Discussions By Condition: I cannot get a diagnosis.

Can someone help with diagnosis

Posted In: I cannot get a diagnosis. 7 Replies
  • Posted By: t_spoon
  • April 10, 2008
  • 00:25 PM

Patient details
Male, African-American married school teacher, 37 years old, 5’10” in height
Weighs 70kg, former smoker stopped 4 years ago, blood pressure 138/80
Clinical presentation
Day 1
Loose stools and mild abdominal pain for 8 days. Cramping and fullness, feeling tired. Patient suspects food poisoning. Patient has managed symptoms by taking light meals and drinking lots of fluids. Diarrhoea has stopped.
Pronounced abdominal cramping with frequent evacuation of loose stools some of which contain blood. Feeling not related to meals. Diarrhoea comes on suddenly and impacts on his sleep and his job as a teacher.
Medical History
Past medical history unremarkable. Has never travelled outside USA. No use of antibiotics or NSAIDS
No family history of gastro-intestinal disease, cancer or autoimmune illness.
No family history of diabetes or atherosclerosis.
Medical examination
No abdominal mass or abdominal distension, but diffuse tenderness. Rectal examination shows stools containing mucuc, but no bright red blood or peri-anal disease.
Lab/clinical results
All lab results within normal ranges except presence of faecal leukocytes, decreased potassium and declining albumen.
Colonoscopy of terminal ileum has ruled out Crohn’s disease
Sigmoidoscopy shows diffuse erythema and mucopus
Endosopic biopsy histology shows inflammatory cells in lamina propria, acute cryptitis. Biopsy from normal area shows no pathology in transverse colon.

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7 Replies:

  • Have you been tested for HIV?Infections of lamina propria and acute cryptitis can be symptoms. Sorry, I don't mean to scare you, but you may want to check it out.
    Beth56 272 Replies Flag this Response
  • t_spoon,Some of your lab results came up with similar results that can appear with HIV. Also, mucous in your stools. Being that I thought you and your doctor would have covered the normal considerations, I gave you what might not have been covered. Perhaps an outside chance, but something we all should not ignore. STD's can also present some of these symptoms (proctitis).To be fair, your symptoms could be colitis, which could be caused by a number of things including parasites or antibiotics. You could also have inflammatory bowel disease, or diverticulosis. Has your doctor ruled these things out?Also, have you had a full colonoscopy of the large intestine? You mentioned a sigmoidoscopy only.I hope you find your answer. My family and I all seem to be suffering from different kinds of bowel problems this year. It's very disheartening to not know what's causing the problem. Me, I was just diagnosed with diverticulitis after spending days in the hospital in extreme pain. My first colonoscopy is coming up. Yahoo!Regards, Beth
    Beth56 272 Replies Flag this Response
  • Hey, thanks for your help, i was just wondering Beth you seem very very knowledgeble< are you a medical professional?
    t_spoon 2 Replies Flag this Response
  • Hey, thanks for your help, i was just wondering Beth you seem very very knowledgebleNo, I am not a health care professional. But I have taken care of several family members during illness. And along the way picked up some knowledge. Other than that, I love research and helping others any way I can.
    Beth56 272 Replies Flag this Response
  • If you love research why dont you do a phD or an research based MSc, at present am studying an MSc and its fun
    t_spoon 2 Replies Flag this Response
  • Sounds like an infectious etiology (GI) could be protozoa, bacterial, viral, helminth. Might want to read Jordan Rubin's book "patient heal thyself" if you run out of options - in which he details his struggle w/ GI problems. Also there is the SCD diet that should be considered. Also badbugs.org for some reference.
    LINENUP 122 Replies Flag this Response
  • If you love research why dont you do a phD or an research based MSc, at present am studying an MSc and its funNah, I've recently retired. So many things to enjoy, so little time. :p
    Beth56 272 Replies Flag this Response
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