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

my name is bide and my date of birth is first of january of 1990

my name is abide and my date of birth is first of january off 1990

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

so whyd i understand that you went to see your gp with some changes in your bowl have it can you tell me some more to buy those symptoms

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

ive been having loose twos dia beerfor the past few months and i went to my gp

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

okay so im prior to city months would you say that your battle have it was normal

and have you been passing any blood in your bowel motions

on have you being passing any blood in your bell 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 mouthon my stool and its kind of mixed with this too

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

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

um that has been happening more recently

and 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 you noticed any mucous eso thats white stringing substance being passed in your studio

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

yeah now that you mention it i do i do know is that

and what about your weight

and what about your wit

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 seems like ive lost a little bit off wait simply because my clothes are looser nowi havent actually measured it but i people do tell me that 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 off abdominal crowned stomach crampsand thats been also getting worse recently

and can you tell me when your abdominal pain is worse

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 worse just before going to the toilet and then once i opened my blouse better

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

okay on dhis 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 severethat i have to be been double but it is not mine it is this 100 perhaps

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

okay on dh have have you had any episodes like this before off look diarrhoea on blood being 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 months before that i had no problems with my bow emotion

okay and have you noticed any joint pains

on dh have you noticed any joint pains

maybe some pain in my knees especially my right knee

maybe some pain in my knees especially my right knee

but no not anywhere else

but no not anyone 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

any problems with nausea or vomiting or 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 some 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 gp started me on some steroid tablets which made me feel better initially thats not completely back to normal

okay and do you have any other medical conditions

okayah nde do you have any other medical conditions

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

and i suffer from asthma for which id taken healers okay nothing else

and do you smoke

do you smoke

uh yeah i do

uh yeah i do

how many do you smoke a day

hi many do you smoke a day

perhaps about 10 a day

perhaps about the other day

and do you drink alcohol

and do you drink alcohol

only socially

only socially

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

okay on 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 my my mom had about problems but that she died a few years ago off a heart attack

okay and any allergies

on any allergies

no i do not have any allergies

no i do not have any allergies

and are you working at the moment

and are you working at the 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

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

and no really i didnt knowwhat may be happening but whether its even related to my but moms condition but i dont know exactly what 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

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 mentionedbut in order to diagnose you with this we will need to do some further tests and 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 examine you todayah nde do some basic measurements like blood pressure and heart rateim came pictureandi i would also like to get some routine blood tests on dev in some stew tessas well to send off to the labsdoes that sound okay to 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 bowel diseaseis it something that i could be treated in cuba for

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 bowel disease both types are chronic which means that you know you will have them lifelong but we can use medications teo improve the symptoms on to try and normalise your battle habit as much as possible

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 dont know at the moment which type of inflammatory bowel disease you have whether its ulcerative colitis or croons diseaseand thats why well require a colonoscopy which is a camera test it goes up the tail end on we take some photographs on some biopsiesto look at the lining of the barrel to try and decide which type of inflammatory bowel disease you have okay does that 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 back in clinic and around it im

okay thank you

thank you

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

hello my names amy im honest gastroenterology doctors can i take your name please

sure its ally cotter

sure its anne coulter

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

on dh youve come to the i v d clinic today do you want to tell me what kind of shit claims 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

and for the last few months probably 30 months ive been having quite off bloody diarrhoea and andi i think i know some weight loss is well

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

ok when youve noticed the blood has it being mixed in with your stewart hasnt bean just wiping or

mixed in yeah

mixed it yeah

yeah okay and how much weight do you think youve lost

how much do you 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 sure probably 45 kilogrammes as well its also the diary i also get some peyton as well

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

okay on its opinion just there when youre moving your bells are there all the time

um no its just kind of cramping comes and goes

and i know its just kind of cramping comes and goes

okay and hows your appetite been

okay hows your appetite being

um not great actually yeah its been reduced

a not great actually he has been reduced

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

yeah any problem swallowing are my cell service or anything like that

okay and is there any family history of anything

okay and is there any family history of anything

um my moms dads my grandfather has ulcerative colitis

and my moms dodds and my grand grandfather has ulcerative colitis

so i think hes had some problems with his bowels

so i think you sense and problems with this

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

okay on have you ever had problems before they happen

no okay and are you working at the moment or

no okay andi are you working at the moment or

um im a student

a m a student

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

your student okay on dh i havent had any problems in the past have you had any other medical conditions

um no im just asthmatic

and you know i just lost my head

and have you noticed any skin changes or joint pains

and have you noticed any skin changes or joint pains

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

ive got some rats is formations but there were no its you anything

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

okay okay that they should have come and gone a day or has a

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

yeah okay on dh whats your understanding so far 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

and well ive had the camera test and i think theyve done some tests on my still a swell i just kind of in the dark waiting to hear can cause harm me

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 stew cultures have been negative so thats to exclude any infected because of your idea on obviously youve had your colonoscopy and we took some biopsy results 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 youre imperative those terms before

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

i think about my granddad having it happened i didnt

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

okay so its a chronic inflammatory disease affecting predominantly the barrel but it cant affect other parts of the body like skin joints sometimes even eyes on dh thats more unusual so we plan to start you on some standard initially to try and reduce the information down on also medication called taesa which is a maintenance state a p so have you had any standard to tell 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 no okay so well get you started on those on then arrange to see you back in clinic and a couple of weeks time to see how youre getting on okay if you got any questions youd like to ask about that are

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

to this maintenance treatment like how long do you think i need to be on that 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 little bit different in terms of high their disease course progresses and some people are you know very well controlled on therapy for years and some people have a more rough ride and required other medications to be added in a swell so well keep you on it for you know at least if our year or so on them will give you things after that on the ulcerative colitis is a krone along parent condition that you have for the rest of your life i have to sort of learn to live with as well but theres lots of support available or soon

yeah thank you very much

yeah thank you very much

okay thank you

okay thank you

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

hello im mainly i wanted to gastroenterology doctors can i take your name and date of birth please

yeah sure its annie caldwell and its the second of february 1982

yeah sure its anne caldwell on its the second of february 1982

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

great thank you so what 22 clinic today on me

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

so i have cones and i have had for many years

for about 20 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

yet proven 20 years now and ive tried loads of treatments for this on dh recently its been quite well controlled but recently my bowels of being kind of more water and ive been going more frequently im just feeling really tired lethargic and exhausted and so 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 im sorry to hear that so i know that youve previously been on a combination of steroids and a society on dh now youre on something called outer limit of the little love

yes thats right

yes right

and how have you been getting on that

on dh how have you been getting on 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

and its been finest like my symptoms have been well controlled and ive been getting on fighting with my life just seems to be recently that is kind of my symptoms could come back to me bets i dont really know whats been happening

okay and are you managing to take your injections regularly

okay you managing to take your injections regularly

at home and things any problems with the injection sites

woman thinks any problems at the injection sites

no no

no

im usually quite good of my treatments

im usually quite good of my treatments

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

ok and have you noticed any blood in your body motion or is it just barely walk today

no no blood actually just kind of watery going more often

no no blood actually just came out watering going more often