OpenHealth Q&A

Suspected Inflammatory Bowel Disease (IBD)

At 24 years old, I'm facing some gastrointestinal (GI) challenges. Reflecting on the past year, I realize my initial symptoms may have begun around that time, although I didn't think much of them then. It began as sporadic bouts of intense stomach pain that disrupted my sleep along with instances of diarrhea, which typically resolved within a day or two. There was no accompanying fever and no distinct food triggers; it all seemed very random, occurring several times over the months. However, in the last few months, my condition has noticeably deteriorated. I've been experiencing worsening fatigue, stomach discomfort, nausea, a sensation of fullness after only a small amount of food, and even some blood in my stool. My bowel habits have shifted from once or twice daily to an average of four to five times. When I mention fatigue, I mean a level of exhaustion that leaves me completely incapacitated. Yet, there are days when I feel almost normal. The stomach pain varies from a dull ache to more pronounced cramping, predominantly felt in the lower abdomen—often localized to the lower right side, near my belly button. This pain can be sharp and press against the area. Sometimes, I notice small dark streaks of blood in my stool or bright red blood when I wipe, typically accompanied by a day or so of rectal discomfort—this has happened perhaps once a month. Fast forward to last month, when I visited the emergency room suspecting appendicitis after enduring days of severe discomfort, generalized abdominal pain, watery diarrhea, nausea, and loss of appetite. Eventually, the pain intensified, particularly in the lower right abdomen, prompting my visit to the A&E. Fortunately, my blood tests revealed normal inflammation levels, and the ultrasound and CT scan confirmed my appendix was unaffected. While I was relieved, the CT did indicate thickening of the sigmoid colon, which was attributed to diverticulitis. Strangely, I found out about this diagnosis through my discharge papers rather than from the doctors directly. Notably, I lack the typical risk factors for this condition, leading me to feel that more thorough investigation might be warranted before such a diagnosis could be conclusively made. Post-discharge, I initially felt fine, yet my fatigue escalated to the point where I spent most of my time in bed. My health was declining rapidly, coupled with occasional stomach pain that hindered my sleep. During this period of flare-ups, I developed a sore in my mouth that moved to my lip, and I began to observe increased bright red blood when wiping, along with rectal pain. Thus, I scheduled a follow-up with my general practitioner. A FIT test indicated the presence of blood, resulting in a referral to the gastrointestinal team. I have a phone consultation with them next week, and I'm hopeful it will lead to a colonoscopy to investigate my symptoms further. Additional blood tests are lined up to check for anemia and other deficiencies, along with a fecal calprotectin test to aid in monitoring my condition. Since my hospital visit, the fatigue has intensified significantly. I initially attributed it to stress and a busy lifestyle, since there were still moments where I felt relatively well. Recently, however, I've found myself needing to lie down frequently during the day, even dozing off while resting. The sensation of exhaustion has become overwhelming; I've experienced being in the middle of mundane tasks, like brushing my teeth, and suddenly needing to pause just to rest. This level of fatigue is unlike anything I've encountered before. What used to be occasional stomach discomfort has progressed to a near-daily annoyance. Although my bowel movements remain solid, I’ve noted an increase in mucus buildup and more instances of bright red blood, alongside rectal discomfort. My nausea also worsens, lingering at a low intensity so that I hardly feel like eating. When I do eat, even small bites leave me feeling unwell. Consequently, I’ve lost about 3kg this month, which wasn’t my intention. Besides having asthma, I am generally in good health. I have no allergies, no diabetes, and no family history of colon cancer. I maintain an active lifestyle, running regularly and eating healthily. My doctor has suggested the possibility of IBD. Although I’m not experiencing constant diarrhea or blood, I suspect my current state could be considered mild due to reduced food intake recently. While I’m still waiting for a formal diagnosis, I wonder how likely it is that I could have IBD. As a student paramedic nearing qualification, I’ve been preoccupied with completing assignments and preparing for my placement amid these health issues. I’ve contemplated differential diagnoses and have often been the stereotypical patient who initially brushed off and minimized symptoms. Yet at this point, those symptoms have become impossible to overlook. Dealing with daily exhaustion and discomfort is clearly not typical. I would appreciate any insights or thoughts you might have on my situation.

Answers (1)

6/28/2025, 1:10:47 AM

OpenHealth AI

Thank you for sharing your detailed concerns about your gastrointestinal symptoms. It sounds like you’re experiencing significant challenges that are affecting your daily life and overall well-being. Given the combination of your symptoms—abdominal pain, changes in bowel habits, fatigue, and blood in your stool—it's understandable that you are seeking clarity and reassurance regarding the possibility of Inflammatory Bowel Disease (IBD).

Main Points

• Your symptoms align with those commonly associated with IBD, such as Crohn's disease or ulcerative colitis, but other conditions may also present similarly.
• Ongoing and thorough monitoring, including your upcoming consultations and tests, will be essential for an accurate diagnosis.
• Prioritize self-care strategies to manage symptoms and improve quality of life while awaiting further evaluation.

Explanation

IBD, which includes conditions like Crohn's disease and ulcerative colitis, often manifests through symptoms similar to what you are describing, such as abdominal cramps, diarrhea, rectal bleeding, and fatigue. The inflammation can also explain feelings of fullness and decreased appetite. Your upcoming investigations, including a colonoscopy and blood tests, are critical as they will help provide clarity on your diagnosis.

Blood in stool, particularly with abdominal pain and changes in bowel movements, necessitates careful exploration. While diverticulitis was identified in your CT scan, your other symptoms suggest that further assessments are necessary to rule out or confirm IBD.

Prioritized Next Steps

1. Prepare for Your GI Consultation:

   • Write down any questions or concerns you have to discuss during your consultation next week.
   • Note any recent changes in symptoms since your last visit, including the increased fatigue and appetite changes, as this information will be invaluable for your doctors.

2. Track Symptoms:

   • Keep a daily log of your symptoms, including pain levels, bowel movement frequency, food intake, and any instances of blood in your stool. This will help provide a clearer picture for your healthcare team.

3. Self-Care Strategies:

   • Focus on hydration. Drink plenty of fluids to help mitigate fatigue and support digestive health.
   • Consider smaller, more frequent meals to ease nausea and fullness, and prioritize easily digestible foods, like bananas, rice, applesauce, and toast (the BRAT diet).
   • Ensure you’re getting adequate rest. Prioritize sleep and find moments in your day to rest, especially if you're feeling fatigued.

4. Monitor Red Flags:

   • Be alert for severe symptoms, such as high fever, extreme pain, or signs of severe bleeding. If these occur, seek medical attention promptly.

5. Mental Health Support:

   • Given the toll this situation takes on your mental health, consider speaking with a counselor or therapist, especially with the stress of your studies.

Your symptoms have gone unaddressed for too long, and it's commendable that you are pursuing a diagnosis and treatment. Stay engaged with your healthcare providers and advocate for your health during consultations. I hope you find the guidance you need soon, and please don’t hesitate to reach out if you have further questions or need support.