Suggest Treatment For Severe Abdominal Pain And Loose Stool

Posted on Wed, 26 Aug 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 26 Aug 2015 Answered on

Fri, 18 Sep 2015 Last reviewed on

Question : I was admitted to hospital on Saturday following multiple episodes of loose stools followed by severe abdominal pain. I was last seen by a gastroenterologist in XXXXXXX who said I have ibs constipation and wasn't concerned about the non specific inflammation of the terminal illium found on a colonoscopy in XXXXXXX 2014 which was treated with steroids. They're discharging me despite not being seen by a gastroenterologist with constipation despite my oral symptoms flaring up. The gastro consultant last year said there was a possibility of crohns but I was also under a rheumatologist with a query of lupus but was discharged this year in February as my ana was negative. The flare up started 2 weeks ago when my period started. Initially my knuckles went red and then swollen then at the weekend I had ten episodes of loose stools n then got a strawberry tongue. The following weekend was wen I had a further ten episodes of loose stools and was admitted to hospital I had taken tramadol to stop the loose stools. I barely ate anything on sat and only had clear fluids Sunday. Is this lupus or crohns please see images. I've had an inflamed mouth for two months.

I have a strong family history of rheumatoid arthritis and psoriatic arthritis

Answered by Dr. Dr. Shruti Rijhwani (14 hours later)

Brief Answer:
It seems more like IBD

Detailed Answer:
Dear Madam,

Thank you for posting your query on HCM.

Well looking into your problem I would like to tell you that your features are more suggestive of Inflammatory bowel disease rather than lupus and since you have strong family history of psoriatic arthritis it is more likely to be crohns only . I think you should send me the biopsy report done earlier . Also whether your colonoscopy has been done ? and what about XXXXXXX , ASCA levels . I would like to see your previous reports also . Enteropathic arthritis that falls under seronegative arthropathies is also a possibilty.
Any other query please ask.

Take care.

Dr. Shruti

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Dr. Shruti Rijhwani (15 hours later)

see image of my hospital d/c letter

Answered by Dr. Dr. Shruti Rijhwani (19 hours later)

Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Your discharge summary mentions about crohns disease only , so that remains the most likely possibilty . Also you are having symptoms of enteropathic arthritis . I think you need to see a gastroenterolgist and rheumatologist and seek their opinion for the same . Also you can discuss these possibilities with them , any help you need with that I will be more then happy to do it .

Dr. Shruti

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar