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Dr. Sohaib
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In 2008, I had a Colonoscopy and the Gastroenterologist

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In 2008, I had a Colonoscopy and the Gastroenterologist said that I had CROHN'S disease and started me on ASACOl 3 times per day. I never had any pain in my bowels. My stool has always been loose, which depends on what I eat or drink. If I'm busy or traveling, I don't have bowel movements very often. Since taking ASACOL, it seems that my bowels are much more loose. Is this just a coincidence? I keep wondering if I do have CROHN'S disease? I am 72 years old. Besides ASACOL, I take COUMADIN, LIPITOR, VITAMIN D3, IRON and ZOLOFT, once a day. Please reply. Thank you very much for your help. Dick xxxx

Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Sohaib replied 1 year ago.

Hello and thank you for the question.
Answers given are for informational purposes only and are not meant to replace an exam by an in-person.
I am Dr. Sohaib, a practicing Internal Medicine Specialist and i will do my best to help you today.

You need to answer a few questions first which will help me assist you in a better way.

Have you lost some weight recently?

What were your symptoms initially when you were diagnosed with crohn's?

Did the doctor took a biopsy from the bowel for the diagnosis?

Customer: replied 1 year ago.


I didn't lose any weight until I have a problem with depression.


 


My problem was that I lost blood. I am on a blood thinner, Coumadin. I had mistakenly take too much Advil for anther problem. I was hospitalized and had 2 pints of blood given to me. I had a colonoscopy and stomach exam.


 


I'm not sure if the Dr. took a biopsy of my bowel. I assume that she did.


I also had a Cat scan and MRI, SINCE.

Customer: replied 1 year ago.


I didn't lose any weight until I have a problem with depression.

 

My problem was that I lost blood. I am on a blood thinner, Coumadin. I had mistakenly take too much Advil for anther problem. I was hospitalized and had 2 pints of blood given to me. I had a colonoscopy and stomach exam.

 

I'm not sure if the Dr. took a biopsy of my bowel. I assume that she did.

I also had a Cat scan and MRI, SINCE.


Expert:  Dr. Sohaib replied 1 year ago.

Thank you for the useful information.

I just received your Reply.

Please wait a few minutes so that i write down and post my answer.

Thank you for your patience.

Expert:  Dr. Sohaib replied 1 year ago.

Okay.

This continuation of loose stools despite using Asacol in crohn's disease can be due to few important reasons such as;

1. Inadequate treatment; may be you need escalation of dose of asacol. Or you need a different formulation of mesalamine (Asacol) (such as timed release or PH sensitive formulations ----- one release mesalamine slowly through out the gut therefore supplying mesalamine to all parts of gut equally; which the other release mesalamine only at colonic ph in high concentration). The choice of formulation depends upon what specific area of your bowel is involved.

Also there are number of other drugs that can be used such as immune modulators and biologics (which provide a rapid relief from the symptoms).

Please note that longer the disease remain in remission, lower are the chances of complications (such as colorectal cancer).

2. Bacterial overgrowth: it is a complication in which there is multiplication of large number of bacteria in small bowel, and can be diagnosed easily by means of a "breath test" and if found to be positive, a round of antibiotics can cure this problem.

3. Irritable Bowel Syndrome: yes, this can co-exist with crohns and may be responsible for the continued loose stools you have. Drugs like colofac can help in this situation.

4. Colon cancer: although the risks increase in long standing crohn's disease, i will consider a re-do colonoscopy if there was weight loss or if the symptoms continued despite treatment or if the symptoms get worse. Other wise, a surveillance colonoscopy for colorectal cancer is planned 8-10 years after diagnosis.

So at this point, you should get back to your doctor, discuss all these details with her, and get further management plan chalked out that suits best to your needs.

She may optimize drug's dose, change/add new drugs, may order some tests.

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service as this is the only way i get credit for my time and expertise on your question.

If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

Dr. Sohaib, Doctor
Category: Medical
Satisfied Customers: 4708
Experience: MBBS, FCPS Experienced in all Medical Specialities
Dr. Sohaib and 4 other Medical Specialists are ready to help you
Customer: replied 1 year ago.


Could my condition have been misdiagnosed? I have never had any pain. Should I get a second opinion?

Customer: replied 1 year ago.


Could my condition have been misdiagnosed? I have never had any pain. Should I get a second opinion?

 

Thank you very much for your help!

 

Dick xxxx

Expert:  Dr. Sohaib replied 1 year ago.

There is no harm in getting a second opinion; but its EXTREMELY UNLIKELY that your diagnosis was not correct; since the diagnosis of crohn's is not only based upon history and physcial examination, but also depends upon the colonoscopic findings as well as histopathological reports by pathologist from the biopsy sample.

Goodluck :)

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service as this is the only way i get credit for my time and expertise on your question.

If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

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