Back in 2013, I mentioned that I started having diarrhea episodes reminiscent of episodes I had back in 1993. The cause for these episodes in 1993 was never clear. They mostly cleared up spontaneously sometime in 1997 as far as I can recall. At this point, I was dealing with continuous lower gut symptoms of spray painting and the cheesegrater made worse by the aerophagia. On December 16, 2016, after I had dinner, I felt ordinary abdominal pain for like the first time in 30 years. It was in the lower right quadrant. It wasn’t super bad, probably a 4 out of 10, but it was quickly followed by nausea, which was extremely intense and then I started vomiting and I vomited and vomited and vomited. The vomiting just would not stop. I immediately became concerned this was a pseudoobstruction, but if you think it didn’t make much sense. The upper gut symptoms mostly resolved after the PEG and the lower gut symptoms had resolved from the olanzapine. Anyway, a trip to the ER revealed an elevated white count and a CT revealed an obstruction.

 

The less than competent physicians at the ER somehow chalked it up to a spontaneous adhesion. However, a fecal calprotectin taken later on was elevated and an MRI enterography confirmed Crohn’s disease. 

 

So how did I develop it? I have a theory. The aerophagia and the upper gut symptoms conditioned the LES to relax to get the air out. It failed, but instead created LPR, which led to me to take H2 blockers and PPIs full dose for years. That altered the gut flora by reducing the stomach acid and allowing bacteria that would otherwise be killed to grow in my gut and produce a dysbiosis that led to the Crohn’s.

In later years, Crohn’s is becoming more than a nuisance and I had to get more aggressive in treating it.