Crohn's Disease Forum » General IBD Discussion » Microscopic Colitis » Biopsies negative - can it still be MC?

04-23-2014, 01:33 PM   #1
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Biopsies negative - can it still be MC?

I am seeking information. I have some questions about MC. I am undiagnosed. On 3/4 I had appointment with P.A. (not my GI MD) and I was prescribed antibiotics (assuming it was SIBO). At the same visit I had blood and stool lab work done. It showed I have elevated sed rate, CRP, positive lactoferrin (white blood cells), and low iron (ferritin), and low iron SAT %. Can SIBO cause all of the above blood and lab results?

Suspecting MC, I had recent colonoscopy on 4/4/14 with biopies. I have not been back to MD but phone call to office on 4/21 revealed - Negative for microscopic colitis. I go back to MD on 4/28. Can a negative biopsy test be "false"?

I am finding it strange I have these blood and lab results but show no colitis. MD took only 3 biopies. Could they have been taken from place where no MC is shown and that I might still have it? Anybody ever have negative biopsies but later found out that they had MC the whole time?

I am extremely frustrated and feel like my MD takes my symptoms "lightly". I feel that he is discounting the severity of my symptoms (especially severe bloating) and continues to attribute my problems to bile acid (I had gallbladder out 10 years ago in 2004).

My GI put me on Questran after colonoscopy and it has helped with D. I don't think bile acid malabsorption would cause blood and labs to be messed up, would they? I would assume someone can have bile acid and another disease (IBD?) as comorbid - anybody know? Anyone have bile acid issues and something else diagnosed as well?

I also have questions about GI pill cam. When would a MD order one and what would it show that colonscopy didn't? My GI has only explored colon but not small intestine. Any advice on what tests to push for that might look for problems in SI?
04-23-2014, 02:52 PM   #2
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Hi huffpz6410, I've moved your post into its own thread so that you will hopefully get more answers here and won't get lost within that other thread.

To answer your question about biopsies - my understanding is that microscopic colitis can have a "skip pattern" the same way that Crohn's can. Meaning, the inflammation is patchy - and since it's microscopic, they'd essentially have to luck into biopsying the right areas in order to find microscopic colitis (presuming it's there). So, yes and no - if they biopsy the right place then it should show evidence of MC, but if they don't take a lot of biopsies or don't luck into biopsying the right areas, then it would show things as being normal when really they aren't. That's how my GI explained it to me (I'm in a similar boat, I seem to have some form of IBD but I'm not formally diagnosed, and my GI suspects microscopic colitis). I hope that helps a bit!
04-23-2014, 04:16 PM   #3
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Also wanted to add that a pill cam would show the small intestine. You may have to push for it with your doc if you aren't getting any answers. Of course, a CT scan, MRI or MRE would show if there was thickening in the small bowel, which would be indicative of inflammation or scar tissue. Also, some member have had a small bowel follow through(SBFT) which is where you drink a barium type shake and they take xrays, this could also show issues in the small bowel. Problem is only the pill cam would show the inside of the small bowel so if you were to have simmering inflammation or ulcers the pill cam would pick it up even if it hadn't led to a thickening yet.

Good luck.
Mom to
C age 19
dx March 2012 CD

CURRENT MEDS: MTX injections, Stelara

Dx May 2014: JSpA
8/2014 ileocecectomy
9/2017 G tube

PAST MEDS: remicade, oral mtx, humira
04-24-2014, 11:27 AM   #4
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thanks cat-a-tonic and clash for replying with info.

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