Gastroenterology/Chronic pain in Bowel area
QUESTION: Hello and thank you in advance for answering my question.I'll give you my stats first 41 female Crohn's disease 12 years 17.5 milligrams prednisone is there. 3 75 milligrams apriso daily. About 2 months ago I started having pain between my vagina abd
rectu.m inside .and I just assumed it was a Crohn's issue So I went to the hospital because the pain got pretty bad and they did a CT scan and they could not find anything wrongMy crohns is always in remission I take good care of myself and really have a flare upBut I don't understand what this pain could possibly be figured it was something in my colon maybe a tumor god only knows whatSo I honestly just don't know what to do I do not have insurance and I don't want to have to keep going to the ER but if they couldn't find anything wrong what gives I don't know what to think what's your opinion? The pain never goes away it's a constant but I figured if it was something terrible they would have seen it on the CT. I do not drink or smoke I keep my stress low I generally take good care of myself and I just don't know what it could be.Thank you very much for your time have a great day Never had children not pregnant anything like that
ANSWER: Hi, sorry I do not know your name
Do not kill the messenger, but the first what came to my mind it is a possibility of the rectovaginal fistula with pain in the woman with 12 years of Crohn’s disease and taking prednisone and mesalamine (5-aminosalicylic acid). It is rare, but having Crohn's disease increases your risk of this condition.
You have to be checked by GYN doctor and proctologist. It is difficult to rule out flare up, hemorrhoids, very rare condition as rectal diverticula, etc. Try to get the reason for your pain. It can give a clue for the proper treatment.
I see, you take good care of yourself. Just taking prednisone and salicylates is symptomatic, anti-inflammation treatment. With age, it is very difficult to continue taking or get rid of them. You may easy your condition by other approaches. Educate yourself.
I wish you health.
Peter Melamed, Ph.D.
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QUESTION: Hello and thank you for your reply. Sorry for some of my grammar as I was using my smartphone. Yes you are right about the meds. My Gastro calls them the love hate drugs. Love the remission, hate the long term side affects. But, it wasn't until I got introduced to natural solutions that my Crohn's improved. However, when I tried to taper off Prednisone and other meds completetely I flared up again. So even though I swear by my natural supplements and lifestyle changes (because that's what keeps me well) I have tried many times to get off meds and the best I can do is low doses but not completetely. I have tried. I just accept it now but the goal is always to get off prednisone. Anyway, how serious is that (possible)condition that you mentioned? I'm not insured but trying in next few months...thanks again for your time.
By answering medical questions, for me the most important thing is the safety of those who asked me and then education of them. Sorry, I do not know your name, your detailed history, I did not check you; therefore, giving you medical advice will be unprofessional. Is your condition serious? I do not have the answer because we do not know why you have a pain.
Pain in the perineum area in person like you has to have various reasons. The primary goal is to find them. The medication that you take decrease inflammation and also repairing. In the rectum, there is severe mechanical damage; cells of the mucous membrane constantly change and new cells grow. If this repair mechanism reduces, ulcers or fistula may be developed. You have to be checked!
Next, after taking prednisone more than 10 mg during 2 months, your adrenals stop or produce the low amount of your own prednisone (cortisone). “What we do not use, we lose.” If you reduce prednisone fast, you can have adrenal deficiency. Withdrawal from hormone therapy needs the restoration own adrenal function, time and supervision of a knowledgeable medical practitioner.
I wish you health and happy life.
Peter Melamed, Ph.D
Biotherapy Clinic of San Francisco