IBS or Colitis?

The following is an Editorial Resource from YourTotalHealth.

ulcerative colitis
questionIs it IBS or Colitis?

I'm 17 years old and have been dealing with a stomach/intestinal issue for almost a year. It started off with pain in the stomach every time I ate or drank anything (even water!). The pain wasn't that bad at first, but gradually got worse. It was a sickening, nauseating, cramping, bloating pain.  My doctor thought that it could possibly be a stomach ulcer.

When I went to get an upper GI test, there was no ulcer. The only thing that helps the symptoms, especially my stomach, is smoking cannabis. I didn't mention that to my doctor?should I?

There's also been constipation throughout.  My doctor now thinks it might be either IBS or colitis. Between IBS and colitis, which seems more likely that I have? And if it is IBS, then what about the excruciating pain I experience when I eat and afterwards?


AnswerPain in the GI tract can be a very frustrating problem. It is difficult to describe. It can be unpredictable and it can be quite debilitating, but it remains invisible to others. It sounds as though you have suffered for quite some time from these problems. As a physician, the clues we look for would be any signs of a more systemic illness with a low blood count and elevated marker of inflammation or unexplained weight loss. All of these would prompt a directed workup in certain ways. 

The fact that sometimes your symptoms are directly related to specific foods suggest that this may in fact involve the GI tract, and the upper GI exam being normal is helpful but only part of the evaluation. The term "colitis" implies that your doctor may think you have inflammation of the large intestine. That is a diagnosis that can be made with a colonoscopy and biopsies of the lining of the large intestine. Usually, patients with colitis experience urgency and frequent trips to the bathroom, and in the condition known as "ulcerative colitis," there is also rectal bleeding. Based on what you have shared, it does not sound like you have ulcerative colitis. The other organs that are involved in digestion, and may be contributing, include your gallbladder and your pancreas. I would suggest that you consider discussing this with your doctor to find out whether or not an abnormal gallbladder may be contributing to some of your problems.

As for the marijuana use, it is known that cannabis can aid in bowel relaxation and pain, as well as increase appetite. Unfortunately, this ?therapy? has not been fully explored and obviously remains illegal in most places. I am sure this is a difficult challenge for you and would encourage ongoing discussions and approaches by your doctor. There are good treatments, whether this is an irritable bowel or some other condition, and I would encourage you to find someone who will continue working with you until the right treatment and control of your symptoms are identified.

?Dr. Rubin

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