Hello. I'm new here and I'm posting because I have an urgent and very worrying question.
My medical history is very complicated. I was diagnosed aged 2 with coeliac disease. However, the paediatrician who diagnosed me, and the GP who confirmed that diagnosis, made the diagnosis purely based on the fact that I seemed to be unwell when I ate gluten and better when I didn't. Doctors I have spoken to more recently have agreed that this was in fact completely unacceptable. At the time my parents were persuaded that it was unnecessarily unpleasant to subject a child of that age to a biopsy test. Unfortunately that decision has led to problems more recently as the gastroenterologist I am now being treated by doesn't really know how to proceed until he knows for certain whether or not I actually have coeliac disease. I was perfectly healthy for about 25 years on the gluten-free diet, but over the last five or six years I have become increasingly unwell with symptoms including diarrhoea, bloating, bleeding, and pain. If I did not take large quantities of loperamide on a regular basis I would probably have almost constant diarrhoea. I have had stool samples analysed, I have had blood tests, I have been genetically profiled, I have had abdominal and rectal examinations, I have had an OGD and colonoscopy, and I am now waiting for the results of D1 and D2 biopsies (following 7.5 weeks eating gluten). Stool samples were inconclusive as my incompetent GP didn't know that rectal bleeding causes raised calprotectin. Blood is normal. Genetic profile is positive for HLA-DQ2. Abdominal and rectal examinations were normal. OGD and colonoscopy were normal. The only thing we don't know about now is the biopsy results. I am now following the gluten-free diet again and I feel absolutely terrible, so whether or not I do have coeliac disease I obviously have something else as well. The only diagnosis I've been given so far is IBS.
Here is my present concern: next week I am due to attend the Crown Court for at least one whole day. I'll be giving evidence for about three hours before lunch and for at least two hours after lunch, with the possibility of the court sitting late or my returning the next day to continue in the morning session. The judge will be informed that I have these symptoms and that I am in the process of further investigations by a gastroenterologist. Stress seems to be a very big factor in my symptoms, and this is almost certainly going to be the most stressful thing I have ever done (and I hope the most stressful thing I will ever have to do). I visited the court last week and just seeing the courtroom was absolutely terrifying. It is just terrifying me all the more that I may or may not have symptoms while giving evidence. All I can think to do is to take a huge dose of loperamide prophylactically. I am currently due to give evidence under special measures, but I am considering declining the agreed measures, partly (though not solely) because the procedure for entering and leaving the courtroom is so lengthy and complicated, and I know that I may need to be able to leave the courtroom immediately.
I am just wondering whether there is anyone else who has ever been in a similar situation, and whether anyone has any suggestions. One idea that occurred to me was to take strong laxatives (such as Moviprep) on the day before I am due in court, so that my digestive system will be completely empty. There are two problems with this. The first is that if I'm in court having not eaten for nearly two days, probably having very little sleep, and being dehydrated, I am unlikely to be able to give evidence very effectively. The second is that if my digestive system is completely empty, and if I am drinking water to prevent dehydration and to help when I am speaking, I will have to keep leaving the courtroom to pass urine! People will probably think I am being completely ridiculous, but people who have had symptoms as severe as mine will perhaps understand just how awful it can be and how worrying it can be. I was even wondering about having a urinary catheter, which I think shows how out of my mind I am going with worry about how to get through this. It's got to the point where I am actually more worried about my bowel symptoms than I am about the trial itself.
Any suggestions gratefully appreciated!