A Rare Bird

May 12, 2009

I had a check-up with the gastroenterologist this morning to get the results of the tests I had a couple of weeks ago. I’d hardly sat down in his consulting room when he announced “I’ve got the answer to your problem”.  I could have hugged him there and then. You see, after two months of struggling with constant diarrhoea and pain, I’d reached a stage where I didn’t care what diagnosis was made as long as treatment was available.  As it turns out, I’m not just a fine old bird, I’m a rare one as well!

Ever heard of microscopic colitis? I certainly hadn’t until today. I know about ulcerative colitis and Crohn’s and coeliac disease but no, Steph had to go and get something much rarer. The biopsies and blood tests have confirmed that I’ve developed an inflammatory bowel condition known as microscopic colitis (MC). The cause of MC is currently unknown. One theory is that the use of non-steroidal-anti-inflammatory drugs (NSAIDs) may contribute to the development of the condition. Another theory is that MC is caused by an autoimmune response where the body’s immune system attacks other tissues in the body. This is similar to the autoimmune disorders that cause chronic ulcerative colitis and Crohn’s disease. It’s also thought that bacteria or viruses may play a role in the development of MC but the exact relationship is unknown. As I’ve been on NSAIDs for years, have a long history of problems with autoimmunity and appear to be riddled with bacteria, it seems I was a sitting duck to develop this condition. My EDS is also thought likely to be a predisposing factor.

The symptoms of microscopic colitis are chronic, watery diarrhoea, accompanied by cramps and abdominal pain. Other symptoms include fever, joint pain, and fatigue. I’ve had them all unfortunately. The condition has been known to resolve spontaneously after several years but most patients have recurrent symptoms. Treatment varies depending on the severity of the symptoms. Anti-diarrhoeal and anti-spasmodic agents are the first line of treatment but as they’ve failed to work for me so far, I’ve been started on the same anti-inflammatory drug used to treat ulcerative colitis and Crohn’s. If this treatment fails, I will move onto corticosteroids but hopefully this won’t be necessary. Steroids and Steph do not go well together.

Living with any form of colitis is never easy but today at least, has felt positive. I’m very fortunate to have been thoroughly investigated and diagnosed in a matter of weeks. Some people have to wait years for a diagnosis. The tests might have drawn a blank leaving limited treatment options or worse, the diagnosis could have been very much more serious. Next week, I head to the UK for investigations of a very different kind but that’s a story for another day. In the meantime, thanks to an upstart airline, I’m off in a few days to dip my toes in the Med. I might not return.