I was diagnosed with Crohn's disease more than 25 years ago. Recently, I changed GI doctors, and after various tests, my new doctor believes I have irritable bowel syndrome (IBS) and not Crohn's. I have the same symptoms I've always had: pain in my lower right abdomen, constipation/diarrhea and some inflammation in my lower colon. Is it possible for the Crohn's to turn into IBS? I am very confused.

Jane

Crohn's disease is a chronic inflammatory disease affecting the digestive tract (most often the lower part of the small intestine and the colon). Symptoms include diarrhea, abdominal pain, blood in the stool, fevers and weight loss. The diagnosis is usually made when a patient undergoes a colonoscopy) for such symptoms, and the doctor detects ulcers or other damaged tissue in the bowel. Symptoms of Crohn's usually not seen in patients with IBS include fever, gastrointestinal bleeding, anemia, and diarrhea that occurs during sleep or that leads to anal incontinence.

IBS is a chronic condition characterized by a change in bowel habits (most commonly alternating bouts of diarrhea and constipation) associated with abdominal cramps, mucus in the stool, abdominal bloating and a change in the thickness and consistency of the stool. In contrast to Crohn's, IBS does no visible damage to tissue in the bowel. The exact cause of IBS is not clear. However, it appears to include a psychological element of anxiety/depression.

If your new doctor is questioning your diagnosis of Crohn's, then your old records should be reviewed. In addition, it may be necessary to repeat some tests (such as colonoscopy and small-bowel radiographs) to reassess your case. Keep in mind that Crohn's can also go into remission, especially with the right medications, and that you may not have any evidence of active disease at this time.