# How accurate is a CT scan of abdomin? Please help, need advice!



## Jen37 (Nov 10, 2011)

Last Saturday I ended up going to the ER due to severe pain in my very low intestines and pelvic area. I also have been having vaginal discharge off and on that is pinkish tinged. I also told the ER doc this. Well they ended up doing blood work and urine tests. They were normal. At that point they were just going to send me home. Well after my husband and I begged do have a CT scan, they did one. I did not drink any contrast, but they did inject me with an iodine contrast in my vein. Well the ER doc comes and says the CT scan was normal and he had no explanation for my pain and basically told me to follow up with my doctor.

I have had a few tests so far since having intestinal issues for the last 2 years. These are the tests I have had: Blood work, stool cultures, MRE of small bowel, CT scan and abdominal ultrasound.

Well after the doctor at the ER discharged me, I decided to get a copy of the CT scan. Well low and behold it was NOT normal. It stated that they found uterine fibroids. This is not normal. I am not sure if this had anything to do with that sevre pain or not though.

I mean I have not had a colonoscopy as of yet. My gastro doctor thinks it would likely make me way worse. He thinks I have IBS. I had a nasty reaaction to the MRE I had when I drank all that contrast and it gave me severe diarreha and in turn I got a UTI that I suffered with for over 2 months. Well after that my gastro said he did not think doing a colonoscopy would be a good idea since I would have to drink all that prep which would likley mess my bladder up again( I also have IC).

My question is this, I am worried about this being crohns disease. I mean no matter what I eat, even if I dont eat much, I still have a lot of pain in my intestines. Would a CT scan have seen crohns?? I mean mind you, I did not drink any contrast at all. I asked the ER doc there and he said that since I had the IV contrast that it was like 90% of a good picture. He said the oral contrast will give you like a 99% picture. So he said it was ok and they WERE able to get a good picture without the oral contrast. He said he was sure they would have seen crohns if I had it with my MRE and with this CT scan. But I am not sure, I mean everywhere I read, it says crohns is very hard to diagnose. Do you think if this was crohns or like an abcess or complications from crohns that the CT and MRE I had three months ago would have found something??

Also, can uterine fibroids cause intestinal pain that is chronic???


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## Kathleen M. (Nov 16, 1999)

CT scan would see the thickening of the small intestine as would the MRE, as would your blood tests.

If all your blood tests are normal it is unlikely you have Crohn's and IBS can cause as much or more pain that Crohn's does.

Fibroids can cause pain, but mine was mostly during a period, but they could very easily cause the pink discharge. Fibroids are pretty common so even if "abnormal" sounds like they weren't explaining the symptoms. IBS can cause severe pain as can the other painful functional bowel disorders.

Usually pain severity isn't what tells them apart. If you are getting fistulas (internal between the intestines and other organs, or to the outside) have bloody diarrhea, inflammation markers being high and inability to maintain weight that would say something is still being missed by the tests.

And a colonoscopy often doesn't see Crohn's anyway and they would do a CT scan or MRI/MRE to see the areas they can't see with the scope.

Really, IBS is bad enough, you don't need to have Crohn's to be having severe pain and other symptoms of IBS.


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## Jen37 (Nov 10, 2011)

Thanks Kathleen for the response. I was just concerned since with the CT scan I did not really drink any contrast and they say that sometimes you cannot get a good pic unless you drink the contrast or have the contrast up the rear. I have issues with the contrast so I just was able to do the IV contrast. I dont know how well they can see the bowels especially if they have fecal matter in them without the oral or rectal contrasts. I mean I literally had one ER doc lady tell me, NO a CT would be useless unless you drink the contrast. Well after she left and shifts changed, I had another ER doc and he said you could still get a decent picture without it. I mean who am I suppose to believe???

I have an appt. with a gyne on Feb 5th about the fibroids. I will likely need a ultrasound. The ER doc said that he for sure seen one fibroid that was 4 to 5 cm in size. The other ones he could not tell. He said CT is not the best at diagnosing fibroids, that an ultrasound is better..

I am just so frustrated. I mean I have all these health issues. I mean I have the bladder issue, the fibro, the skin rash under my left breast that flares up when my intestines are flaring, muscle pains all over..and now the gyne thing. I may also have endometriosis. My late gyne who I use to see for years retired and she told me years ago she was sure I had it. I just was not having too many issues back then so did Not really look into it. I mean you have to have a laprocsopy to dx that and I in no way want to have surgery if I dont need it!

If this is all IBS, then this is awful!! I would not wish this on anyone.. It is so horrible, the pain. Thanks again for all your info, I appreciate it..


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## Kathleen M. (Nov 16, 1999)

The fibroids can cause pain, where mine was (inside the uterus on a stalk) it really only hurt at that time of the month. Only when it made the bleeding really really heavy did we need to do anything about it. A lot of time if they aren't causing problems you can just wait for menopause and then they shrink up on their own when the hormone levels drop.

Doctors aren't quite as bad as economists but they often won't agree. I think that your blood work is normal and you aren't reporting any bloody diarrhea or weight loss that doesn't make any sense because you are eating more than ever probably makes Crohn's unlikely. Why do you seem to feel it has to be that and every test has to have missed it? Is it just you can't believe IBS (nerve pain which is often the worst type of pain there is) can be this bad? Or is there something else?

Fibromyalgia (muscle problems) and IC and IBS do seem to run together fairly often.


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## Jen37 (Nov 10, 2011)

I guess I just cant accept all these symptoms I am having as being just IBS. I mean I have lost like 10 pounds in the last couple months, but likley due to me not eating much due to all the pain I get when I do eat. I have a very limited variety of things that I can eat and even those seem to bother me.

Last week when I went to the ER in severe pain they gave me IV zofran and 3 tylenols. Well I had a severe bout of constipation the other day and now have a lump on my anal area. I am thinking it may be a hemrrhoid. I mean my whole anal area gets inlammed and irritated a lot. I dont get it as I do not have diarreha which would explain anal irritation and I do not normally have constipation either. My biggest issue is severe pain.

It is not that I do not believe that IBS can be that bad, it is just that I dont know anyone else with IBS that has all the issues I am having. Most seem to do well when they change their diet. I do not. I mean I get all these little things too that are just weird. Like I have a rash that flares at times and it is only under my left breast and rib cage area. It is not big, just a small area. I saw a dermatologis thinking it was heat rash but he said no. I just put cortisone on it when it gets real bad. Then I have this feeling lately( since I had that bout of constipation the other day) that I can feel something in my anal area, like inside. I also have air escaping as well. Not like when you have flatulence and it makes a noise, just it seems to slip out with no noise or anything. It kind of feels swollen in there. I mean I guess maybe that could be from that bout of constipation and the possible hemrrhoid too.. I just dont know.

I just cannot figure out why I cannot accept the IBS diagosis. Maybe it is because I have not done a colonosocpy yet due to my high risk for other complications and my GI does not feel I need to have it done, he thinks it will make me worse( and I agree). But there is that lingering question of maybe there is something more going and I they are missing it. I have visitied the crohns board in the past when I first had issues with my intestines and some of the people on there were saying that they were all told they had IBS at first too only years later to end up having surgery due to dmamage and it being crohns disease all along. Pretty scary.

I think I would feel a lot better if there was something I could take that would relieve my symptom without causing severe side effects. I mean everything I have tried for the IBS either does not work or I get bad side effects from it. 

I think if I was able to find something to relieve my symptoms some, then I would feel better and not so worried if that makes any sense.

Thanks for listening and all the support. I really do appreciate it. It is just so difficult to live like this which I am sure you know all about it, you have been there and know what it is like..


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## Kathleen M. (Nov 16, 1999)

My pain was severe, like I'd drop to the ground severe.

Diet made zero difference in my symptoms. Diet works well for some people, but it is not required for IBS.

A lot of us respond to when the colon is more active and it does that regardless of which thing you eat. If gas volume is a bigger trigger then diet will often make a difference.

Will they do the pill camera? I don't know if you need as much prep, but you might. It will be more likely to see Crohn's than a colonoscopy (as crohn's can be where the colonoscopy won't reach, but then the MRE and the CT see all the parts the colonoscopy can't reach, but I don't know if it will convince you, either.

Zofran can be constipating, was the tylenol with codiene? That can do it too.

When you have multiple issues (and all your issues can have a functional explaination and having one functional issue can make you prone to have multiple functional issues) often you do end up choosing which side effects you want to deal with, and likely all the drug for crohns which are much more powerful will set something or other off so it isn't like they are likely to make you feel great and not bother anything else. Some of them can be pretty rough on the body.

If you had something autoimmune going on it would show up in the blood tests after all this time. Also sounds like normal weight loss. Losing weight when you eat less is normal. Usually they are much more worried when you lose weight and you are eating an extra thousand or two calories as a midnight snack because even a large dinner will not hold you until breakfast and you are still having a hard time maintaining weight.


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## Jen37 (Nov 10, 2011)

Yeah, The pill cam you still have to do all the prep so it would probably effect me the same way as a colonosocpy would( regarding drinking all the prep).

I mean last night I woke up at 1 in the morning in severe pain in my lower intestines.Felt like massive gas pains that would come in intervals. Now this morning I got up used the toliet and it it was so hideous(the smell), Very acidic and sulphuric smelling. I am afriad to eat even as I feel like i have the Bid D coming on. I hope I did not pick up C-diff when I was in that ER last week! I mean I am on antibitocis long term low dose to prevent UTI's so that is always a worry. But I was verycareful not to touch my mouth and washed my hands All the time when I was in the ER, so maybe it is not that at all. I just dont know. I always though IBS would NOT wake a person in the middle of the night usually( at least that is what all the sites about IBS say).

Anyhow, it seems you had a terrible time with the IBS though so I guess it can be bad. Like I said, I just need some relief. I guess my next step is starting the imipramine. I held off due to the fact that elavil was hard on my bladder and this imipramine is a sister drug. But right now I am desperate and need some relief of any kind.

Oh, the tylenol they gave me in the hospital was just plain tylenol. Would that be constipating?? I hope not, I mean that is about all I can take actually, I cannot take NSAIDS.

Thanks again for the help and support. I hope you are doing well.


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## Kathleen M. (Nov 16, 1999)

Plain tylenol usually isn't constipating.

About the "wake you up at night" thing.

IBS is LESS likely to wake you up at night with pain than GERD. It is not impossible for it to wake you up at night. It does tend to calm down at night but it doesn't mean impossible to have symptoms at night.

I looked up the study where they did the red flag work. I don't have the exact numbers but pain that wakes you up at night was like 5% for normal healthy people 30 % for people with IBS and 60% for GERD.

If you do have watery diarrhe PREDOMINATELY at night and usually are OK during the day that also tends to not be IBS but tends to be microscopic colitis, but that is not it once in a great while wakes you up at night that is it is more diarrhea during the night most of the time when you have diarrhea.

So if you have a lot of night symptoms they may need to also check for GERD which tends to cause pain much more when you lie down than when you are up and about or like I said if you have a lot of watery diarrhea mostly at night when you do have diarrhea that would need a colonoscopy with biopsies, but sounds like your night symptoms are once in a while, not mostly at night and much less during the day.


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## Jen37 (Nov 10, 2011)

Kathleen M. said:


> Plain tylenol usually isn't constipating.
> 
> About the "wake you up at night" thing.
> 
> ...


Thanks for the info. Yeah, I do not have Gerd, I was checked for this before. My symptoms are all in my intestines, usually the lower intestines. That is where am having my pain. I have only been woke up twice from sleep so far for my pain and all in the last week. I took the imipramine this morning. Gastro gave me 10mg. Already my bladder is a bit upset( and I only took half the pill). I was really hoping I would be able to take this without it upsetting my IC. I also had issues with the elavil messing making my bladder flare as well . This really sucks. I am still going to give it a try for a few days though and see how it goes, you know, give it that ol college try! Thanks again Kathleen for all your support!


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## Kathleen M. (Nov 16, 1999)

It may be worth discussing Desipramine which is in the other group of tricyclics as sometimes that is better tolerated before giving up on TCA's all together if this one doesn't work so well for you.

And I do think sometimes calling them "red flag" symptoms can make it sound like it just can never happen in a given syndrome or disease. Usually nothing is black and white or absolutely can't happen. Usually it is a red flag because it is more common in another disorder or isn't likely to be directly caused by the disorder so needs more investigation. Weight loss is like that. Nothing about IBS prevents you from ever losing weight again. But nothing about IBS directly prevents you from absorbing calories or using them. So if you lose weight for reasons anyone would lose weight then it may be indirect (like if I eat as much as I used to I feel sick) or because of any of the many myriad other things that can directly cause weight loss. It may not mean you don't have IBS at all, but may mean you have IBS and another disorder that is causing the weight loss (like new onset of diabetes). Nothing about having IBS prevents other things from going on.


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## Jen37 (Nov 10, 2011)

Kathleen M. said:


> It may be worth discussing Desipramine which is in the other group of tricyclics as sometimes that is better tolerated before giving up on TCA's all together if this one doesn't work so well for you.
> 
> And I do think sometimes calling them "red flag" symptoms can make it sound like it just can never happen in a given syndrome or disease. Usually nothing is black and white or absolutely can't happen. Usually it is a red flag because it is more common in another disorder or isn't likely to be directly caused by the disorder so needs more investigation. Weight loss is like that. Nothing about IBS prevents you from ever losing weight again. But nothing about IBS directly prevents you from absorbing calories or using them. So if you lose weight for reasons anyone would lose weight then it may be indirect (like if I eat as much as I used to I feel sick) or because of any of the many myriad other things that can directly cause weight loss. It may not mean you don't have IBS at all, but may mean you have IBS and another disorder that is causing the weight loss (like new onset of diabetes). Nothing about having IBS prevents other things from going on.


Thanks Kathleen,

Yeah, that makes sense, I understand what you are saying. I am sure my weight loss is likely just due to me not eating as much due to how it makes me feel. I can always ask my regular doc to check my Vitamin levels ( Vit D and Vit B 12) just to make sure they are ok next time I see her. One thing is for sure, digestive disorders really suck. I would have to say for me the worst and 2 most painful things I deal with would be the IC bladder and IBS. They are torture. Thanks for the tip on the desimpramine. If the imipramine does not pan out, I will ask my GI doc for the desipramine. Thanks again..


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## TVgirl (Sep 16, 2009)

It would show severe chrohns but doctor really has to scope tge intestine to look at it. But the fibroids could be problematic. You could have endometriosis wuth fibrous tissue in your abdomen stucking to bowels etc causing pain and inflammatuon. I had fibroid and endometriosis and had lots of cramps and bowel pains/problems. I wiuld go for gynecological checkup.


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