OpenHealth Q&A

Navigating Crohn's: Seeking Guidance

Is this typical? I'm a 39-year-old man with three young kids, and my wife is currently 32 weeks pregnant. My children are aged 4, 3, and 2. About two years ago, I began experiencing symptoms that included a recurring perianal abscess, which has flared up seven times since then. Just last Friday, I underwent a colonoscopy that revealed significant inflammation in my terminal ileum, although they found no ulcers or serious concerns, just mild internal hemorrhoids. Over the past couple of years, alongside the abscesses, I've struggled with waves of extreme fatigue and irritability. My white blood cell count started at an elevated 14,000 and rose to a recent high of 19,500. I've had some mild diarrhea intermittently and have noticed a disruption in my formerly regular bowel movements, which used to occur shortly after getting up — now, there's no blood present in my stools. Strangely enough, I've gained weight during this period, going from 170 pounds to 190, which is unusual for me, and I feel that I've lost muscle mass. I used to be quite active, running three miles three times weekly, but fatigue and abscess flare-ups have made it impossible for me to maintain that routine. Transitioning from half-marathons to being inactive is quite challenging. Additionally, I usually wear contacts, but I've found myself switching back to glasses intermittently because my contacts irritate my eyes. I've also been dealing with pain in my left shoulder, elbow, and wrist — what I suspect might be arthritis. Last fall, I thought I had severe poison ivy on my hands; after a visit to urgent care, I learned that it was actually mild psoriasis affecting my elbows and knees as well. My previous primary care physician suggested that I was simply aging and needed to quit smoking, reassuring me that we'd keep tabs on my white blood cell count in the coming years. In contrast, my new doctor, whom I consulted after relocating, implied my symptoms were likely due to depression and advised a follow-up only a year later. However, my new doctor was concerned when my white blood cell count spiked to 16,000, referring me to a hematologist to rule out leukemia. The hematologist conducted further tests, resulting in an increase to 19,500, but ultimately ruled out leukemia after a month-long wait, while my primary care provider remained silent throughout this process. When I reached out to inquire about my results, I was told that I needed an appointment to discuss anything further, leaving me frustrated. It's important to note that I’ve faced depression before, approximately 15 years ago, and have included this in my medical history as I began treatment with a psychiatrist and psychologist, starting buspirone. I usually possess a high level of energy and enthusiasm, engaging playfully with my kids, but currently, I find myself lacking that vitality. My work now relies on mental acuity, yet I am plagued by cognitive fog and incredible fatigue. There are nights when I can barely get a few hours of sleep, making it feel like I have a newborn at home every night. In search of answers, I input my symptoms and results into AI, which guided me to consult a gastroenterologist. The colonoscopy confirmed inflammation in my terminal ileum. I'm not certain if sharing images from the colonoscopy is permissible here, but if it is, I can share that I thoroughly prepared for the procedure — it was surprisingly clean! My follow-up appointment with the gastroenterologist is scheduled for April 11, where I will receive my biopsy results. From my readings, this inflammation often suggests Crohn's disease. I also discovered that my BCBS FEP insurance does not cover biologics effectively, leaving me with high costs to consider. I feel overwhelmed and uncertain about my next steps. I desire to be a better husband and father, and I want to fulfill my obligations at work as well. Is it common to experience all these symptoms, even if the pain and diarrhea are manageable and there's no blood in my stools? Could this still indicate Crohn's? Any guidance on what I should do next would be greatly appreciated; I just feel so lost right now.

Answers (1)

2/15/2026, 8:40:51 PM

OpenHealth AI

It sounds like you're dealing with a complex situation involving multiple symptoms and concerns. Your experiences with recurrent perianal abscesses, inflammation in your terminal ileum, fatigue, irritability, and other symptoms are understandably overwhelming. While many aspects can indeed align with Crohn's disease, there are also other factors at play given your symptoms and history.

Overview of Your Situation:

1. Inflammation in the terminal ileum: This may suggest Crohn's disease, especially with your history of perianal abscesses.
2. Elevated white blood cell count: This could be related to inflammation or infection and should be monitored closely.
3. Fatigue and other symptoms: These could stem from a number of factors including inflammation, stress, depression, or possible nutritional deficiencies.

Next Steps and Practical Guidance:

1. Prepare for Your Upcoming Appointment:

   • Make a list of all your symptoms, their onset, and any changes you've noticed. Include the context of your fatigue, weight changes, and joint pain.
   • Note any specific questions you have about the possibility of Crohn's disease, management strategies, and lifestyle changes.

2. Explore Treatment Options:

   • Discuss the results from your colonoscopy and any biopsy findings with your gastroenterologist.
   • Inquire about treatment options for managing Crohn's or other inflammatory conditions, considering the limitations of your insurance coverage for biologics.
   • Ask if dietary modifications or nutritional supplements may help with inflammation and overall health.

3. Address Fatigue and Mental Health:

   • Since fatigue and cognitive fog are significant concerns, ensure you discuss these symptoms openly with your healthcare providers, including your psychiatrist. They may be related to both physical health and mental health aspects.
   • Consider working with a therapist to explore coping strategies for managing stress and your mental health during this challenging time.

4. Lifestyle Adjustments:

   • Focus on maintaining a balanced diet that may help alleviate gastrointestinal symptoms; consider consulting a dietitian knowledgeable in Crohn's disease.
   • Incorporate gentle physical activity as tolerated to enhance mood and energy levels. This can be something manageable, like short walks, especially as you aim to be active with your kids.

5. Monitor Symptoms:

   • Keep a journal to track your symptoms, medications, dietary changes, and their effects. This will provide meaningful insight for your appointments and help identify triggers.

6. Stay Informed and Engaged:

   • Research reputable sources about Crohn's disease and its management. Understanding your condition can empower you to make informed decisions about your health.
   • Connect with local or online support groups for individuals with Crohn’s disease, which can offer valuable camaraderie and information.

Closing Thoughts:

It’s completely normal to feel lost amidst all these challenges, especially with your responsibilities to your family and work. Remember that effective management often involves collaboration with healthcare professionals to address both the physical and emotional aspects of your condition. You are taking proactive steps, which is commendable, and reaching out for guidance is key to moving forward. Stay hopeful, and know that progress can be made with the right support and treatment strategy.