Are labs normal when not flaring

[llake]

Hi everyone:

I just have two quick questions. Are your blood tests or labs normal when not in a flare up? I just got my labs back today and they said everthing is fine. I'm waiting on a barium ct scan to rule out crohn's and now I need to have a colonoscopy. My other question is that since I'm not flaring (I don't know if I have IBD or IBS) right now will the GI specialist find anything during the cscopy? Thanks.

 

[Colt]

Quite often, your tests will be fine when not flaring. Of course it depends on your base level compared to another person's. Someone who's been through 6 resections is probably going to always have something going on for the tests to pick up. We all are very different too. Some of us ALWAYS have a high sed rate, others almost never do. Some have blood in their stools all the time, some never do. It's a crazy, complexe little monster.

The real trick is, the various blood tests aren't even going to reliably show something when an average crohnie is flaring. If they show something that's great, but negative blood results are far from conclusive.

Tests for Crohn's disease suck. They're horribly unreliable. Even in earlier confirmed cases of crohn's disease colonoscopies only show crohn's disease 1 in 6 times. Pill cams are a little more effective at about 60% but they require small intestine involvement which not all Crohnies have. It all depends on how bad the inflammation is for where they're looking right at that moment.

Crohn's is one of the most difficult diseases to diagnose. Period. Most doctors can't handle that and do a horrible job. Your average crohn's patient goes through 6 misdiagnoses before getting the proper one. The only time Crohn's disease is reasonably easy to diagnose is when it's severe and features scar tissue which, unlike the inflammation and ulcers, is always there.

The diagnostic process for most of us is a total nightmare. Even going through it all once isn't enough. Most of the time if you get a new doctor they'll want to go through the entire process all over again because they all think they've figured out some ingenious reason why it's not really crohn's disease but instead something practically harmless or entirely curable.

The main issue with Crohn's Disease diagnostically is that it can literally be there tonight and come tomorrow morning it's gone, only to come back next week.

But, I shouldn't frighten you too much. Not ALL of us have diagnostic horror stories. Things may work out for you just fine. Good luck on your tests.

 

[D Bergy]

The only abnormal thing that has ever appeared on a standard blood test for me is a low total protein level. It has been consistent all of my life and causes new doctors to ask me if I am a vegetarian.

I am about as opposite from a vegetarian as I could be. I eat lots of meat and lots of protien.

I am wondering if anyone else has this show up on blood tests.

It is puzzling to me because everything else is in line. It is likely an absorption problem due to Crohn's but I would think it would show up in more ways than that one. It appears to be just a protein absorption thing.

Any ideas on why this is?

Dan

 

[Colt]

Bergy, different parts of the intestine absorb different things. You may just have inflammation in much of the protein absorbing area.

The vegetarian thing is a sterotype. Yes, doctors fall for ridiculous stereotyping and discriminate. More than a non-doctors even. Your average vegetarian consumes slightly more protein as a percentage of their intake. What they get less of is fat. A huge portion of meat is fat. A hamburger from a fast food place will often consist of about 50% fat.

The meat substitutes used by vegetarians are 100% or almost 100% protein and because they are consuming less fat with it, their absorbtion of the protein is far more efficient. We tallied it up once years ago and with me eating meat and my wife vegetarian she consumed 50% more protein than me despite eating 2/3 of the total amount of food I did.

 

[D Bergy]

This would make sense, but it would have to be a small area of the intestines, since I had no indication of inflammation with the exception of my stricture of about two inches and the terminal Ilium. My results have never changed in over twenty years.

It could be a low grade inflammation with no physical damage also.

Apparently this is one possible indication of Crohn's from what I have read so far.

I am going to have to see if there are any other possibilities or at least try find out what specific parts of the intestine is responsible for the absorption of protein.

I want to make sure this is not some kind of genetic flaw that may or may not be part of Crohn's that is not related to damaged intestines.

It would be nice to get my absorption up a bit. It is not drastically out of range, but a little lower than what would be considered normal.

Thank you.

Dan

 

[NatalieMT]

My blood tests are always come back really weird, I was flaring badly throught December 2008 yet my CRP was totally normal for weeks, although I suppose for some of that time I was on prednisolone. Then I got admitted to hospital in early January this year, for a couple of weeks and every test came back with something abnormal - but I was very sick by this point. I had a colonoscopy then on an emergency basis but unfortunately bowel prep was not adequate. I had a repeat colonoscopy March 12th and my gastro found the whole of the large bowel had been inflammed, with ulcers (hence why I was bleeding all the time) but had healed substantially due to the steroid treatment and also the Elemental diet. There were still however active ulcers in the small bowel.

So what I think you are getting at is can you have normal blood results and then still get diagnosed with crohn's and the answer is yes from experience.

 

[CD68]

I had a doc appointment yesterday and asked about the blood work that was done some months ago, just cuz you asked about it on this board!

I was/am in the middle of flare and everything was still normal: liver panel, CBC diff, c-reactive...all normal.


I have to say that part of my problem in getting diagnosed in the first place was completely normal blood tests.

 

[llake]

Thanks everyone for replying. I hope you all get better or stay better.

 

[teeny5]

My blood tests show normal now. Of course I still am taking a bunch of meds and I know that though I am feeling great, I still cannot eat some of the things I could pre-crohn's. (Trust me I have tried). It is like I have a constant reminder that I still have the disease just in case I try to eat something I am not suppose to.

Even though my colonoscopy showed what looked like Crohn's to 2 doctors. A third still was hesitant to diagnose me with it. So, I think it is just really hard to diagnose.