Does Crohn's disease always manifest with diarrhea?

by Jennifer
(Ontario, Canada)

My four year old son has had bright red blood in his stool and iron deficiency for about eight months now. Of course my holier than thou doctor doesn't think the two are related. Needless to say I am seeking another opinion. I'm concerned because Chrohn's disease is prevalent on my husband's side of the family. His mother, cousin, aunt and great aunt all have it. I am so frustrated with my doctor but here in eastern Ontario it's really hard to get a family doctor. Please help I don't know what to do to get my doctor to listen to me.

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Does Crohn's disease always manifest with diarrhea? NEW
by: Annette Young

Hello there,

I am sorry to hear that you have concerns over your son. I completely get why you are worried. Crohn's certainly does run in the family so your son has a far greater risk of getting the disease as a result unfortunately.

Crohn's disease can have a variety of symptoms including diarrhea and constipation among others. It can also be difficult to diagnose.

Sadly, your doctor's reaction is not an isolated case and i think that you should seek advice from another doctor.

Some medical professionals are very aware of Crohns and others are not. If your son is bleeding consistently, then an iron deficiency is likely and it is important that his iron levels are topped up.

I would change my doctor or at the very least, take a load of Crohn's literature with me and point out the similarities of any symptoms. I would also keep an eye on his diet. You need to establish any food or drink that could also be affecting the disease. Give your son a bland diet, easy to digest but with plenty of nutrients. Avoid fizzy drinks.

Of course, there are tests that need to be done first, as a correct diagnosis must be made but if it is Crohn's, your son is likely to need medication.

I attach a link that may be of use.
http://www.webmd.com/ibd-crohns-disease/crohns-disease/crohns-disease-in-children-and-teens

Hope this helps.

Annette
crohn's diagnosis NEW
by: Anonymous

Hi Jennifer, my 12yr old son was diagnosed with crohn's disease three years ago. I had the same problem with my son's former pediatrician. He kept telling us my son had a virus and the diarrhea would eventually stop. My son lost a lot of weight, and wasn't growing the way he should be. We finally deceided to take him to a pediatric gastroenterologist. He had bloodwork and a colonoscopy and endoscopy done. He was then diagnosed with Crohn's. I don't know how your health care system works in Canada, but try and find someone who can properly diagnose your son. You may have to come to the US to find a pediatrics gastroenterologist. I hope he feels better soon. Take care
when your doctor wont listen to you.. NEW
by: Anonymous

most people dont like making a fuss but if you feel unwell and you are getting no better and you think no one is taking any notice, you have to grab the bull by the horns and go for it ,you dont have to be rude just say i would like a second opinion and if this fails BE RUDE,,,TELL YOUR DOC YOU WILL DO EVERYTHING IN YOUR POWER TO SUE THEIR BACKSIDE OFF IF ANYTHING HAPPENS as you have everything documented ..this usualy does the trick.
There are a lot of challenges with paediatric Crohn's - stunted growth, delayed puberty, time off school, generally not being able to participate in life (the really bad cases), etc. NEW
by: Lydia D.

If I were a doctor, I would be very concerned about a child with blood loss. Everybody knows that steady blood loss affects Hb levels.

There are many Crohn's subtypes and one is a constipating Crohn's - others include fistulating, stenosing and stricturing, Crohn's of the skin, Crohn's with diarrhoea, etc. All with or without varying degrees of pain. It took me a couple of decades to get a diagnosis - I never had blood or pain until it got completely out of control.

Crohn's diagnosis seems to peak around 30 and again around 50.

I think that your fears that it is Crohn's are very real and you need to find a good gastroenterologist.

It is a hereditary disease and over 70 susceptibility gene loci have been detected to date. They think that there might be over 300 Crohn's susceptibility gene loci - which would explain the overlapping with other (auto)immune diseases. There is about a 10 to 30% chance of children getting the disease if the parents have Crohn's or are carriers of the susceptibility genes.

There are a lot of challenges with paediatric Crohn's - stunted growth, delayed puberty, time off school, generally not being able to participate in life (the really bad cases), etc.

The way to make the doctors sit up and listen is to keep a food/mood/symptom/medication diary and to graph your sons blood tests. Use the following to describe the problem:

CDAI
http://www.ibdjohn.com/cdai/

Bristol Stool Scale
http://en.wikipedia.org/wiki/Bristol_Stool_Scale

The comparative pain scale (no pain 0, 10 excrutiating pain)
http://www.tipna.org/info/documents/ComparativePainScale.htm

For children the following faces pain scale can be used:
http://www.iasp-pain.org/Content/NavigationMenu/GeneralResourceLinks/FacesPainScaleRevised/default.htm

Mood diary
http://web4health.info/it/bipolar-self-monitor.htm

Prepare thoroughly for a doctor's appointment with bullet points for items to discuss. http://ibdcrohns.about.com/od/diagnostictesting/a/15minutes.htm

Crohn's
What is Crohn's Disease?
http://www.crohns.org/congress/submission01/appiv.htm

Crohn's Disease
http://www.mayoclinic.com/health/crohns-disease/DS00104

Crohn's Complications
http://www.umm.edu/patiented/articles/how_serious_crohns_disease_000103_4.htm
http://www.umm.edu/altmed/articles/crohns-disease-000043.htm

I also refer you to this site:
http://www.nlm.nih.gov/medlineplus/crohnsdisease.html


How old is your son? NEW
by: Dannielle

How old is your son? I find that if Doctors don't listen then change in process and keep the old Doctor til you find a new one. Also, research... research.... research and be your own physician. Try aloe vera juice if over age two and try instant carnation and the vitamins he is lacking. Usually, having diarrhea for me is common however the older i got the sometimes i am constipated but that is because I have kink in my small intestine. Brat diet works wonder and sorry for the Doctors giving you trouble in the eastern side the western side is not helping either. Good luck to health and happiness. Dont give up.

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