Question: hello doctor
My age is 24, and I am having following problem :
1) fatty liver for many years.

2) I have stools 3 times in the morning for last 3 months. First bowel movement is generally solid and fully formed. But the following two times, the stools can be "soft but formed" and sometimes "unformed loose stool". Very rarely it is watery. After breakfast i have to go once or twice the whole day. These (after breakfast stools) are generally formed stools and can be sometimes soft stools. Very rarely i have urgency.
3) i have heavy "upper central abdominal pain", which is relieved after having eno, antacids or after trying to burp. generally with burping, pain subsides. I am taking rab 20 for two months, but only temporary relief.

I did the following test.
I have attached the reports.
PLATELETS - 0000/CU.MM
SERUM TSH - 2.49 uIU/ML
SERUM HBSAg - non reactive
Accept for slight liver problem all test were normal.
So doctor asked me to do endoscopy and colonoscopy.
Here the problem lies.
i had erosive antral gastritis and duodenitis.
I also had multiple erosion in terminal ileum and IC valve.
biopsy from ileum said :
Gross : multiple tiny bits of greyish white tissue. All the bits embedded.
Microscopical examination : Section shows multiple bits of ileal mucosa showing focal erosion of the lining surface epithelium. The glands in one of the bits shows mucin depletion. The lamina propria is infiltrated by inflammatory cells composed of lymphocytes, plasma cells admixed with eosinophils. Lymphoid follicles are present. No cryptitis or crypt abcess seen. No granuloma found. There is no evidence of malignancy in this biopsy.
Impression : Non specific ileitis.
my ESR level is 6
my CRP is 2.6
Vitamin b12 = 186 pg/ml, after taking b12 oral medicine it shot up to 1410pg/ml in one month.
(i think my terminal ileum is functioning well, as it absorbed b12, i am vegetarian)
Vitamin d3 = 12 nmol/l, took vitamin d3 supplements.

what do u think the problem is ? is it ibs or something more serious ? I do not have lower abdominal pain.
This gastric pain (upper central abdomin) is nothing new to me. it is occuring for last 2-3 years. this pain occurs in once or twice a month. But these days it is frequent. Please help.

1 well Rabeprazole along with domperidone is only giving temporary relief. i have tried it.
2. for last 2 months i am taking bifilac.
3. can h.pylori cause EROSIVE gastritis ?

IF not, what is the solution.


4. what do u mean by ileitis ? is it a common problem ? is the reason for my altered bowel movement and increased frequency ? or is it due to ibs ? what do u think ?

5. vitamin b12 therapy did nothing good.

Apart from altered bowel movement i do not have any other symptoms... No lower abdominal pain, no weight loss, no watery diarrhea, and normally there is not urgency even, no fatigue. Problem is worst only in morning.

My family doctor and also a gastroenterologist said it is ibs.
2 other gastroenterologist said it might be SIBO, crohns or some other infection. They are not sure.

I have high anxiety level and generally all day I am tensed fearing crohns.

I have seen your portfolio and find u very experienced. what according to u is my problem as per your experience and my symptomns mentioned above.
can SIBO cause erosion in terminal ileum ? what do u think the problem is ? how should i go about ?

well after taking psyllium husk, my stool gets formed, but frequency is unchanged.

my doctor has suggested to use mesacol od
should i start it ?
my family doctor is against using it.

does mesacol od is given to non crohn patient also, who have non specific ileitis ?

or should i go for another colonoscopy, and see if sibo and ibs medication has solved the ileitis. If not solved then i should take mesacol od.

Frankly speaking doctor i need advice.

I dont have weight loss, no watery diarrhea, normal esr and crp levels, platelets are also normal, no cryptitis in biospy, no lower abdominal pain.