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Could I Have Ulcerative Colitis? How Does It Normally Present.

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Posted on Mon, 11 Mar 2019
Question: Could I have ulcerative colitis? How does it normally present. My main symptom is an intermittent abdominal pain that happens every 20 minutes or so on the left side of stomach parrell to my belly button. Sometimes I have diarrhea but sometimes my stools are Normal. No apparent blood in stools. I’ve been feeling it for 4 weeks. It started 1/21/19, stopped 1/26, then started again 1/30. I had a CT scan, stool sample, and blood tests done that all came back normal. Would these tests have picked up UC or Chrons or do I likely just have a mild case of IBS?
doctor
Answered by Dr. Ramesh Kumar (2 hours later)
Brief Answer:
Go for colonoscopy.No these tests wont.

Detailed Answer:
Hello there,
Welcome to 'Ask A Doctor' service.I've gone through your query in details.I can understand your concerns,

1)As CT scan and stool tests are normal it could not be diverticulitis.
2)Yes it could be ulcerative coilitis or Crohn's disease but it would not be reflected in a CT scan.Colonoscopy would be done and microscopic study of sample of intestine would be performed to rule out the pathology of disease.
3)However a screening test called fecal Calprotectin can be done.In any inflammatory condition level of Calprotectin rises. However gold standard test is colonoscopy.

4)If all test are normal then you would be considered as a patient of IBS because IBS is a diagnosis of exclusion which means that when despite of all possible tests no disease is there pathologically but patient has symptoms we label them as having IBS.

5)loose motions abdominal pain and rectal bleeding are usually the presenting features of ulcerative colitis but problem with gastroenterology is that almost all problems from inflammatory bowel disease to simple diverticulitis have same symptoms.Therefore tests have to be done.

Hope my answer was easy to understand.
Follow ups are welcome.
Regards!
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ramesh Kumar (2 hours later)
Thank you. Are my symptoms more likely correlated with IBS or UC/Chron's? I do not have blood in my stools and still have a normal appetite, no weight loss. My main symptom is the intermittent abdominal pain that goes on throughout the day. I have 3-4 bowel movements a day, not all of which are diarrhea.
doctor
Answered by Dr. Ramesh Kumar (11 hours later)
Brief Answer:
follow up.

Detailed Answer:
Hello and thanks for follow up,
Very likely your symptoms are suggestive of irritable bowel syndrome.However as explain earlier IBS is a diagnosis of exclusion and there is no test to directly rule out IBS.
Hence a colonoscopy is to be done.
For your symptoms to be relieved as of now you can take antispasmodic like Dicyclomine 10 mg twice daily.
You would need a prescription for the same.
Thanks.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2910 Questions

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Could I Have Ulcerative Colitis? How Does It Normally Present.

Brief Answer: Go for colonoscopy.No these tests wont. Detailed Answer: Hello there, Welcome to 'Ask A Doctor' service.I've gone through your query in details.I can understand your concerns, 1)As CT scan and stool tests are normal it could not be diverticulitis. 2)Yes it could be ulcerative coilitis or Crohn's disease but it would not be reflected in a CT scan.Colonoscopy would be done and microscopic study of sample of intestine would be performed to rule out the pathology of disease. 3)However a screening test called fecal Calprotectin can be done.In any inflammatory condition level of Calprotectin rises. However gold standard test is colonoscopy. 4)If all test are normal then you would be considered as a patient of IBS because IBS is a diagnosis of exclusion which means that when despite of all possible tests no disease is there pathologically but patient has symptoms we label them as having IBS. 5)loose motions abdominal pain and rectal bleeding are usually the presenting features of ulcerative colitis but problem with gastroenterology is that almost all problems from inflammatory bowel disease to simple diverticulitis have same symptoms.Therefore tests have to be done. Hope my answer was easy to understand. Follow ups are welcome. Regards!