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Stomach ulcer, IBS with test results. CROHN'S?

Resolved Question:

I have been suffering with GI issues on and off for several years. Back in 2007, I had an upper endoscopy and they found several severe ulcers and scaring in my stomach. That developed into an infection. I've also been told I have IBS and I've learned to deal with that over the years.

Over a month ago, I went to the Emergency Room for severe diarrhea, abdominal pain, and blood in my bowel movements. I have suffered discomfort, pain, tenderness, and cramping ever since then. I've had a full stool sample test done, full blood work done, a CT scan, and a colonoscopy. I have been told "it could just be a virus" or "you might have a bacterial infection." However, my stool sample tests came back clear and normal. My blood work did not show any signs of an infection. However, on the last two blood tests, I've had elevated liver enzymes, over the normal amount. One count was 38 and the second test done a few weeks later showed 58.

My colonoscopy did not show any obvious visual signs of UC or Crohn's disease, although my GI doctor told me he believed I had symptoms of both. Biopsies were taken and sent to pathology. I recently received the pathology report and a call from the medical assistant at my GI doctor. She told me that the doctor believes it is either a bacterial infection of some sort or Crohn's, but wouldn't make any definitive diagnosis.

I have been prescribed Lomotil, among other medications and have little relief. The diarrhea can subside some, but the chronic pain and cramping is always present.

I am just trying to get some answers and a proper diagnosis, so I can be given a proper treatment plan to get my life back to normal. Can you please review my attached test results and render an opinion?

Additional files, including Pathology Report emailed to [email protected].  Please review.


Thank you!

Category: Gastroenterologist, Medical

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Category: Hepatologist
 28 Doctors Online

Hello,
Thanks for posting your query at DoctorSpring.com
I am Dr.R.K and I am pleased to assist you.
In about 5% of the cases the bleeding per rectum is from the upper GI source.
You have had lesions in the upper GI tract which was diagnosed way back in 2007.
I would advise you to get an upper GI scopy done again.
Your colonoscopy and stool test are normal.
If the upper GI endoscopy also does not reveal anything, then the next step is to explore the small bowel to look for lesions.
This can be either done with an enteroscopy or a capsule endoscopy.
As far as the abnormal liver function is concerned, the most common cause of raised ALT is fatty liver disease. But your CT scan shows a normal liver. I would advise you to get the liver function test repeated after 4 weeks, If the repeat liver function test also shows abnomal values, then further testing may be done.
You can discuss with your doctor about these things.
Let me know if I can assist you further.
Regards,
Dr.R.K.


Dr. Ratnakar Kini
Category: Hepatologist
Experience: 
Fellowship - DM - TN Dr.MGR Medical UniversityResidency - TN Dr.MGR Medical University Medical School - Stanely Medical College, TN Dr.MGR Medical University
Dr. Ratnakar Kini and 4 other Medical Specialists are ready to help you

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