What is considered normal? I suppose that is to be flushed out – but from those, I have discussed the question of “What triggered your Crohn’s or Colitis?” There always seems to be some type of physical injury or stress that puts our bodies over the edge. In my case, it was a car accident that triggered my Crohn’s, nothing as serious as having to be hospitalized, but at the same time, grade 3 whiplash was nothing to shrug a shoulder about.
A History of Bowel Troubles
Looking back, I can say that the car accident did not cause my Crohn’s but rather, that the increased stress that the accident put on my body limited its natural ability to keep my Crohn’s at bay. As early as 1998 I started to work with my family doctor to diagnose a few annoying stomach related issues, most notably sever gas and bought of uncontrollable diarrhoea or evacuation. I remember having life down to a science, after the third trip to the toilet I was “usually” safe to wander away from home or jump on the bus to head to/from University. Even as far back as high school, I recall questioning my doctor about the amount of “gas” that seeped out of my body. The diagnosis at that time, “I probably swallow air while sleeping, try to sleep with my head elevated”. Similarly, following a “Barium Enema” and a heap of blood work during my University days – I was diagnosed with Irritable Bowel Syndrome (IBS).
For those that are curious, Wkipedia defines IBS as:
Irritable bowel syndrome (IBS or spastic colon) is a diagnosis of exclusion. It is a functional bowel disorder characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any detectable organic cause. In some cases, the symptoms are relieved by bowel movements. Diarrhea or constipation may predominate, or they may alternate (classified as IBS-D, IBS-C or IBS-A, respectively). IBS may begin after an infection (post-infectious, IBS-PI), a stressful life event, or onset of maturity without any other medical indicators.
It is interesting that many of the symptoms of IBS are identical to Crohn’s and Colitis. Was this a missed diagnosis or simply, my body was generally capable of keeping my Crohn’s in check – however, many of the “typical” symptoms persisted. At the same time, I have never been prescribed a colonoscopy to truly see what was going on within my colon or upper GI tract.
Shortly after University, I went through a second round of tests following an occurrence of pancreatitis. I was out of town at the time at time of the infection and was referred to my local hospital for follow up. The gastroenteritis that performed scopes on both my upper (stomach) and lower (colon and small intestine aka colonoscopy) gastrointestinal tract had an even more cryptic diagnosis — literally suggesting that it was all in my head and even mimed circular movements on the side of my head. Honestly, a great vote of confidence in how I was feeling. Maybe these nausea and loose stool feelings are my normal, or everyone’s normal? That was until the car accident.
Diagnosed with Crohn’s Disease
As I mentioned in the opening, although not physically injured when it comes to bones or stitches, I did suffer from severe whiplash and was being treated by a physiotherapist several times a week. Within two months of the car accident, blood became a normal occurrence with each visit to to the bathroom; within six months – my episodes of diaherria progressed from an episode or two a day to an ongoing basis.
What was even more concerning was the variety of other symptoms that progressed:
- mouth ulcers (canker spurs), at times up to a dozen – try kissing someone in that state
- persistent low-grade fever
- a cough (the ulcers progressed from my mouth and down my throat)
- skin rash and mucous lesions on my body
- weight loss
- blurred vision (almost like a was looking through a milky film)
- instant intestinal gas that could be triggered with pressure / compression of the abdomen, and
- stiff joints – to the point where the “arthritis” was so severe that I could not bend my legs
When these symptoms hit, I was still seeming my physiotherapist 3 times a week. The sudden onset of severe arthritis without any new injury that I could recall sustaining had her baffled. My family doctor prescribed antibiotics to try to keep the cough and diaherria under control however within a few days his professional recommendation was to visit the emergency department. The truth of the matter was that even the emergency department was at a loss. I wish I had the inclination to write down each possible diagnosis they threw at me – the truth is that most of then I could hardly pronounce, not to mention write down. Although my Rheumatologist did have a frank conversation with me asking what was the chance I could have an STD, as the symptoms matched identically to Syphilis. Approaching were considering transfusions.
About the same time, I was scheduled for a gastroscopy which probably saved me from some more serious complications. The scope revealed severe ulceration and inflammation of the large intestine with signs of progression to the small intestine. Many of the ulcers were nearing the stage of perforation of the intestines – I had Crohn’s Disease.
I always joke – the proper medication does wonders – and within a week of being on intravenous prednisone, I was on my way home. All in all, it took a week to figure out what was wrong, and a week to get better. In total, I lost about 30 lbs – and went home barely able to walk without assistance, but I was home. And more importantly, I was home without surgery and a label to my disease.
Crohn’s disease: Evidence for involvement of unregulated transcytosis in disease etio-pathogenesis
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070014/
————
Radical induction theory of ulcerative colitis
http://www.wjgnet.com/1007-9327/11/2371.asp
Thanks for the links Andrew – will certainly give them a read.
Hi, I was just wondering if you ever considered that the steroids caused your diabetes? I am 28yrs old and was diagnosed with IBS a little over 10 years ago, then with Crohn’s in March of 2009, with a resection to follow in May. When I was hospitalized prior to the surgery on a Prednisone drip I was having trouble seeing, my nurse took my blood sugar and it wouldn’t read. When they got the results back it was 684. They put me on insulin right away to bring down the levels. The doctors said it was probably due to the steroids, and after the surgery and a tapper down dose I would get to come off the insulin. So, after I was home for 4 weeks and still on the insulin, I was having chest pains and a hard time breathing. I went to the ER and was admitted and shipped out with DKA (diabetic keto acidosis) and a pneumomediastinum. To this day the diabetes have never gone away. I am on insulin and when my crohn’s flares, my sugar sky rockets because of the stress on my body. So is there any tricks that help one or the other that youhave found. Thanks for making this site, reading your story and others makes me not feel alone.
Hi Melissa:
Thank you or your email / comment. I have to agree with you about steroids sending our blood sugars through the roof. The first time I was on them, no adverse reactions that I was aware of, however after my third round of Pancreatitis, my sugars started to climb and have been on diabetic drugs ever since (Gliclazide, Onglyza, and Crestor). When my Crohn’s begins to flare up, or any stress for that matter, as you noted they have crept up. However, the last time I was on sterioids my sugars were constantly through the roof and had to substitute my daily pills with insulin. Fortunately my pancreas is still working, however only at about 30-40%, so will always need that boost. As steroids, naturally raise your blood sugars, my dailies can not keep up and the insulin takes over the rest at meal time.
Did my medication kill my pancreas? I think steroids have been around long enough that that I will argue no, does my Crohn’s impact how my body manages my blood sugars, absolutly. Has my pancreatits (an wh knows what causes that, as I am not a heavy drinker), done a number on my pancreas, absolutely. Fortunately, I respond well to my drugs, and between my Humeria (one shote every 7 to 10 days), Methotrexate, and my diabetes meds I can generally present myself as “normal”.
When it comes to both my Crohn’s and diabetes, my key suggestions built that rapport with your doctors. Know your body and how it responds / reacts to your drugs, know what triggers feelings of unwell, and control the diabetes. As much of a short stick we have been felt, I try to eat well, be active, and at least the diabetes is under control. I do not have as much”rainy day weight” as my Gastro doc would like however, I feel good. That must mean something?
Thank you. I’ve been trying to tell my Dr this for months. Your story is identical to mine. I am sharing this with her. Maybe this will convince her. Thank you. I’m not crazy. 🙂
Well mine is just “my” story, but a factual one. Getting the trust and understanding of your doctors is critical. In once had a gastro specialist who implied that “maybe” my ailments were all in my head and even went as far as to do circles around his temple. I have been fortunate enough not to have to encounter him again with during a trip to the emergency wards. My specialist today and my family doctor respects my opinion and how I articulate my body is responding or not responding to my medications and include that knowledge in their recommendations.
Good luck and please keep me informed!!