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I am a 51 year old male. Although my general health has not been good
since my early 20's (I was diagnosed with "fibromyalgia" when I was 25,
even though I have no tender points, but I typically just feel achy and
lousy all the time), I have never really had any chronic GI troubles
until recently. Approximately 14 months ago, quite suddenly, I developed
chronic digestive pain. Although there is some variability to the
symptoms, 3 stand out: 1) pain centered around the navel, generally
beginning 2.5 hours after eating a meal, 2) variable pain in the lower
right hand side of the abdomen which feels a bit like the "catch" you
may have gotten in your side as a kid when you ran on the playground too
much, but which can be intensified by pressure as on an internal sore
spot. Walking can bring the pain on and 3) a feeling in the rectum
after defecating which feels a bit like the area has been moderately
traumatized or distended, and which sometimes is made worse by sitting,
and which is occasionally accompanied by feelings of spasms. I have had
hemorrhoids off and on, this last rectal sensation is different. I also
have GERD, and have been on acid blockers for about 9 years, Omeprazole
for the 1st 8 of them, Ranitidine since. I am not overweight. I have
been to 2 gastroenterologists and have had extensive testing, as follows:
Complete blood count (normal)
Complete metabolic panel (normal)
Sedimentation rate (normal twice)
Thyroid stimulating hormone (normal)
Cyclospora (negative twice)
Crytosporidium (negative)
Ova & parasite (negative twice)
Hepatic function panel (normal)
C Reactive protein (normal)
CT scan of abdomen and pelvis w/contrast medium (normal)
Creatinine (normal twice)
Tissue transglutaminase antibody, iga (Normal)
Fecal fat stain (increased twice)
Fecal fat quantitative (increase, 5.4g in 24 hours w/a normal max of 5.0)
Colonoscopy/esophageal endoscopy (normal, including one small bowel
biopsy w/no sign of villious blunting)
C. difficle (negative)
Giardia antigen (negative)
Stool salmonella shigella campylobacter (negative)
CBD w/platlet differentiation (normal)
BUN (normal)
Electrolytes (normal)
IBD Serology:
Component Your Value Standard Range Flag
IBD PREDICTION Pattern Not Consistent with IBD
ASCA IGA ELISA LESS THAN 12.0 0-20.0 EU/ml
ASCA IGG ELISA LESS THAN 12.0 0-40.0 EU/ml
ANTI-OMPC IGA ELISA 2.2 0-16.5 EU/ml
ANTI-CBIR1 ELISA 5.1 0-21.0 EU/ML
NEUTROPHIL AUTOANTIBODY ELISA LESS THAN 12.1 0-12.1 EU/ml
IFA PERINUCLEAR PATTERN Not Detected
DNASE SENSITIVITY Not Detected
In addition to the above I have had a colonoscopy & upper endoscopy,
which were normal, including a small biopsy taken during the latter test
to look for sprue. Next, I had a capsule endoscopy, which showed
"multiple areas of erosion and erythema were seen in the proximal small
bowel, with a few scattered in the mid and distal small bowel. A small
ileal ulcer was also noted".
Long story short, the only abnormal results have been mild steatorrhea
(fat in the stool), and the capsule endoscopy results, quoted above. No
diagnosis has yet been given, and the only treatment has been codeine,
which does little or nothing to provide relief. My bowel movements went
suddenly from a normal 1 each morning, to 2 or 3 a day. They are not
really diarrhea, the codeine may be keeping that at bay. Feces are
typically quite light in color, and about half tend to float. For the
last 10 weeks or so, I have not had any gluten. There has been no real
improvement. Last week, I had a Tissue Transglutaminase Antibody test,
which was negative. This condition has just about destroyed my life. 5
months ago, my lovely wife actually abandoned me as a result of the
limitations this has put on me. I don't want to bore everyone with the
sad details, but as a result of a number of financial/personal reasons,
if I am not able to eliminate or at least moderate this condition, I
might as well be dead. The 1st GI doc initially said I had IBS, though I
think the capsule endoscopy pretty much rules that out. The 2nd one said
I could have Crohn's, but I have not been able to pursue that owing to
insurance changes which occurred when my wife left.
I am scheduled to see a 3rd GI tomorrow, and I'm wondering what course
of action I should stress. If anyone can give me ANY helpful input
after reading the above, I would very much appreciate it.
Thank you for your time, group.
David in Seattle
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