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Why is it difficult to diagnose?


At 9 Natalie Rosenthal starts terribly stomach pain, fatigue, en diarrhea. She has dark circles under her eyes. She stopped getting taller or gaining weight.

“I had cramps when I ate something,” says Rosenthal, now an adult. “The pediatrician first told my mother that I had a nervous stomach. Medical to calm down muscle spasms did not help, and her mother tried to make another diagnosis.

“She was a real tiger,” said Rosenthal, who lives in Atlanta. “She kept taking me back to the doctor. She said that I was not a nervous child and that I was not afraid of school or socializing. She said: ‘It is not psychologically. ‘

After a year, a gastroenterologist gave Rosenthal a colonoscopy showing that she had Crohn’s disease, not nerves. Symptoms of Crohn’s include stomach painfatigue, diarrhea, nauseaor vomiting, so doctors may confuse it for other conditions. Tests that show infection or its damage, such as lesions, may reveal the correct diagnosis.

Different people, different symptoms

Crohn’s is caused by an out-of-whack immune system that causes inflammation in your digestive tract.

It is difficult for doctors to diagnose the disease because it can affect different parts of the canal. This means that not everyone has the same symptoms, says Edward V. Loftus, MD, a gastroenterologist at the Mayo Clinic in Rochester, MN.

“It is important to rule out other conditions because the symptoms are not specific,” he says.

Stomach pain, diarrhea and fatigue can also mean that you have irritable bowel syndrome (IBS) or celiac disease, says Loftus.

Mild inflammation may not appear on blood tests. Your doctor may mistakenly think you have it anemia of low iron, not of low iron and the bleeding that can occur with Crohn. Infections such as salmonella, E coli, en tuberculosis may also have Crohn’s-like symptoms.

The treatment for these conditions is completely different, says Loftus, so it is important to definitely test before you start, says Loftus.

You can help the process

Talk about all of your current or past symptoms so your doctor can determine Crohn’s clues, says Shamita Shah, MD, medical director of the inflammatory bowel disease program at Ochsner Health System in New Orleans.

She says that some people have a symptom, like blood in the stool, and they think, ‘Oh, it’s just piles. ‘It goes away, and then it comes back months or even years later. ”

Do not avoid any symptoms from your doctor as you may be embarrassed or think that this is not a major problem. And do not wait until it becomes unbearable too, says Shah. You may damage your intestines or need stronger treatment.

‘I saw patients come to the hospital to undergo surgery appendicitis, and then it turned out to be Crohn’s, ”she says.

Get the right tests

Blood tests may show signs of inflammation, but your doctor will probably need to see the inside of your digestive tract to diagnose you, says Shah.

“Crohn’s can affect you from your mouth to your anus, so we need to look for inflammatory signs,” she says. These include lesions, or areas of inflamed tissue along areas that appear normal.

These are the most common tests:

  • Colonoscopy uses a small camera that is inserted through a long tube into your anus while you are anesthetized or asleep.
  • Enterography is a type of scan that takes a cross-section of your digestive system.
  • Endoscopy can show lesions in your upper digestive tract.

If these tests still do not confirm Crohn’s, your doctor may want to do a wireless capsule endoscopy, Loftus says. You swallow a pill with a small camera in it that allows your doctor to see your entire digestive tract.

Do not ignore the symptoms

Crohn’s can affect children, teens or young adults, Shah says. You may be tempted to treat your symptoms on your own, or even reduce them, but these are not good ideas.

Some young people are ashamed to tell anyone about it, or they think nothing is wrong, she says. ‘They do not know what these symptoms mean, or feel that it is not really a big problem.

Years ago, Dana Hartline was diagnosed with ulcerative colitis, a disease that also causes pain and diarrhea. About a year later, she found out she really had Crohn’s.

Everyone’s body and illness are different, says Hartline, who lives in Marietta, GA. Her doctor at the time was not willing to listen to her concerns or questions. “I did not have enough experience to know what to ask, and I was in so much pain at the time,” she says.

If you feel that your diagnosis is wrong because you are not relieving any treatment, speak up.

Or look for a doctor who suits you, says Hartline. “The diagnosis and treatment came easily when I had someone who was willing to spend time with me, and who actively gave me the background and education about the disease, what to expect, what is normal and what.” can raise a red flag.



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