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Irritable Bowel Syndrome/Patchy Congestion & Inflammation in Colon

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Question
Hi

I have suffered severe nausea and bloating and a slight burning sensation across my lower abdomen.  I had cameras down my throat and up my back passage - can't remember the terms you use.

They found evidence of gastritis, acid reflux and I have a sliding hiatic hernia.  I am now sleeping on a wedge and not too worried. However, they also found patchy congestion and inflammation in my colon.  They took 4 biopsies.  I asked at the time if this could be IBS and they said there was no way IBS could cause the inflammation.

The biopsies came back negative.  They also did a test for an infection (can't remember which) which came back negative.  They tested for celiac disease and I assume that was negative because not been told otherwise.

Upon seeing the results doctor has diagnosed IBS but the consultant said IBS could not cause this inflammation?

I'm now taking a drug that is supposed to help IBS but on reading the info for the tablets it says they are to stop spasms.  I don't get spasms!  Just burning, bloatation and nausea.

If I don't have cancer, an IBD such as Crohn's, and inflammation can't occur in IBS what could this be assuming Celiac is also not a possible diagnosis?  I used to take effexor and amisulpride and transferred to sertraline several months ago and have had severer stomach problems since.  However, I did have similar problems before I started the efexor.  Could anti-depressants be doing this to me?  I don't take a lot of anti inflammatory drugs so can't see it being that either?

Would a general food allergy/intolerance test be a good idea?  can certain foods cause such inflammation in the colon?

Your help would be much appreciated I'm not getting any answers, am feeling very uncomfortable and the tablets the doctor gave me are not helping!

Thanks

Answer
Hi Michael, thanks for getting in touch. I can understand your confusion and concerns over this. Clearly, you have been told conflicting advice and I will take you through this. You had an endoscopy and were found to have evidence of reflux or GORD.

Now comes the more difficult bit! The Colonoscopist found inflammatory changes, but the biopsies are normal. Why? Well, sometimes the bowel preparation can cause the lining of the bowel to be a bit engorged with blood and can look like inflammation. In this situation, the biopsies are normal usually. Secondly, the colonoscopy shows inflammation, but the biopsies taken have been misinterpreted in the lab. Third possibility, the wrong biopsies where sent to the lab. Which one is it? I donít know! What do I normally do in this situation? I normally advise repeating the test due to the uncertainty of the test and re-biopsy. Not pleasant I know, but I think this is necessary when I see this with my patients.

Never assume, check your coeliac results with your doctor! Can antidepressants cause your symptoms? Certainly they can cause GI upset so its worth discussing with your doctor. Would a food allergy/intolerance test make any difference? In my opinion no! Is this IBS? You donít mention about your bowel movements, but you can read more about IBS on my web site, IBS Help Online. You also might find an IBS diet helpful too.

Good luck Michael!

Peter

Irritable Bowel Syndrome

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Dr Peter Thatcher MBBS, MRCPI. IBS Physician & Gastroenterologist

Expertise

I can answer questions on all aspects of IBS or the Irritable Bowel Syndrome, Medicine and Gastroenterology. This would include aspects of diagnosis, investigation and management of IBS and other gastroenterology or medical conditions.

Experience

I am a Consultant Physician and Gastroenterologist in the United Kingdom. I qualified as a physician in 1993 and have been practicing Medicine and Gastroenterology ever since. I regularly run gastroenterology clinics and 1:4 patients have IBS. I am also the web master of IBS Help Online, an Irritable Bowel Syndrome help site.

Organizations
British Society of Gastroenterology Member of the Royal College of Physicians of Ireland Consultant Physician and Gastroenterologist, Royal Cornwall Hospital, Truro, Cornwall. UK

Education/Credentials
Consultant Physician and Gastroenterologist, Fully UK Trained Medical Degree at Kings College School of Medicine & Dentistry 1993 Membership of the Royal College of Physicians of Ireland Examinations 1997

Awards and Honors
MBBS 1993 MRCPI 1997

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