“IBS or IBD? ”
Hello,
I was wondering what your thoughts are regarding my current health situation. I'm a 21 year old female who is very fit, thin, and in otherwise great health. I don't have any family history of IBD.
I have been seeing a gastroenterologist for the past year and have been diagnosed with IBS-D. I have tried several IBS-D drugs with minimal improvement. My CBC and CRP blood work is normal, however I have many alarm symptoms that are not typical of IBS- low grade fever that comes and goes (no other reason for this!!), fatigue, weight loss, nocturnal symptoms, bleeding, perianal manifestations etc. In addition, I recently had an abdominal/pelvic CT scan with contrast done, and it revealed some "hazing in the left colon that was concerning for a mild inflammatory process". I'm having a colonoscopy done next week to diagnose IBD, but I wanted to know what your thoughts are regarding the chances of this being more than just irritable bowel especially given the abnormal radiological finding.
I was wondering what your thoughts are regarding my current health situation. I'm a 21 year old female who is very fit, thin, and in otherwise great health. I don't have any family history of IBD.
I have been seeing a gastroenterologist for the past year and have been diagnosed with IBS-D. I have tried several IBS-D drugs with minimal improvement. My CBC and CRP blood work is normal, however I have many alarm symptoms that are not typical of IBS- low grade fever that comes and goes (no other reason for this!!), fatigue, weight loss, nocturnal symptoms, bleeding, perianal manifestations etc. In addition, I recently had an abdominal/pelvic CT scan with contrast done, and it revealed some "hazing in the left colon that was concerning for a mild inflammatory process". I'm having a colonoscopy done next week to diagnose IBD, but I wanted to know what your thoughts are regarding the chances of this being more than just irritable bowel especially given the abnormal radiological finding.
Female | 21 years old
Complaint duration: 1 year off and on
Conditions: IBS-D
3 Answers
The radiology findings are not as important as the other symptoms that suggest a more systemic inflammatory process. A colonoscopy may or may not be able to make a diagnosis. If the colonoscopy is negative then further work up may be needed by GI or other specialists. The various symptoms may not have a GI origin after all.
There are many reasons that the abdominal CT scan can show haziness of the left colon. There are also various forms of “colitis” that can cause haziness such as Ulcerative Colitis, Crohn’s Colitis, infectious colitis, as well as ischemic colitis. The colonoscopy and possible biopsy is a procedure that can aid in the diagnosis.
Good luck!
Lynn M. O’Connor, MD MPH FACS FASCRS
Good luck!
Lynn M. O’Connor, MD MPH FACS FASCRS
Hi. IBS is a functional bowel disorder and is not associated with any lab test or imaging abnormalities. The Rome criteria need to be met before we can tell someone that she has IBS. You can proceed with getting tested to rule out other conditions first.
