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Diagnosed with Crohn's disease after abdominal surgery. What treatment do you suggest for constant nausea?

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Internal Medicine Specialist
Practicing since : 1980
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My son (age 21) has been diagnosed (4 yrs ago) with Crohns after abdominal surgery. I do not believe he has the correct diagnosis. (He was being operated on for appendicitis when they discovered inflamation and removed some of the inflamed bowel). There was much disagreement about his diagnosis in the hospital. He is seeing a GI specialist and they have stayed with that diagnosis even though he does not, and has never had, the typical symptoms of Crohns. He does have near constant nausea, stomach pain and fatigue. He also has hand temors. He seems especially prone to infections. He has gum disease and has had strep and mono this year. Any thoughts?
Posted Fri, 29 Nov 2013 in Abdominal Pain
Answered by Dr. Rakesh Karanwal 1 hour later
Brief Answer: Endocopy + colonoscopy for alternative diagnosis Detailed Answer: Hi there, Thanks for your query. To be XXXXXXX I cannot comment on the findings of the inflamed bowels, which lead the surgeon to diagnose Crohn's disease. There are several possibilities:- * A delay in diagnosis of Appendicitis with consequent spread of bacterial infection in the adjacent bowel, mistaken for Crohn's disease. * H. pylori infection of the stomach/ intestine which produces similar symptoms, in addition to occasional inflammation of bowel. Alternatively, given the history of gum disease, the causative organisms trickling down into the stomach and intestine can also cause bowel information. * Irritable Bowels (in view of present symptoms and tremors, which can be due to anxiety/mental stress) * Ulcerative Colitis or non-specific colitis. * Celiac disease or food intolerance, which is characterized by abdominal problems following ingestion of wheat, barley, rye, soya products, dairy products etc... Now that surgery has been carried out and part of bowel removed, the only course of action left to establish the diagnosis is, to do colonoscopy along with biopsy of the inner lining of the bowel. Colonoscopy will provide valuable information. Secondly, an endoscopy with biopsy of the stomach lining, which will establish the diagnosis of H. pylori infection (completely treatable/curable with 2-3 weeks' of therapy). If you son has deep anxiety/mental stress (which can account for hand tremors), Irritable Bowels would be the obvious diagnosis. In that event, regular anti-anxiety + anti-depressants will keep the abdominal problems under check. Kindly discuss my views/opinions/recommendations with the treating doctor, who- if concurs with my opinion- will then opt for the best course of action for your son. Hope I have answered your query. I will be happy to address to further clarifications, if any. Fond regards, Dr. Rakesh Karanwal
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