Could this be Crohns or is it just IBS?

Digestive health
1

Chronic pain, LEFT UPPER abdomen and chest, already for 5 months.

I would be curious to know if my symptoms, especially my pain in LUQ matches those if you guys, with Crohns. I dont have bleeding, have only constipation, and a positive calprotectin test.

- Dull pain, sometimes also feeling like bubbles, mostly under lower left ribcage. Worsens with body movement like moving fast around the house (but not with shaking of for example going on a car).

- Sometimes also at heart level, rarely radiating towards armpit. Occasional back pain, also in left side. No pain in right side, be abdomen or chest.

- Pain started 5 months ago. One lung infection 4 months ago (pain reduced temporarily with antibiotics).

- Periodic constipation and occasional nausea and heartburn.

- Besides body movement, pain also worsens after fatty meals and stress.

- Doctor first suspected as pericartitis or pleurisy, then costochondritis, now suspected to be IBS) Says it can't be Crohns dye to lack of diarrhoea and bleeding.

- Blood tests all normal (blood count, thyroid, liver)

- Negative celiac, negative H. pylori, no blood in stool).

- Normal ECG, normal Abdominal ultrasound, no Colonoscopy yet.

- Abnormal tests: slightly elevated IgA (but only barely above upper limit); weak positive calprotectin stool test (intestine inflammation), low ferritin.

- I have mody diabetes (mild), controlled by diet, and periodontal disease (with periodic flare-ups). Age 36, male

- My suspected diagnosis: mild diverticolitis, Crohns or IBD, pleurisy or something related, fibromyalgia, Lyme's, B12 deficiency, Chronic pancreatitis, Costochondritis

Has anyone experienced something similar? Upper abdomen pain, under lower ribcage, that worsens with simple body movement? It's very localised pain. Never changes location.

Is there any way of controlling my pain with diet? (Tried already GF and FODMAP without much improvement) Haven't tried any medication yet. Pain refuses to go away.

2

I have Crohn’s disease and based off your symptoms and blood work and stool sample results I would say this likely isn’t crohns. You mention it’s worse after fatty foods. Maybe it could be your pancreas or gallbladder? I know for myself, I don’t experience constipation. 

I do get the upper left abdominal pain but I think it’s mostly gas. 

It’s so tough trying to figure these things out! 

3

With Crohns you are more likely to get gall stones which cause amazing pain in LUV.

I would ask your doc for an ultrasound to see if you have stones.

4

There are no stones in abdominal ultrasound. Everything looked normal including gallbladder.

Does Crohns cause persistent one spot pain under low ribcage as main symptom?

Doctors have diagnosed as IBS.

But recently I developed other nerve and muscle symptoms in left side of body.

5

Hi. I have had Crohns for over 50 years and the worst part was always the pain in my abdomen, tummy, sides and back. I remember when I was really in trouble having to pinch my sides which stopped the pain for a while at least. I was told by a Consultant  that the reason for the pain being high up when you expect bowel pain to be lower stomach,and he said "It is referred pain" so in other words your body is in trouble and your nerves are messed up tryin g to decide where it is. Th, nowey discovered very early on that I was B12 deficient and from then onwards I have had B12 injections every three months, but that is now down to two months. Crohns is a very nasty complaint and it is with you for life. The biggest problem is that they still don't know enough about it. I personally feel that my problem started after I caught a very nasty case of Jippy Tummy in Spain which never went away, and from experience learned from others, it is something that seems to happen. I now have a Colostomy because they were worried, with the constant ulceration that it would turn to Cancer, so in their words I had run the gauntlet for 30 years. To some extent this has helped me and although I get pain from joints because I spent 15 years on Steroids which was the only tablet offered then to help you. I weaned myself off them in the end, because I felt the steroids although they had kept me alive, were a bit of a sham, because no one knows how they work.  These days there is a blood test which will show if it is Crohns or something else. But going back to your initial statement, yes I did suffer very badly from pain in my higher abdomen and as I said they put it down to referred pain.

Hope this helps

Sheila 

6

NHS considered my case after a detailed review. Doctors suspect main cause its a neurological disorder, like MS, and also some degree of IBD (due to positive calprotectin). I await new tests to evaluate the causes of nerve disruption (whether B12, Lyme. Fibro, MS, or something else). As pains started to affected several areas of the body, they suspected something neurological, and so did I.

7

After 15 months i finally got a diagnosis!!!
The journey went like this:

Aug 2017, pain in upper left abdomen starts, initially some chest pain too. A week later, chronic constipation starts for a few months. ECG shows normal heart function

Sep2017, got pneumonia. Doctor suspected lung pleurisy. Symptoms disappeared for a month. Between guts and lungs, both me and doctors are left confused!

Nov 2017: return of constant pain under lower left ribs, now with GERD and food intolerances. I do many tests, mostly blood. Mild iron deficiency. No celiac. No H. pylori. Small raise in calprotectin. Abdomen ultrasound negative. Relief that pancreas, spleen and aneurysm, are not the cause of pain. Three doctors says its IBS, despite the unusual local persistent pain (not typical of IBS).

Jan 2018. Fasciculations started in the area of pain. I feel worried. Doctor wonders Crohns (but i have constipation rather than bloody diarrhoea). Other options considered were lyme disease (negative test) and multiple sclerosis.

Apr 2018. Slight swollen in same site of pain. This is unusual and I am worried about what is causing it. But all doctors and a gastroenterologist dismiss that as IBS and colon spasms. I do not believe them. I do a MRI for that part of abdomen, everything is fine. Frustated by not finding the root of the pain and swollen, I did also a chest x ray: also nothing usual.

May 2018. At this time, I suspect the culprit may be the stomach or colon (as others exams ruled out other organs in that area of the pain). I asked many of these doctors if it could be a hernia, all said no.

Jun 2018 I managed to get a gastro referred me into the waiting list for a colonoscopy and gastroendoscopy. He said probably IBS and the swelling is caused by air.

Nov 2018: colonoscopy shows that colon is fine. Endoscopy reveals a paraesophageal hernia!