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Dr Basu
Dr Basu, Experienced Specialist
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I am now 21 years old. I have been having problems with Irritable

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I am now 21 years old. I have been having problems with Irritable Bowel Syndrome since I was around 14 years old - I had every test possible in my teenage years, colonoscopy, endoscopy, ultrasound, caeliac - all came back negative - except for a tiny, 2mm irritation in my duodenum. My IBS diarrheal symptoms continued until I was 19 and left for university, when I suddenly noticed a drastic improvement. However, as my IBS subsided the mental issues perhaps behind it really came to the fore - I have seen two psychologists for emetophobia and obsessive compulsive disorder. This is my medical background.

2 months ago while living alone in a foreign country I experienced an attack which left me extremely shaken and nervous. Roughly 6 weeks ago I began to experience extremely loose bowel moves right after eating, always accompanied by severe nausea - however I have been taking prochlorperazine and cyclizine intermittently, and I have managed to avoid vomiting.

I had a full blood test done a week ago and was given the all clear, as well as a bacterial stool test which also came back clear. Yet I am still experiencing a high degree of anxious agitation and I am still having loose movements 3-4 times a day, usually after eating. I have lost over a stone in weight from decreased appetite, although I am still eating rice, chicken, plain sandwiches and electrolyte replacement drinks.

I have been having panic attacks today however as this morning I was examining my stool and I noticed that there were tiny black specks, similar to pepper (which i have not eaten in over a month), and furthermore while showering I noticed they were visible in the water on the floor of the shower - I am really terrified that this is blood and something serious. I have a history of anal fissures, but these were always obvious, as I could feel the rip of the cut on my anus as I had a bm - what are these black specks? Should I be worried? I am moving countries in 2 weeks and fear it will no longer be possible :(

mysticdoc :

The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.

mysticdoc :

Hi there,


I am Mysticdoc, experienced Internal Medicine Specialist.


I am here to help you with your concerns.

mysticdoc :

Sorry to hear about your distress.

mysticdoc :

The black specs can be blood from the intestine.

mysticdoc :

Anal fissure should cause red blood not black.

mysticdoc :

Also iron rich food can cause these changes.

Customer:

Is it possible that these black specks are no blood?

Customer:

I mean i haven't been eating any iron-rich foods at all

Customer:

*not

mysticdoc :

hmm--

mysticdoc :

unless it is food related, no other suitable explanation.

mysticdoc :

do you smoke cigarettes?

Customer:

no

Customer:

what could the bleeding be from?

Customer:

I have not been experiencing any symptoms like fever

Customer:

there was no evidence of inflammation in my blood tests

mysticdoc :

see this can be due to the infection of the intestine.

mysticdoc :

loose stools are also another sign.

mysticdoc :

Bacterial or parasitic infection.

mysticdoc :

Another possibility can be Crohn's disease.

Customer:

but my stool was tested for these and came back negative....

mysticdoc :

This is often missed.

Customer:

is it possible it is just a flare up of IBS?

mysticdoc :

Given h/o anal fissure and some duodenal irritation, you need to get another colonoscopy to check for Crohn's disease

Customer:

right

mysticdoc :

I think, Crohn's is very likely.

Customer:

what are the tell-tale signs of crohns?

mysticdoc :

That explains every thing you are experiencing.

Customer:

I mean i haven't had any problems for 2 years

mysticdoc :

loose stools with blood 9 black specs for example since blood comes from upper part of intestine).

mysticdoc :

anal fissure

mysticdoc :

and IBs like symptoms.

mysticdoc :

Flar ups

mysticdoc :

Flare ups can occur after long time

Customer:

I was of the impression that if it was blood it would make the entire stool dark

Customer:

not just a few miniscule flecks

Customer:

surely crohns would illicit more bleeding?

mysticdoc :

no that depends on severity of the disease.

Customer:

does crohns cause severe nausea?

mysticdoc :

in early stages, hard to diagnose and less prominent symptoms.

mysticdoc :

yes it can

Customer:

these symptoms are identical to my symptoms 5 years ago though

Customer:

when I was checked and my colonoscopy and endoscopy were both clear

mysticdoc :

ok

mysticdoc :

now the probability of diagnosis is higher since disease process progresses over time.

Customer:

right

mysticdoc :

Definitely see a gastroenterologist

Customer:

How dangerous is crohns?

mysticdoc :

Well--- when treated not that dangerous.

mysticdoc :

But this is an autoimmune disease.

mysticdoc :

diagnosis at early stages offer better outcomes.

Customer:

I have been eating bananas everyday

Customer:

is it possible that the specks are just seeds?

Customer:

or could they be from the medications I have been taking?

mysticdoc :

unlikely related to bananas.

Customer:

right.

mysticdoc :

And medications you are on --should not cause that.

mysticdoc :

in your case i find it hard to explain any other way

Customer:

theretically if I had had crohns since I was 14

Customer:

and it was untreated

Customer:

could it have progressed to something really serious by now?

mysticdoc :

that is possible

Customer:

and why crohns as opposed to colitis?

mysticdoc :

but sometimes, we see the disease may not be active for long time.

Customer:

right

mysticdoc :

and that is why difficult to predict the course without endoscopies.

Customer:

right

Customer:

well thank you anyway

mysticdoc :

very welcome

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