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What Causes Tiny Bumps On Stoma When Suffering From Crohns Disease?

Posted on Fri, 2 May 2014

Question: Hi i was diagnosed with crohns disease 21 years ago and have recently had a permanent ileostomy in january due to a undiagnosed condition which they feel was not to do with ny crohns. I had lots of other symptoms as well as the extreme weight loss and unable to have a bowel moment properly, these were including joint pain and boney lumps appearing on hand and chestplate, coldness, aching in the right calf, tiredness, pain what almost feels like its in my veins also i havnt been able to have a blood test in the last 6 months without my veins collapsing. I had some blood tests run and it was commented that my vit d is 15.5 my b12 is 241 myferritin is 7.7. my uibc is 67. iron 6.0. total iron binding 73.0. transferrin saturation 8.2. I also have lots of tiny lumps all over my stoma spout which they are not sure about. surely all of this must point to something, im currently on no medication and am very tired and ache most of the time. I appreciate your input.

Answered by Dr. Ashish Verma (18 hours later)

Brief Answer: its all due to uncontrolled Chron's Detailed Answer: Hi XXXXXXX Thanks for writing to HCM. I have looked at the uploaded reports. Those bumps you are having over your hands and chest plate can be 'erythema nodosum' if they are red in colour and painful. And they are mostly due to your Chron's only. Also the tiny lumps over your stoma could be pseudopolyps due to your Chron's. Following a permanent iliostomy, you are bound to have deficiencies of those nutrients which are absorbed either in the terminal ileum or colon. Iron, vit B12, vit D are all absorbed in the terminal ileum, also a major portion of the food is also absorbed in this region. This may be the reason why you are having severe weight loss and those vitamin and iron deficiency. Also the thrombosis of veins is seen is a minority of patients with Chron's. This my explain your pain in calf and collapsing veins. And all this needs treatment for your Chron's which you are not taking and so your Chron's is progressing. If peripheral venous access is not possible in you, a central venous line can be safely put in you, preferably one having double or triple lumen, where one lumen can exclusively be reserved for parenteral nutrition and supplements and from other medicines can be given. Because building up your nutritional status is equally important as is controlling the disease. Talk about this with your doctor. I m sure thing will work out in a better way. Hope i have been helpful. Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Ashish Verma (1 hour later)

Hello thankyou for answering the lumps on my hand and chest plate are not external, sorry maybe i didnt explain them very well. They are internal and almost feel like a extra boney growth i am also suffering alot of back ache, some coxis pain and tender (almost feel like they are bruised) bottom 2 left side rib at the side i have had this for over 7 months now. I have been told that all these symptoms are not my crohns as i have had blood tests and a colonoscopy and it is not active.Also can you advise me on what the best treatment for crohns would be with a ileostomy and would it be more advisable to have a central venous line to take the medication. thankyou

Answered by Dr. Ashish Verma (15 minutes later)

Brief Answer: see an orthopedic for back pain and swelling Detailed Answer: Hi XXXXXXX In that case i would suggest that you get an xray of your hand to see if the swelling is indeed from the bones, and show to an orthopedic who will also examine then and your spine for your back pain. For nutrition, though home parenteral solutions are available, but they need a venous access. But as you said that getting a peripheral venous line is very difficult in you so you can get a central line inserted and get that administered. That wont be needed for ever, once your nutrition improves then you can be maintained on oral diet. If your Chrons is not active then no medication are needed. In any case steroids and antiinflammatory drugs are best for chrons. Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Ashish Verma (3 hours later)

Thankyou, also probably of no concern but i thought i would also mention my blood pressure on my right arm reads 128/82 and my left 112/84 for a long time, on my left arm i also have a very large raised vein on my inside elbow crease which often stings. This vein often collapses on blood tests. Thankyou

Answered by Dr. Ashish Verma (2 hours later)

Brief Answer: it can be due to peripheral vascular disease Detailed Answer: Hi XXXXXXX A difference of more that 15 points or more between systolic pressure in both arms is linked with 2.5 times extra risk of peripheral vascular disease, mostly due to arteriosclerosis. Also it signifies increased risk of heart diseases. So you need to show to a cardiovascular specialist for proper evaluation of the same. Dont ignore it, maybe its in early stage and can be treated or reversed. Regards Dr. Ashish Verma

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Above answer was peer-reviewed by : Dr. Yogesh D