated. They both are caused by inflammation of the wall of the GI tract. They are very similar in the pathogenesis hence, in the presenting symptoms, as they both lead to bouts of watery or bloody diarrhea and abdominal pain While, Ulcerative colitis occurs mainly in the large bowel (colon and rectum), Crohn's disease can occur anywhere in the digestive tract. Therapies used in the treatment of these diseases can result in long term remission of the symptoms, but not in cure.
Symptoms range from mild to very severe, and can arise suddenly or gradually over a long time.
1-Diarrhea which is due to water and salt secretion from the inflamed intestinal cells can be severe to affect sleep and the daily activity
2-Abdominal pain and camping result from the thickened wall due to scaring can be mild to severe associated with nausea and vomiting. Blood in stool is due injury of the inflamed wall by the passing food. It can be just an occult blood in stool to severe continuous bleeding..
3-Crohn's diseases causes scattered small ulcers that can coalesce forming a large one that can penetrate all the intestinal wall leading to serious situation..
4-Loss of appetite and weight are very common sequences of the disease. In addition other associated symptoms that occur outside the GI include fatiguability, arthritis, eye and sin inflammatory conditions, and hepatitis.
Once you have frequent or persistent attack diarrhea, abdominal pain, blood in stool, fever more than a day, you have to visit your doctor to start investigation and proper medication. The disease is not fatal but is can lead to life threading conditions. Again it is not curable but treatable and treatment results in most of the case to long remission.
The diagnosis of Crohn's disease is usually reached after exclusion of other causes that give Crohn's disease like symptoms. These conditions include, irritable bowel syndrome (IBS), colorectal cancer and diverticulitis.
•Colonoscopy and biopsy is the investigation of choice as it confirm the diagnosis by the presence of granulomas which are formed by inflammatory cell. In ulcerative colitis there is diffuse infiltration by inflammatory cells rather than the granuloma formations.
Free colonscopic examination dose not mean negative disease since the disease affects primarily the entire GI tract and usually starts in the small intestine, so a Barium follow through can help investigate the small intestine with a Small bowel X-ray.
•Capsule endoscopy, a capsule that contains a camera inside is swallowed. The images it takes through its passage in the GI tract is displayed on a monitor and are checked for any abnormalities.•Blood tests help to check for anemia and circulating antibodies.
I advise you to take an appointment with your consultant and check with him the possible investigations that should be needed to reach the right diagnosis , hence the proper treatment.
Best of luck,
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