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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diarrhea, Maroon Substance In Stools, Mucus, Ammonia Smell. Weight Loss And Cramping. Have Crohns Disease. Normal?

I am passing whole undigested food with diarrhea . Accompanied with this I also have a lot of maroon like substance and mucus and smells like ammonia . This started around 3 days ago. I m having weight loss over night and stomach cramping. I feel the urge to use to bathroom a lot. Most of what I eat its not digested at all it looks exactly how I swallowed it I eat very healthy. I got diagnosed with crohns disease about 2 months ago and I m on pentasa but it doesn t seem to be working. Another concern is i m also a T1 diabetic and for the past 2/3 days when this kicked in have been having a difficult time keeping my BG up even though ive adjusted my pump I m still constantly staying between average of 50-90 and beginning to spill small ketones. Is this normal for crohns disease?
Fri, 16 Nov 2012
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Gastroenterologist 's  Response
Hello, crhand.ch,
I see that your diagnosis of Crohn's disease was very recent and you have
been put on Pentasa as part of the treatment. I am not sure if you know
how much of your intestines are affected by Crohn's. Typically it affects
the last portion of the small bowel and the beginning of the large bowel,
the area called the ileo-cecal junction. But the disease can affect any
part of the digestive tract from mouth down to the anus. Maroon
colored stools are suggestive of colon involvement, Crohn's Colitis.
If your type-1 diabetes is well controlled, the diarrhea is probably
not from that, a condition called "Diabetic Enteropathy" due to lack
of digestive enzymes from your pancreas.
I am assuming you are on adequate dose of Pentasa.
From your response, this has not been effective.
It is possible that you could try other Mesalamine products such as
Asacol and see if the response is any better.
But, I think because of significant weight loss and presumably blood
loss, Crohn's seems to be active despite your therapy.
There is locally acting steroid called Budesonide which can bring on
remission if the mesalamine is not working. A 9mg. dose daily can
be effective.
There are other ways of treating by using what we call
"Immunomodulator " drugs such as 6-mercaptopurine or Azathiprine.
There are known side effects from this type of drugs.
Next is called "Biologicals" which are highly effective.
The most commonly used drug is Infliximab given as injection.
The best thing I would advice you is to see a gastroenterologist
who can asssess your situation properly and select appropriate
treatment that I have briefly mentioned above.
I wish you well.
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General Surgeon Dr. Biji Thomas George's  Response
You are having an acute episode of Crohns with a probable fistula formation with blind loop.
See a gastroenterologist immediately
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Diarrhea, Maroon Substance In Stools, Mucus, Ammonia Smell. Weight Loss And Cramping. Have Crohns Disease. Normal?

Hello, crhand.ch, I see that your diagnosis of Crohn s disease was very recent and you have been put on Pentasa as part of the treatment. I am not sure if you know how much of your intestines are affected by Crohn s. Typically it affects the last portion of the small bowel and the beginning of the large bowel, the area called the ileo-cecal junction. But the disease can affect any part of the digestive tract from mouth down to the anus. Maroon colored stools are suggestive of colon involvement, Crohn s Colitis. If your type-1 diabetes is well controlled, the diarrhea is probably not from that, a condition called Diabetic Enteropathy due to lack of digestive enzymes from your pancreas. I am assuming you are on adequate dose of Pentasa. From your response, this has not been effective. It is possible that you could try other Mesalamine products such as Asacol and see if the response is any better. But, I think because of significant weight loss and presumably blood loss, Crohn s seems to be active despite your therapy. There is locally acting steroid called Budesonide which can bring on remission if the mesalamine is not working. A 9mg. dose daily can be effective. There are other ways of treating by using what we call Immunomodulator drugs such as 6-mercaptopurine or Azathiprine. There are known side effects from this type of drugs. Next is called Biologicals which are highly effective. The most commonly used drug is Infliximab given as injection. The best thing I would advice you is to see a gastroenterologist who can asssess your situation properly and select appropriate treatment that I have briefly mentioned above. I wish you well.