Diagnosis of digestive disorder

[Aryan111]

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.

[nomorepanic]

You don't say what your symptoms are and why can't it be colitis?

[Aryan111]

Hey thanks for your reply!:)

Here is the list of symptoms:

I HAVE FOLLOWING SYMPTOMS:
1.Usually I have to go to the loo 3-4 times in the morning. Mostly I don’t feel need to defecate after morning but sometimes have to go in afternoon, evening or night as well.
Stool types & consistency:-
First time in the morning:
The faeces are sausage shaped, smooth & soft. Mostly brownish-yellow in color. Since I drink lukewarm water before going to the loo, some mushy stool also appears.
Second time in the morning:
Mostly loose motions. Stools have some form & are not watery.
Third time in the morning:
Usually 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. This time usually defecation happens in the form of blobs & sometimes mucus or candida (some white stuff) appears with stools. Sometimes when I feel that I have passed stools & when I look into the bowl only mucus appears over there.
After meal or in evening:
Brown colored sticky stools which doesn’t float on water
2 Feeling of incomplete evacuation after defecating in the morning. (Usually I have to go to the loo 2-3 times in the morning to get the bowels completely emptied. But sometimes even after passing stools for 3-4 times, I just can’t clear the bowels completely)
3 Difficult & painful bowel movements (sometimes I have to sit for long to empty the bowels & sometimes even after sitting for long time if I am unable to pass stools, I have to put pressure to empty the bowels forcefully & this causes pain while passing stools. This happens usually 3rd or 4th time I go to the loo in the morning)
4 Change in frequency (ranging from 2-7 times a day) & consistency (sometimes a little bit watery stools, sometimes solid etc.) of bowel movements
5 Sometimes stools are narrow (not pencil width though)
6 Bright red blood in the stools (sometimes; it is occult or hidden blood sometimes)
7 Fat in stools (Sometimes I get to see faeces floating on water. Sometimes they seem to be greasy & sometimes drops of oil also are seen in the water inside the bowl. Though the faeces aren’t that pale or foul smelling.)
8 Some symptoms are alleviated by defecation
9 Dark urine (rarely). Its usually white when I drink enough of water
10 Abdominal pain (I feel some mild pain very rarely in the upper left abdomen at the place of spleen, usually for few seconds.
Had extremely severe abdominal pain one morning a few months back where I had eaten more than my capacity last night. I feel it happened because of trapped gas.)
11 Abdominal swelling/bloating (only if the bowels don’t get emptied completely.
A few months back used to suffer from bloating after sunset without eating anything or even after drinking small amounts of water. It doesn’t appear anymore.)
12 Used to feel full even after eating a fruit or drinking a glass of water at evening, a few months back. The situation has improved much now. But still at night I feel full earlier than I should be.
13 Sometimes I feel my abdomen to be stiff (not sensitive at all) on the left side of lower abdomen. I think this is what is called as abdominal rigidity or abdominal guarding
14 Growling stomach (very rarely; mostly at afternoon after lunch)
15 Very mild burning in stomach (very rarely)
16 Belching (used to belch a lot a few days back, now since I have reduced my meals, the situation has come under control, I belch but not that much)
17 Wind/gas. (Used to pass a lot of gas for a period of few days, a few weeks back. Now the situation has become normal.)
18 Mild pain in the rectum while passing gas (very rarely)
19 Poor appetite (might be because of my inactive lifestyle & sometimes incomplete evacuation)
20 Enlarged spleen (I feel so because of some symptoms)
21 Fatigue, Sluggishness & Lethargy (I don’t feel the same though when I am outing or at a function etc.). I feel completely fresh only when I take a lot of rest, say 4-5 hours in daytime.
22 I feel hungry & the food consumed gets digested properly when I am travelling or am outdoors. Inactive lifestyle worsens the symptoms.
23 Weight loss (I have lost weight but I think it is because I have reduced my diet.)
24 Presence of excess saliva or some bitter liquid in mouth (this might be acid reflux), usually at daytime (I think that is what causes bad breath)
25 Heartburn or acidity (only when sometimes I get up at mid night at around 2-3 AM)
26 Regurgitation of food (very rarely)
27 Headaches (very rarely; usually when I am not able to empty the bowels completely)
28 Joint pain (very rarely get pain in the wrist. I feel it happens because of trapped gas.
Used to have feeling of uneasiness in the ankle joints for a long period, don’t have any more.)
29 Neck & back pain (rarely; I feel it happens because of trapped gas)
30 Cramping (had experienced only for a period of a couple of days, a few weeks back & that too I felt was happening because of trapped gas in scrotum or area between anus & scrotum. I used to feel pain in the scrotum & it was little difficult for me to sit)
31 Mouth sores (mild)
32 Mild chills (sometimes)
33 Low-grade fever (very rarely)
34 Mimicking heart attack (had a couple of attacks like this which were not that severe. Might have happened because of gas)
35 Itchy, red hives on skin (occur rarely; it seems like they occur because of biting from insects.)
36 Lactose intolerance (experience symptoms sometimes after consuming milk based products)
37 Stress & worries to some extent
38 Stress causes aggravation of symptoms
39 Sensitivity to light and sound (to some extent)


I “DON’T” HAVE FOLLOWING SYMPTOMS:
1 Clay colored or tarry stools
2 Bloody diarrhoea
3 Bleeding during or after bowel movements
4 Pus drainage near the anal opening
5 Urgent need to defecate
6 Itchiness in the anal area
7 Discomfort while sitting
8 Rectal spasm
9 Pain or discomfort near the anus or buttocks
10 Feeling a bulge after coughing, sneezing or lifting
11 Feeling pressure in the rectum
12 Rectal fullness
13 Rectal prolapse
14 Redness, soreness of the skin around the anal opening
15 Rectal tenderness
16 Swelling around anus
17 Lump or painful hardened tissue or mass protruding near the anus
18 Visible tear or cut in the anus area
19 Levator ani syndrome
20 Passing excessive amounts of gas
(Used to suffer from this a few days back for a period of few days. The condition is normal now.)
21 Trouble passing gas
22 Incontinence
23 Inability to pass wind (Used to suffer from this a few weeks back, where the gas was moving from here & there inside body but wasn’t getting out. Not anymore.)
24 Abdominal tenderness
25 Abdominal cramps
26 Abdominal bleeding
27 Abdominal discomfort
28 Full, round abdomen
29 Increased abdominal size.
30 Lump or protrusion in the abdomen
31 Mass in the belly
32 Changes to the belly button
33 Difficulty belching
34 Less urine than normal
35 Inability to urinate
36 Urinary tract Infections
37 Kidney stones
38 Malaise
39 Swelling on any other body part than abdomen
40 Dizziness
41 Migraine
42 Fainting
43 Light-headedness
44 Used to get itchy red small boils on hand fingers, every summer a few years back. No more have these symptoms.
45 Vomiting
46 Fever
47 Feeling sick
48 Jaundice
49 Muscle pain (pain used to be there in the lats muscles. But disappeared after getting massage & taking rest.)
50 Fibromyalgia
51 Arthritis
52 Chest or shoulder pain
53 Pelvic pain
54 Lump or protrusion in the groin or scrotum
55 Groin discomfort or pain
56 Pain while coughing, bending or lifting a heavy object
57 Sleep disturbance
58 Night sweats
59 Cough
60 Feeling that something is stuck in your throat or chest
61 Choking during swallowing
62 Pain in the throat or chest during swallowing
63 Coughing during or after the swallow
64 Difficulty swallowing (suffered from little bit difficulty while swallowing for a period of few of days, felt it happened because of swollen tonsils.)
65 Trouble forming food and liquid into a soft ball in the mouth
66 Trouble pushing food or liquid to the back of the mouth
67 Throat irritation
68 Sore throat
69 Throat clearing
70 Hoarseness
71 Nasal regurgitation
72 Runny nose
73 Hiccups
74 Swelling or puffiness of the tissue directly under skin, especially in legs or arms.
75 Bone pain
76 Dehydration
77 Dry mouth, nostrils or skin
78 Not urinating as often
79 Fast heart rate
80 Shortness of breath
81 Difficulty breathing
82 Anorexia
83 Spider-like blood vessels
84 Bruising
85 Pain aggravated or relieved by meals
86 Burning or gnawing feeling similar to hunger pains
87 Red, purple, dark or discolored bulge
88 Stretched skin (but do have some strechmarks on some parts of the body)
89 Shiny skin (Used to be oily at teenage but became normal after taking treatment)
90 Skin that retains a dimple (pits), after being pressed for several seconds.
91 Weight gain
92 Increased salivation


I DON'T HAVE IDEA ABOUT FOLLOWING SYMPTOMS:
1 Decrease in caliber of stool
2 Osteoporosis (I feel my bones to be weak though & my posture is usually little bit stooped.)
3 Bumps or lumps on bones of legs, arms, skull and jaw
4 Infertility
5 Colitic arthritis, an arthritis that migrates along the body and affects knees, ankles, hips, wrists and elbows
6 Low blood count (anaemia) that makes you feel tired
7 Low blood pressure
8 Pericholangitis, inflammation of the tissues around the bile ducts
9 Malnutrition
10 Severe air swallowing
11 An enlarged bubble of gas in the stomach following heavy meals
12 Water-electrolyte imbalance
13 Teeth changing color or losing their enamel (My teeth always seem to be a little bit yellowish, no matter how properly I brush them.)


I feel that it can't be infectious colitis because I don't have the relevant symptoms.

[nomorepanic]

Blimey did you google and copy and paste all of that?

I have Crohn's and IBS and a lot of what you wrote I can relate to.

Not sure what else to say as you have been given a diagnosis by a professional.

[Aryan111]

Blimey did you google and copy and paste all of that? - haha. No I didn't. I had made this list of symptoms a month ago so that I can reach accurate diagnosis.

I have Crohn's and IBS and a lot of what you wrote I can relate to.

Not sure what else to say as you have been given a diagnosis by a professional.

- I think I should not get panic & wait for the biopsy report to come. Will update once I receive it.

[Aryan111]

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.

[Aryan111]

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.

[samina77]

Hi Aryan,

I think you should trust these results, they are very detailed and they have seen exactly what's going on inside your gut. I think it's a classic example of just how big an impact our brains have on our stomachs. I would absolutely follow the doctor's advice, keep eating well - lots of water and lots of healthy meals, and most importantly, don't worry about it because you know for certain you don't have anything nasty going on. Definitely do some yoga or meditation this will help you A LOT!

Good Luck
Sx

[Aryan111]

Hi Aryan,

I think you should trust these results, they are very detailed and they have seen exactly what's going on inside your gut. I think it's a classic example of just how big an impact our brains have on our stomachs. I would absolutely follow the doctor's advice, keep eating well - lots of water and lots of healthy meals, and most importantly, don't worry about it because you know for certain you don't have anything nasty going on. Definitely do some yoga or meditation this will help you A LOT!

Good Luck
Sx

Hey Samina!

Thanks a lot for such a firm advice. A couple of guys on other forums also advised me to trust the results. The reason why I was not able to trust is that I don't have any symptoms related to the diagnosis & the biopsy report said it is "likely" infective origin. But now I think that I must trust the diagnosis made by the doc (BTW he is one of the most renowned gastroenterologists of the city).

Might my brain or my inactive lifestyle be the reason. I would now try to improve in every aspect of my life related to this issue. Like having an active lifestyle, doing Pranayam, Yoga & meditation, eating well, drinking lots of water, being happy & stress free.

Yes, you caught it right. Somewhere I know that there is nothing serious to worry about.:yesyes:

Thanks once again for your guidance.:)

[Aryan111]

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 has prescribed me to get anal manometry done now. I would like to have your opinion on whether should I get manometry done or seek for second opinion.

Thanks in advance :)