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Have IBS. Can IBS be the cause of ileum pain?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
Dear Doctor

Can ileum pain be caused from ibs? I have had ibs for a number of years never realy troubled me only cramping in anal area when i have urgent bowel movements. I noticed sudden sharp stingy pains in my ileum they would come and go without warning sometimes every few weeks.
since that pains started i have lost 20 kilos of weight loss in 10 months, and loss of appetite and changes in appetite i have sweet tooth and cravings for high calorie food. And more diarroeoa that efects me even when i do my hobbies. My diarroeoa is dark very glossy in appearence. I had lots of tests all negative . My appendix is in a slightly strange position but normal. five days ago i woke up during the night with stinging and burning in my ileum i felt i needed the toilett but could not do it. since then my pain is more severe and comes and goes more. i went to my gp i had suspected apendicites i was sent to hospital i had an ultrasound no appendix seen. I was very ill in hospital i was constipated and unable to pass wind, my stinging pain in ileum is very sore unable to eat aswel . I had no fever present i was very flushed on my face. I have been let out of hospital as i was improving by taking painkilers paracetemol and codiene .I have a sceduled enteroscopy pill in two weeks. Is this ibs or is this my first severe bout of ileitis?
Posted Tue, 17 Jul 2012 in Abdominal Pain
Answered by Dr. Ketan Vagholkar 1 hour later
Thanks for writing in.
From your description it appears to be Crohn's Disease (inflammatory bowel disease).
weight loss.Even the appendix can be affected by Crohn's disease.
You have also suffered from an episode of intestinal obstruction which is due to strictures of the terminal ileum typically seen in Crohn's disease. Another disease which closely mimics these features is tuberculosis. However TB is not so common in the United Kingdom.
You also give history of allergic or immune disorders which go more in the favor of Crohn's disease.
A capsule endoscopy will be diagnostic. The other alternative to diagnosis is small bowel enema.
I hope this explanation provides you with a road map for further investigation.
With regards
Above answer was peer-reviewed by
Follow-up: Have IBS. Can IBS be the cause of ileum pain? 7 hours later
Thank you for the reply i think me and my symptoms fall very much in that catagory. thats why i im geting so many tests. i can not understand how they have not found it yet. mabee they might now since i had a bad flare up of which im suffering as i write this i have not eaten or been to the toilett and the day is over . i dont want a disease, im just desperate to get my health better with treatment . All the anti spasm tablets ive been getting are not working. Since being on strong pain killers pain is not as bad. my family and have sufered for months. i am a smoker and i have had bad chest infections in the past which i needed steriod tablets prednisolone that two things will not done me much good
Answered by Dr. Ketan Vagholkar 9 hours later

Thank you for the feedback.

Both steroids and nicotine can cause damage to the blood supply of the bowel. This can cause severe cramping pain. This can aggravate an already existing lesion like Crohn's disease.

Therefore you should get yourself diagnosed at the earliest. I feel that a capsule endoscopy will help us here. Discuss with your physician.

Hope this helps. Let me know if you need more help.

Wish you good health.

With regards
Above answer was peer-reviewed by
Follow-up: Have IBS. Can IBS be the cause of ileum pain? 17 days later
Dear doctor

Hi again i would like to ask some more questions. I also updated medical history some things i forgot to put in. I had my pill camera just awaiting results also have a ct scan of small bowel next week. My symptoms are getting very bad at the moment. Regular pains and I have lost more weight and unable to go to work i feel burnt out . I have no appetite unless it is for something sugery. If my tests come back normal is it likely i would be diagnosed with ibs even though i have symptoms that are not of ibs ?. ok i could have ibs because i have known myself as i wrote previously, but that would not explain the extra symptoms like severe unexplained weight loss and suger or sweet cravings and loss of appetite. Could there be something else wrong outside my GI tract. I sometimes notice getting very shaky, lighthead and cold sweats and cravings for suger then i feel better after some buiscuits or cakes. I never used to eat chocolate but now i do. i had an mri scan for my bowel i reacted badly to the barium drink i had a allergic reaction it looked like bite spots on my chest and had severe diarroea

Sorry i pressed submit button before i finnished.

Durring that mri prep i could not manage to finnish the barium drink they took the remaining half a litre of me. The mri consultant asked me a few times if i was diabetic she kept asking are you sure. All i could say was well i dont no, i dont test my blood.
I had to fast for my camera pill the day before all i could think about was suger.
If you were my Doctor would you be happy to diagnose me with only ibs? if there was nothing found in my small bowel. My general doctors would be , but i know my GI doctor is baffled by my mri not showing anything abnormal in my bowel. Ever since my pain in my illeum my health progresivly went downhill. when this pain started i was happy with life i had energy.
Is there any other problems that could be missed or not looked at?
Answered by Dr. Ketan Vagholkar 1 hour later
I can imagine the agony which you are experiencing.
If the results of capsule endoscopy are normal, it suggests that there is no XXXXXXX lesion.But persistence of symptoms especially pain with weight loss could also be due to ischemic colitis (mesenteric vascular insufficiency)as you have been taking both nicotine and steroids in the past.The diagnostic test for that would be CT angiogram of the abdomen.
I feel that is the only possibility which can be perhaps missed or overlooked amidst a set of normal reports.
I hope this answers your query.
With regards
Above answer was peer-reviewed by
Follow-up: Have IBS. Can IBS be the cause of ileum pain? 5 hours later
hi doctor thanks for your reply. im not sure what that type of colitis is, i will wait for my results in the meantime. I do know something is not with right my health My general doctors are not easy to talk to.
Could my cold sweating and shakes for suger fix be something to do with my bowel.
thanks again
Answered by Dr. Ketan Vagholkar 10 hours later
Thanks for the feedback.
Your symptoms of cold sweating ,shakes and sugar craving are unlikely to be related to the bowel.
They are related to the autonomic nervous system. This is a part of the nervous system which controls several involuntary things like heart rate, breathing rate etc. It would be advisable to get your sugars checked during such a episode.If that comes as normal then you don't have to worry.If abnormal it could possibly be related to the neuroendocrine dysfunction. If that is the case, a detailed workup would be needed.
I hope this answers your query.
With regards
Above answer was peer-reviewed by
Follow-up: Have IBS. Can IBS be the cause of ileum pain? 18 days later
Hi doctor
Im still awaiting results from my pill cam and ct scan. I have been feeling better for four days now eating better and generally feeling well with minimum pain.
The last time i had severe pain was four days ago, last wednesday. i felt normal pain dull ache and sharp stings most of that day coming and going like usual. At night time it got so severe just before going to bed i laughed at somthing and the pain was so sharp in my ileum my laughing turned to teers. I tried walking it seemed to come on from walking and breathing in and ou it was so sharp more than before . I didnt need to go to the loo either, i felt no need to . I was awake most of the night in pain but it eventually
went away. Since then i have felt generally better eating better minimum pain. But still have watery diarreoa which is like marroon in colour, or soft dark glossy porridge like.
Im still unable to gain weight that i have lost even when feeling better. Is these symptoms still like crohns ? or appendix crohns or something else?
I also read about ischemic colitis its about blood loss to the gut. If someone has this do other parts of the body get affected in simillar ways for example varicocele? I also suffer
from that when im in a flare up
Answered by Dr. Ketan Vagholkar 16 hours later


I am happy to hear about some improvement in your symptoms.

Irritable bowel syndrome cannot cause such significant weight loss as described by you.

Persistence of watery diarrhoea suggests the high likelihood of inflammatory bowel disease. Your capsule endoscopy results would help in arriving at a conclusion. Computed Tomography (CT) of the abdomen will help only if there is a significant mass or thickening of the intestine. Any way let’s wait for the result.

For the time being you can take antispasmodic medications to reduce the severity of the attack.

In addition, I would suggest you to start a course of probiotics for a period of 21 days. It will surely help in controlling the increased frequency assuming it not to be crohn's disease.

Once endoscopy results are available then specific treatment can be commenced.

Ischemic colitis has nothing to do with varicocele. It does not affect the genitourinary system.

I hope I have answered all your queries.

With regards
Above answer was peer-reviewed by
Follow-up: Have IBS. Can IBS be the cause of ileum pain? 1 hour later
Hi thank you again doctor
My results are taking a while my gi doctor been on holiday.
I have tried so many different types of spasm pills with no real positive effect including peppermint oil. They cause ibs type anal pain proctalgia fugax when walking around during the day its stingy pain going down rectum and through tip of penis. And also levator ani it feels like a XXXXXXX hanging of my tailbone. Only experience this pains when on spasm meds and makes no improvement to my my pain or bowel movements. I even bought lavender tea thinking it would really help but never.
My weight is the worrying symptom in all this. I was 94 killos feeling fit enjoying food and so on. Now down to 70 killos and unwell.
I know everyone is different but what would be classed as abnormal weight loss in ibs bowel symptoms? And how much weight loss if any, suffering drastic severe ibs likely to experience?
I know from 10 years suffering ibs having a bad day of it, or week, i might lose a pound or two, but would it would only take a good day to put it back on again . And when stress causes ibs i would comfort eat and put weight on.
Thanks again doctor.
Answered by Dr. Ketan Vagholkar 47 minutes later
Significant weight loss is loss of 10% bodyweight within a span of 6 months.
The presence of pain like proctalgia fugax is suggestive of a significant component of stress. Even disorder. Usually there are no findings on investigations. Yoga has been shown to have a fairly good therapeutic impact on the severity of symptoms in irritable bowel syndrome.You can try yoga till the reports of your investigations are available. If anti spasmodic pills do not work then you can stop taking them.
With regards
Above answer was peer-reviewed by
Follow-up: Have IBS. Can IBS be the cause of ileum pain? 48 hours later
Hi doctor thank you for reply
My pill cam results are in and have been marked normal by the doctor and ct scan .
I feel very strange at the moment . I dont know what to do now or where to go from here , i just simply want to find out my problem and get better. The only findings that have been found through all of my tests is my appendix is prominent and slightly in a strange position but i feel this is unlikely to cause any problem im not to sure? And my colonoscopy showed i have a touch of ibs that was what i remember the colonoscopist said.
Its amazing to me, so much pain and diarrea and significant weight loss that my gut looks normal. Im going to try a probiotic coarse to see if this works.
Is it possible i have multiple food intolerences?malabsorption or bacteria overgrowth or candidiass in my gut that can cause weight loss and other symptoms outside gi tract one of which is cravings for sugery foods and deserts. Should i get tests for that.
Answered by Dr. Ketan Vagholkar 38 minutes later
Thanks for writing in.
It is good to hear that your capsule endoscopy report is normal.There is a likelihood of malabsorption syndrome wherein the person can have significant weight loss. The diagnosis would rest on blood assay of various vitamins, stool evaluation for fats and a small bowel biopsy.
But since the capsule endoscp.results are normal the site for biopsy again cannot be determined.
I would therefore suggest a 4 week course of probiotics along with glutamine supplements.Glutamine has a positive growth effect on the inner linning of the gut. Perhaps this could improve your bowel absorptive function.
I hope this answers your doubt.
With regards
Above answer was peer-reviewed by
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