Diagnosis of digestive disorder?

Hi everyone! I am 27 years old male from Mumbai (India). I have been suffering from digestion related issues since last 3 years.

I have consulted with Allopathic, Ayurvedic & Homeopathic doctors before & all of them claimed my issue to be IBS. But recently I consulted with a Gastroenterologist when I got to see blood on stools. He prescribed me few tests & I have got them done. Below are the details of those tests:

CBC, LFT, Creatinine, Vitamin B12 & D3, TSH, Fasting glucose & stool r/m

There is a deficiency in Vitamin B12 & insufficiency in D3.

The stool r/m shows presence of mucus, occult blood & RBC (1-2). Though it shows absence of blood (non-occult) & fat, I have observed blood to be there & feces floating in the bowl several times.

I also got Colonoscopy done yesterday. Below are the verbatim findings & impression of the report:

Findings - "There were presence of multiple patchy areas of ulceration seen in the colonic mucosa from rectum to hepatic flexure. The ulcers size ranged from 3 to 7 mm with surrounding erythema. The ascending colon, caecum, IC valve and 10 cm of the terminal ileum were normal.

Impression - Infective colitis.

The doctor also did biopsy & sent the sample to histopathology department for further analysis. Will get the reports in 4-5 working days. Once I get it, will update.

Would like to know your opinion on the impression of the report as I don't think that it is infectious colitis because the symptoms just don't match to the symptoms I have.

Hello Aryan welcome to the forum
The report shows you have blood in the stools and of course that is abnormal
There is more than one reason for vitamin and mineral abnormalities and of course these can be corrected.
The histo pathology lab examination of the biopsies are usually definitive and those tests usually take about a week before your doctors get the report.
See what this report shows first and if you are still not satisfied with the report I would suggest a second opinion.
What you report could be suggestive of an IBD...but could be infection.
It is normal for everyone to be mistrustful and have doubts and fears.
Do keep in touch with us and let us know how you get on
We are all patients like you and not doctors generally speaking.
Feel better soon
Hugs
Trysha

Hey Trysha! First of all thanks for such prompt reply.

I agree with whatever you have mentioned in the reply. I think I should not get panic & wait for the report to come first. Will surely update it here once I receive it.

Hello Aryan
Good to hear from you
I’m glad you have settled a little.
It is never easy to put up with things ...playing the waiting game can be difficult
Good to hear you have settled down bit.
Looking forward to following you on the forum
Take is easy and slowly when you get the next news.
Hugs
Trysha

Trysha said:

Hello Aryan
Good to hear from you
I’m glad you have settled a little.
It is never easy to put up with things ...playing the waiting game can be difficult
Good to hear you have settled down bit.
Looking forward to following you on the forum
Take is easy and slowly when you get the next news.
Hugs
Trysha

Click to expand...

Thanks a lot for showing so much of love & support Trysha!

Yes I have settled down a bit after your guidance & support.

I will definitely update once I receive the reports.

& yes I will try to be calm & positive when I get the reports.

Thanks once again.

Hello Aryan
Thank you for your post
I am so pleased to have helped and very glad you have been able to
accept what’s happening so far
Hopefully it won’t be Crohn’s but if it is there are helpful Meds these days to keep you comfortable
Hugs
Trysha

Steave_ said:

There are three parts to making a correct diagnosis of digestive disorders.
These include a scrutiny of the medical history of the patient, a physical examination, possibly also a psychological evaluation, and doing appropriate tests to obtain tissue samples.

Click to expand...

Thanks for replying Steave!

I would like to comment on few things:

1. Here in India, doctors are not much interested in listening to your medical history as it takes time. I had done a thorough research & had made a really long list of symptoms which would have been really helpful for any doctor to reach accurate diagnosis but they just don't want to go through it.

2. They don't spend much time either on physical examination. In my case it was done just for few seconds.

3. They neither do any psychological evaluation nor recommend you to consult with a psychologist/psychiatrist.

That's why I sometimes doubt the diagnosis they reach merely by asking you a couple of questions.

Trysha said:

Hello Aryan
Thank you for your post
I am so pleased to have helped and very glad you have been able to
accept what’s happening so far
Hopefully it won’t be Crohn’s but if it is there are helpful Meds these days to keep you comfortable
Hugs
Trysha

Click to expand...

Trysha, you don't need to say thanks. It's I who should do it.:ybiggrin:

I too hope that its something which has been caused by just some minor infection & not something serious like UC or Crohn's.

Hugs.

Hi guys! Received the biopsy report a few hours back. Have an appointment with Gastroenterologist after two days. Was eager to get to know what is mentioned in the report. I could not understand the meaning of "GROSS" & "MICROSCOPY" section of the report. If anybody understands it, please comment. Here is the report:

DIAGNOSIS :
Moderate colitis; likely infective origin.

CLINICAL DETAILS :
Increased stool frequency with fecal red blood cells.
Colonoscopy - Multiple patchy ulcers from rectum to hepatic flexure.
Impression : Infective colitis.

GROSS :
Received multiple grey-white mucosal tissue bits aggregating to 1.0 x 0.7 x 0.2 cm; Colonic ulcer biopsy.
Sections : A to D.

MICROSCOPY :
Sections show ulcerated colonic mucosa with presence of neutrophils in the lining epithelium. Lamina propria shows
moderate mixed inflammatory infiltrate consisting of neutrophils, lymphocytes, plasma cells, and a few eosinophils.
There is no cryptitis, crypt abscess or crypt distortion seen. There is no evidence of granulomas or dysplasia seen. No
parasites evident.

Hi guys! I consulted with the gastroenterologist yesterday. After reading the report he said that infection is most likely the reason for ulcerations seen in the colonic mucosa. He said that he can't tell how long will it take to get cured. He also thought depression or my too much of thinking might be the reason behind my stomach not getting emptied properly or the reason might be a component of IBS & prescribed me an anti-depressant. He told me to not even think about the issue I am suffering from. He advised me to continue with normal diet and also advised to do some Yoga & exercise. He told me not to have protein powder as well as mass gainer as of now.

I am thinking of taking second opinion. I request you to guide me whether I should continue with his advise or go for second opinion.

Hi Aryan.
If it is a matter of purely infection, then that is not necessarily a long term problem.Within the armoury of antibiotic and anti-inflammatory medications that exist are many options for you .Given the diagnosis that you have been given, I am surprised that you have not been prescribed anything to assist you. Get a second opinion would be my advice.

Cheers,
Merv

Merv S said:

Hi Aryan.
If it is a matter of purely infection, then that is not necessarily a long term problem.Within the armoury of antibiotic and anti-inflammatory medications that exist are many options for you .Given the diagnosis that you have been given, I am surprised that you have not been prescribed anything to assist you. Get a second opinion would be my advice.

Cheers,
Merv

Click to expand...

Thanks for replying buddy! Your comment gave me some hopes

BTW I have been prescribed a few medicines. I just forgot to mention those in the last post. Here is the list:

1. Taxim-0 200 mg tablet for 10 days (antibiotic)
2. Tiniba 500 mg tablet (antibiotic)
3. Vibact capsule for 20 days (probiotic nutritional supplement)
4. Tryptomer 10mg tablet for 30 days (anti-depressant)

& I hope that this infection goes away ASAP. Literally tired of suffering.

Hi Aryan,
I hope that the antibiotics are beginning to kick in. Sorry to have missed part of your initial questions, but GROSS in medical jargon refers to any changes to your colon( or ileum) , in your case the latter that can be seen with the naked eye.Whereas, MICROSCOPY means merely that tissue is examined under a microscope.

May i suggest that if you do seek a second opinion ,or return to your original gastroenterologist you might broach the topic of corticosteroids to help combat the inflamation.
Cheers,
Merv

Merv S said:

Hi Aryan,
I hope that the antibiotics are beginning to kick in. Sorry to have missed part of your initial questions, but GROSS in medical jargon refers to any changes to your colon( or ileum) , in your case the latter that can be seen with the naked eye.Whereas, MICROSCOPY means merely that tissue is examined under a microscope.

May i suggest that if you do seek a second opinion ,or return to your original gastroenterologist you might broach the topic of corticosteroids to help combat the inflamation.
Cheers,
Merv

Click to expand...

Hey Merv!

May be the antibiotics have started to show their effect. I don't get to see blood in the stool as well as mucus in the toilet bowl now.

Googled just now for "corticosteroids", seems to be a very good option to treat inflammation. Will definitely ask the doctor about it.

Thanks once again for your guidance

G'day Ayran
My pleasure. I am not a doctor, but a nurse of thirty +odd years standing ( now retired). I sincerely hope that the combination of medications that have been prescribed for you will suffice. Don't worry about taking antidepressants,.Of late . it has become something of a norm to treat anxiety ( which may affect some of us) and depression under the same banner. If you are concerned about an 'accident' , then why wouldn't you be anxious, or depressed for that matter?

For your sake, I sincerely hope that your medical expert was correct. IBD/IBS/ Crohn's Disease is a controversial amalgam of a disease processes affecting the whole GI tract. You don't need any lectures from this old man. I just wish you well, my friend. Crohn's or not. I still enjoy cooking my own masalas!. You are very welcome too me or contact me at merv.sprague@bigpond .com.

Cheers,
Merv

Merv S said:

G'day Ayran
My pleasure. I am not a doctor, but a nurse of thirty +odd years standing ( now retired). I sincerely hope that the combination of medications that have been prescribed for you will suffice. Don't worry about taking antidepressants,.Of late . it has become something of a norm to treat anxiety ( which may affect some of us) and depression under the same banner. If you are concerned about an 'accident' , then why wouldn't you be anxious, or depressed for that matter?

For your sake, I sincerely hope that your medical expert was correct. IBD/IBS/ Crohn's Disease is a controversial amalgam of a disease processes affecting the whole GI tract. You don't need any lectures from this old man. I just wish you well, my friend. Crohn's or not. I still enjoy cooking my own masalas!. You are very welcome too me or contact me at merv.sprague@bigpond .com.

Cheers,
Merv

Click to expand...

Hello Sir! I am happy that I got advice from someone who belongs to medical profession.

Though I don't like taking anti-depressants (because of the possible side effects), I will continue taking it for at least a month as prescribed by the doctor.

I used to be depressed & full of worries a few years back due to some events which happened with me, but now I don't suffer from depression. Yes, I have got some anxiety issues & I think a lot (I find my mind to be highly unstable). So, that might be the reason.

Now that you have seconded the doctor's diagnosis & medications he has prescribed, I am quite assured that I will get cured soon.

BTW I too hope that you also get recovered soon from the digestive disorder you are suffering from. I don't have much knowledge in it, so can't give any tips or guide anyone:ybiggrin:

Anyways, will update you over here or over e-mail with my progress.

Thanks once again Sir for guidance.

Guys, I got stool test done twice. First time I had given reddish sample for test but it didn't show presence of any blood in the report. So I got it done again. This time as well the report stated no presence of blood (though I still get to see bright red blood stuck to the stool sometimes). The only abnormal thing was that it showed the stool be acidic to which the doctor said that it doesn't matter much.

Mentioning my current symptoms below:

1. I don’t feel fresh & energetic when I wake up even though I sleep for 8+ hours.

2. I have to go to the loo at least 3 times a day & sometimes even after passing stools for 3-4 times in the morning itself, I don’t get the feeling of completion. It feels like I empty the bowels in parts (I mean it doesn’t get emptied in single attempt). Usually third time onwards, I have to sit for long as I don’t get pressure to empty the bowels. Sometimes I have to put pressure to get the stools passed or defecation happens on its own after sitting for long time.

3. The stool is mushy almost all the times. As far as I know mushy stool suggests mild diarrhoea & I think because of this dehydration happens which makes me feel exhausted (tired & sluggish). I have to sleep then as I don’t feel fresh & can’t concentrate on work. It takes me around 4 hours to get ready to kick start the day.

4. I get to see small amount of bright red blood stuck to the stool sometimes.

5. A lot of belching happens when I do simple exercise like warm up.

6. I have to go to the loo when I wake up if I sleep after lunch in afternoon.

7. I mostly feel full in the evening time even if I haven’t eaten/drunk anything or eat/drink only in small amounts. So I mostly skip snacks.

8. Have got 2 attacks of severe abdominal pain in the lower left abdomen till now.

9. Mouth sores (mild)

10. I feel hungry & the food consumed gets digested properly when I am travelling or am outdoors.

The doctor said that I might be suffering from IBS before colitis & guessed that depression or my too much thinking might be the reason behind my bowels not getting emptied properly. So he prescribed me an anti-depressant.

He has prescribed me to get anal manometry done now.

I would like to have your opinion on 3 things:
I. Is it really IBS or something else?
II. What could be the source of bleeding now; Ulcerations in the large intestine or something mild like Anal fissure
III. Is there any need for anal manometry?


Thanks in advance

Guys, I got stool test done twice. First time I had given reddish sample for test but it didn't show presence of any blood in the report. So I got it done again. This time as well the report stated no presence of blood (though I still get to see bright red blood stuck to the stool sometimes). The only abnormal thing was that it showed the stool be acidic to which the doctor said that it doesn't matter much.

Mentioning my current symptoms below:

1. I don’t feel fresh & energetic when I wake up even though I sleep for 8+ hours.

2. I have to go to the loo at least 3 times a day & sometimes even after passing stools for 3-4 times in the morning itself, I don’t get the feeling of completion. It feels like I empty the bowels in parts (I mean it doesn’t get emptied in single attempt). Usually third time onwards, I have to sit for long as I don’t get pressure to empty the bowels. Sometimes I have to put pressure to get the stools passed or defecation happens on its own after sitting for long time.

3. The stool is mushy almost all the times. As far as I know mushy stool suggests mild diarrhoea & I think because of this dehydration happens which makes me feel exhausted (tired & sluggish). I have to sleep then as I don’t feel fresh & can’t concentrate on work. It takes me around 4 hours to get ready to kick start the day.

4. I get to see small amount of bright red blood stuck to the stool sometimes.

5. A lot of belching happens when I do simple exercise like warm up.

6. I have to go to the loo when I wake up if I sleep after lunch in afternoon.

7. I mostly feel full in the evening time even if I haven’t eaten/drunk anything or eat/drink only in small amounts. So I mostly skip snacks.

8. Have got 2 attacks of severe abdominal pain in the lower left abdomen till now.

9. Mouth sores (mild)

10. I feel hungry & the food consumed gets digested properly when I am travelling or am outdoors.

The doctor said that I might be suffering from IBS before colitis & guessed that depression or my too much thinking might be the reason behind my bowels not getting emptied properly. So he prescribed me an anti-depressant.

He has prescribed me to get anal manometry done now.

I would like to have your opinion on 3 things:
I. Is it really IBS or something else?
II. What could be the source of bleeding now; Ulcerations in the large intestine or something mild like Anal fissure
III. Is there any need for anal manometry?


Thanks in advance