If these were your stats, what would you push your Dr. for?

Here are my stats:

Symptoms began July 2014 after a presumed stomach bug
-constant urgency issues
-1-3 BMs per day with extreme urgency
-Occasional "attacks" of cramping and constant diarrhea for 5-6 hours straight
-CRP and ESR slightly elevated
-Fecal calprotectin normal
-Have internal hemorrhoids

December 2015
-Colonoscopy showed nothing abnormal except for small patch of abnormal mucosa in rectum which doctors presumed to be irritation from the bowel prep. Many biopsies were taken and all showed "normal tissue".

Symptoms changed in July 2016
-5-10 BMs per day, most being nothing but large amounts of mucus and blood
-August 2016 test showed: Sedimentation rate of 43 (normal range 0-20), negative lactoferrin stool test, 2 parasite + ova test through 2 different labs which showed large amounts of WBC in stool
-Sept 2016: was sent for CT Enterography with Oral & IV contrast. Results were normal.

Symptoms changed abruptly around February 26, 2017
-15-25 BMs per day, diarrhea with mucus and blood (wake up in middle of night with cramping and diarrhea)
-Unusual (for me) cramping all day and night
-Blood work shows ESR at 29, CRP at 13 (normal range: 0-5), Eosinophils 1180 (normal range: 30-350)

I had an appt this past week (when they took blood for the tests above). My GI doc said that if the tests for inflammation were normal, they would put me on Viberzi. If they weren't, they'd do capsule endoscopy. But I haven't heard anything from them yet either way - just have the lab results.

What tests would you want if it were you in my situation? Is the pill cam sufficient at this point?

Do I really need further tests if I previously had a colonoscopy with normal biopsies and a normal CT Enterography (even though those tests were done long before my recent uptick in symptoms)?

Was the colonoscopy in Dec 2015 the only colonoscopy you've had?

You mention you've had blood in your bowel movements. Bright red blood or darker/black/dried blood? Did they ever find the source of the bleeding? Are they just assuming it's from the internal hemorrhoids?

I'm assuming you didn't have any bleeding before the colonoscopy? If you didn't have bleeding with your bowel movements then, but you do now, then a repeat colonoscopy is appropriate (or at the very least a sigmoidoscopy).

You didn't mention if they did stool studies to look for infection?? That seems obvious but I thought I'd bring it up. And yes, I think you need another colonoscopy. I have internal hummus and while they sometimes bleed with bowel movements, it isn't huge amounts of blood and pooping 15 times a day seems extreme for IBS

Agree w all the others. Def, you need to have another colonoscopy and they have to take biopsies. What is the level of your hemoglobin level?

At the very least, get a sigmoidoscopy done. That way they'll know if the internal hemorrhoids are the cause of the blood you get with bowel movements. If that doesn't explain it, then you'd still want a colonoscopy next. So it's up to you and your doctor (and insurance) whether to do the sigmoidoscopy first or just do the colonoscopy.

Pill cams can be very good at finding disease. This is how I was diagnosed in 2006 and I know there are others on this board who have also been diagnosed via it. My GI then confirmed with a colonoscopy. The good thing about the pill cam is it covers your entire GI tract, so inflammation outside of the areas covered by scopes (top and bottom) will be captured through the imagining.

Just make sure your insurance covers it. I had to fight with them for awhile and my GI wrote a letter and it was eventually covered in full.