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hello my names amy kousha im one of the gastroenterology doctors at the clinic today can you tell me your name and date of birth please

hello names amy kousha im one of the gastroenterology doctors at the clinic today can you tell me your name and date birth please

my name is bide and my date of birth is first of january of one thousand, nine hundred and ninety

my name is bide and my date of birth is first of january of one thousand, nine hundred and ninety

so bide i understand that you went to see your gp with some changes in your bowel habit can you tell me some more about those symptoms

bide i understand that you went to see your gp with some changes in your bowel habit can you tell me some more about those symptoms

ive been having loose stools diarrhoea for the past few months and i went to my gp

ive having loose stools diarrhoea for the past few months and went to my gp

okay so prior to three months would you say that your bowel habit was normal

okay so prior to three months would say your habit was normal

and have you been passing any blood in your bowel motions

and have you been passing any blood in bowel motions

yeah i do i do get blood in my bowel and my stool and its kind of mixed with the stool

yeah i do i do get blood in my bowel and my and kind of mixed with the stool

and has the blood passage of blood been going on for a few months as well or has that been a more recent change

has the blood passage blood been going on for a few as well has been a more recent change

um that has been happening more recently

um that has been happening more recently

okay and have you noticed any mucus as so that white stringy substance being passed in your stool

okay and have noticed any mucus as so that white stringy substance being passed in stool

yeah now that you mention it yeah i do i do noticed that

yeah now that you mention it yeah i do do noticed that

and what about your weight

and about your weight

so yes it seems like ive lost a little bit of weight simply because my clothes are loosened i havent actually measured it but i people do tell me that ive lost weight

so yes it like ive lost a little bit of weight simply because my clothes are loosened i havent actually measured but i people do tell me ive lost weight

okay and have you noticed any abdominal pain

okay and have you noticed any abdominal pain

yeah i do get a lot of abdominal cramps stomach cramps and thats been also getting worse recently

yeah i do get a lot of abdominal cramps cramps thats been also getting worse recently

and can you tell me when your abdominal pain is worse

and can you tell me when your abdominal pain is worse

it seems like its worse just before going to the toilet and then once i opened my bowels its better

it seems like its before going to the toilet and then once i opened my its better

okay and is it very severe or is it just mild cramping

okay and is it very severe or is it just mild cramping

i wouldnt say its severe that i have to be bend double but it is not mild it is moderate perhaps

i wouldnt say its severe that i have to be bend double but it is not mild it is moderate perhaps

okay and have have you had any episodes like this before of diarrhoea and blood been passed

okay and have have you had any episodes this before of and passed

no i think its been all in the past few months before that i had no problems with my bowel motion

no i think its been all in the past few before that i had no problems with my bowel motion

okay and have you noticed any joint pains

okay and have noticed any joint pains

maybe some pain in my knees especially my right knee

maybe pain in my my right knee

but no not anywhere else

but no not anywhere else

any rashes or skin changes that youve noticed

any rashes or skin changes that youve noticed

and any problems with nausea or vomiting or swallowing

and any problems with nausea or vomiting swallowing

okay so i understand that your gp started you on some steroids is that right

okay so i understand that your gp started you on steroids is that right

yeah so thats correct my gp started me on some steroid tablets which made me feel better initially but its not completely back to normal

yeah so thats correct my started me on some steroid which made feel better initially but its not completely back to normal

okay and do you have any other medical conditions

okay and do you have any other conditions

um i suffer from asthma for which id taken inhalers okay nothing else

um i from asthma for which id taken inhalers nothing else

uh yeah i do

uh yeah i

how many do you smoke a day

how do you smoke day

perhaps about ten a day

perhaps about ten a day

and do you drink alcohol

and do you drink alcohol

okay and is there any family history that you feel might be important and significant medical problems in your family

okay and is there any family history that you feel might be important and significant medical problems in your family

uh my my mom had bowel problems but she died a few years ago of a heart attack

uh mom had problems but she died a few years ago of a heart attack

no i do not have any allergies

no i not have any allergies

and are you working at the moment

and are you working at moment

yeah i actually work in university

yeah i actually work in university

okay so do you have any ideas as to what might be the cause of your symptoms at the moment

okay so you have any ideas as to what might be the cause of your symptoms the moment

not really i dont know what may be happening but whether its even related to my moms condition but i dont know exactly what she had

not really dont know what be happening but whether its even related to moms condition but i dont know exactly she had

so its from the history that youve given me it sounds like you might have a condition called inflammatory bowel disease which your gp may have mentioned but in order to diagnose you with this we will need to do some further tests and investigations to confirm that diagnosis

so its from the history that youve given me sounds like you might a condition called inflammatory bowel disease your gp may have mentioned but in order to diagnose you with this we will need to do some further tests investigations to confirm that diagnosis

so to start rest id like to examine you today and do some basic measurements like blood pressure and heart rate and temperature and i would also like to get some routine blood test and arrange some stool tests as well to send off to the labs does that sound okay to you

so to start rest id like to you today and do some basic measurements like blood pressure and heart rate temperature and i would also like to get some blood test and arrange some stool tests as to send off to the labs does that sound okay you

yeah could you tell me a little bit more about inflammatory bowel disease is it something that i could be treated and cured off or

yeah could you tell me a little bit more about inflammatory is it something that could be treated and cured

so there are two main types of inflammatory bowel disease both types are chronic which means that you know you will have them lifelong but we can use medications to improve the symptoms and to try and normalise your bowel habit as much as possible

so there are two main types of inflammatory disease both types are chronic means that you you will have them lifelong but we can use medications to improve the symptoms and to try and normalise bowel habit as much as

i dont know at the moment which type of inflammatory bowel disease you have whether its ulcerative colitis or crohns disease and thats why well require a colonoscopy which is a camera test it goes up the tail end and we take some photographs on some biopsies to look at the lining of the bowel to try and decide which type of inflammatory bowel disease you have okay does that sound okay to you

i know at the moment which type of inflammatory bowel disease you have whether its ulcerative colitis or disease and thats why well require a colonoscopy which is a camera it goes up the tail end and we take some photographs on some biopsies to look at the lining of the bowel to try and decide which type of inflammatory bowel disease you have okay does sound okay to you

okay so ill arrange those those tests for you and then well see you back in clinic in around eight weeks time

so ill arrange those those tests for you and then well see you in clinic in around eight weeks time

hello my name is amy im one of the gastroenterology doctors can i take your name please

hello my name is amy im one of the gastroenterology doctors can i take your name please

sure its ally cotter

sure its ally cotter

and so youre youve come to the ibd clinic today and you want to tell me what kind of symptoms youve been having

and so youre come to the ibd clinic today you want to me what kind of symptoms youve been having

um for the last few months probably three months ive been having quite a lot of bloody diarrhoea um and i think ive noticed some weight loss as well

um for the last few months months ive been quite of bloody diarrhoea um and i think ive noticed some weight loss as well

okay and when youve noticed the blood has it been mixed in with your stool or has it been just wiping or

okay and when youve noticed the blood has it been mixed in with your stool or has it been just wiping or

yeah okay and how much weight do you think youve lost

yeah okay and how weight think youve lost

im not sure probably four or five kilograms as well its also the diarrhoea i also get some pain as well

im not four or five kilograms as well also the diarrhoea i also get some pain as well

okay and is the pain just there when youre moving your bowels or is it there all the time

okay the pain just there when youre bowels or is there all the time

um no its just kind of cramping comes and goes

no its just kind of cramping comes and goes

okay and hows your appetite been

okay and your appetite been

um not great actually yeah its been reduced

um not actually yeah its been reduced

yeah any problem with swallowing or mouth ulcers or anything like that

yeah any problem with swallowing or mouth ulcers or anything like that

okay and is there any family history of anything

okay and is there family of anything

um my moms dads my grandfather has ulcerative colitis

um moms dads my grandfather has

so i think hes had some problems with his bowels

so i think hes had some problems his bowels

okay and have you ever had bowel problems before this has happened

okay and have ever had bowel problems before this has happened

no okay and are you working at the moment or

no okay and you working at the moment or

um im a student

um im

youre a student okay and i know you havent had any bowel problems in the past have you had any other medical conditions

youre a student okay and i know you havent had any bowel problems in the past have you had any other medical conditions

um no im just asthmatic

um no im just asthmatic

and have you noticed any skin changes or joint pains

and you noticed any changes or joint pains

ive had some rashes on my shins but theyre theyre not itchy or anything they didnt bother me

ive had some rashes on my shins but theyre theyre not itchy or anything they bother me

okay okay and have they sort of come and gone a bit or have they

okay okay have they sort of and gone a bit have they

yeah okay and whats your understanding so far of what investigations youve had

yeah okay and whats your understanding so of what investigations youve had

um well ive had the camera test and i think theyve done some tests on my stool as well and im just kind of in the dark waiting to hear kind of whats been happening

um well ive had the camera test and i think theyve done some tests on my stool as well and im just kind of in the dark waiting to hear kind whats been happening

okay so your stool cultures have been negative so thats the exclude any infective cause of your diarrhoea and obviously youve had your colonoscopy and we took some biopsy results and so that sort of confirms the diagnosis of something something called ulcerative colitis which is a type of inflammatory bowel disease i dont know if youve heard of those terms before

okay so your stool cultures have been negative so thats the exclude any infective cause your diarrhoea and obviously youve had your colonoscopy took some and so that sort of the diagnosis of something something called ulcerative colitis which is a type of inflammatory bowel disease i know if youve heard of those terms before

ive heard my granddad having it but i havent i dont know much about it

ive heard my granddad having but i havent dont know much about it

okay so its sort of chronic inflammatory disease affecting predominantly the bowel but it can affect other parts of the body like skin joints sometimes even the eyes um but thats more unusual um so we were planned to start you on some steroids initially to try and reduce the inflammation down and also medication called pentasa which is a maintenance therapy um so have you had any steroids at all yet from your gp or

so sort of chronic inflammatory disease affecting predominantly the bowel but it can affect other parts of body like joints sometimes even the eyes um but thats more unusual um so we were planned to start you on some steroids initially to try and reduce the inflammation down and also medication called pentasa which is maintenance therapy um so have you had any steroids at all yet from your gp or

no okay so well get you started on those and then arrange to see you back in clinic in a couple of weeks time to see how youre getting on okay have you got any questions youd like to ask about that or

no okay so well get you started on those and arrange to you back in clinic in a couple of weeks time to see how youre getting on okay have you got any questions like to ask about or

um so this maintenance treatment like how long do you think i need to be on that for

um this maintenance treatment like how long do you think need to be on for

so everyones a little bit different in terms of how their disease course progresses um some people are you know very well controlled on therapy for for years and some people have a bit more of a rough ride and require other medications to be added in as well so well keep you on it for you know at least the first year or so and then well review things after that and but also with colitis is a chronic long term condition that youll have for the rest of your life and have to sort of learn to live with as well but theres lots of support available for you as well so

so everyones a bit different terms of how their disease course um some people are you know well controlled on therapy for for years and some people have a bit a rough ride and require other medications to be added in as well so well keep you it for you know at least the first or so and then well review things after but also with colitis is a long condition that youll have for the rest your life and have to sort of learn to live as well theres lots of support available for you as well so

yeah thank you very much

yeah thank very much

hello im amy im one of the gastroenterology doctors can i take your name and date of birth please

hello im im one of the gastroenterology doctors can i your name and date of birth please

yeah sure its annie caldwell and its the second of february one thousand, nine hundred and eighty two

yeah sure its annie caldwell and its the second of february one thousand, hundred and eighty

great thank you and so what brings you to clinic today annie

great thank you and what brings you clinic today annie

um so i have crohns and i have had for many years

um so i have crohns and i have had many

for about twenty years now um and ive tried loads of treatments for this and recently its been quite well controlled but recently my bowels have been kind of more watery and ive been going more frequently and im just feeling really tired and lethargic and exhausted um so and ive had to take time off work actually

for about twenty now um and ive tried loads of treatments for this and recently its been quite well controlled recently my have been of more watery and ive been going more frequently and im just feeling really tired and lethargic and exhausted um so and ive had to take time off work actually

okay oh im sorry to hear that so i know that youve previously been on a combination of steroids and azathioprine and now youre on something called adalimin adalimumab

okay oh im sorry to hear that i know that previously been on a combination of steroids and azathioprine and now youre on something adalimin adalimumab

and how have you been getting on that

and how have you been getting on that

um its been fine its like my symptoms have been well controlled and ive been getting on fine with my life but it just seems to be recently that its kind of my symptoms kind of come back again but i dont really know whats been happening

um its been fine its like my symptoms been well controlled and ive been getting on fine my life but it just seems to be recently that its kind of my symptoms kind of back again but i dont know whats been happening

okay and are you managing to take your injections regularly

okay and are you managing to take your injections

at home and things any problems with the injection sites

at home things any with the injection sites

im usually quite good of my treatments

usually good of my treatments

okay and have you noticed any blood in your bowel motion or is it just very watery

okay and have you noticed any blood in your bowel motion or is it just very watery

no no blood actually just kind of watery going more often

no blood actually just kind of watery going more

and any abdominal pain

and any abdominal pain

yeah i do have pain its quite mild though

yeah i do have pain quite mild though

ive always kind of had pain throughout my life and my tummy so its its not unusual for me and kind of combination with everything else

ive kind of had pain throughout my life and my tummy so its its not unusual for me and kind of combination with everything else

okay yeah and i know youve got a background of rheumatoid arthritis as well is that flared up recently or has that been okay

okay yeah and know youve got a background of rheumatoid arthritis as well is that flared recently or has that been okay

no its been okay my rheumatoids quite well controlled as well yeah

no its been okay my rheumatoids quite well controlled as yeah

and what medication are you taking for that

and what medication are you taking for that

okay and are you using that quite regularly or

okay and are you using that quite regularly or

um no as again its been okay yeah

um no as again its been okay yeah