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Discussion Starter · #1 ·
Hello to all. I just signed up for this site today after reading the site for a couple days. I have yet to be diagnosed but am getting closer to an answer. About 3 months ago,I presented with a perianal abscess that formed into a fistula. Upon inspecting throughanoscopy, the doc said I also have two fissures. Before anything is done, they need to screen for Crohn's. The last three weeks, differentphysicians (family physician, colo-rectal, and friends who are physicians) have asked meif I have experienced excessive diarrhea. That question was easy for me to answer but noteasy to admit as for the last few years, I suspected I have excessive diarrhea compared tothe people around me but ignored it. Now I am mapping out every year of my life for the last 10 years or so and writing down my symptoms and experiences. Basically, I get diarrhea when I'm stressed although itcan occur without any obvious stressors. But in the past as challenging circumstances arosein my life, diarrhea usually accompanied it whether this be troubles in a relationship or academicchallenges or job related. Usually a few days was all it lasted but there has been times where2 to 6 weeks in a row were nothing but diarrhea. In general, abdominal pain never existed althoughthere may have been slight cramping. About four years ago, when I got really bad diarrhea for weeks on end, I googled it and eventually endedup on an IBS website where I read people's stories about their experiences. I heard about pain, vomiting,crapping in their pants, etc. I quickly dismissed the idea of having IBS because I've never experiencedanything like that. But I now presume there is a spectrum and the people who come to this forumare generally the ones with more severe symptoms. Upon registering to this site, I saw a poll that asked did you have abdominal pain as a child. That caughtmy eye because one of the recent things I noted was seeing a pediatrician for stomach pain. I don'treally have a strong memory of how severe it was and I have no recollection after childhood of everhaving abdominal pain. The only other symptom I currently have and have had in the past couple yearsis swelling of the abdomen area after a bowel movement. I've mentioned this to about a dozen physiciansand they have never heard of it. Has anyone here ever experienced this? It's as if my stomach were filledwith air, immediately after my bowel movement. It happens on and off, maybe a few times per month.Another question I have for any of you diagnosed with IBS-D is do you ever have immediate diarrhea from a stressful event? In other words, everything is fine, your bowel movements have been solid andregular, then you have a phone call which increases your stress, and subsequent diarrhea?
 

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Welcome SunNsnow. The fact that you have a fistula and fissures makes it a bit more likely that you have Crohn's disease. If this turns out to be the case, I recommend not only using our site, but the Crohn's & Colitis Foundation of America's as well (www.ccfa.org - they have information and a discussion board). However, even if you do have Crohn's disease (and you still may not), that doesn't mean you don't have IBS. Unfortunately having one doesn't get you out of having the other. Both IBS and inflammatory bowel disease patients often report that their symptoms worsen with stress, even if no clinical trial has proved a specific link. Like you said, there is a wide spectrum of presentations for both IBS and IBD, which is part of what can make it difficult to diagnose. I feel like I have experienced the "feeling fine, stressful event, then diarrhea" that you described, but I can't think of a specific instance and I can't remember if I had warning signs prior to the stressful event. I do find that stress doesn't help my symptoms one bit and if I'm able to relax it helps me feel better (though it doesn't take away my symptoms altogether).Aside from the anoscopy, what testing have you had done so far?
 

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Discussion Starter · #4 ·
Hi Blonde,Thanks for responding. I visited a Crohn's forum for a couple weeks to get myselfready for the possibility of having Crohn's as the shock of being diagnosed with itwould be intense. All these ano-rectal problems don't lookgood. I had an anoscopy, blood work, stool tests (stool test showed no blood, no parasite or egg and blood work showed normal blood sedimentation rate with a c-reactive protein level of 1.1) Neutrophils were a bit high but everything elsewas ok (hemoglobin and hematocrit were fine.) The real tests come this weekand the start of next week (x-ray, endoscopy, etc.) My guess is I do not have Crohn's but IBS-D/Post-infectious IBS but am mentallyprepared for any diagnosis including cancer.
 

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Discussion Starter · #5 ·
Forgot to mention that 80 to 90% of individuals with a perianal abscess/fistula do nothave Crohn's. The medical literature seems to have little to no information as to proven or suspected causes of these ano-rectal disorders other than infected fissure or tuberculosis or STDs. The fissures are common but the tb/stds causing ano-rectal issues is extremely rare. Problem is that medicine is generallyunconcerned with the cause of a disease as preventing the disease does not generateprofits. To me it seems logical that sufferers of IBS would have an increased risk of these issues but the literature is scant on that as well.
 

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It was more of the combination of symptoms plus the fistula that made me lean more towards Crohn's than the fistula alone, but like you said, it could very well not be related at all. The cause of the fistula varies by location and what exactly it connects. Like you, so far I have not come across anything that links IBS with an increased risk for fistula or fissure. Your risks also change depending on your age and family history, amongst other things. Best of luck to you on your upcoming tests.
 
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