Can a COlonoscopy miss Crohn's at the end of the small intestine?

[GFreeMom]

Hi I had a question or two. I have not been diagnosed with Crohn's but I was recently diagnosed with Celiac Disease (via blood test and upper endoscopy biopsy). When my blood test came back my serum IgA was also over the upper limit at 521 (normal range 81-463). They reason I was tested for Celiac was because of a large unintentional weight loss 30% of my body weight over 2.5 years. When I went gluten free (I'm already dairy free have been for about 2-3 years) I lost 7lbs in the first 10 days and have not been able to gain it back in almost 3 months. My diarrhea went from sporadic to 2-3 times a day and then steadily increased over a 1.5-2 months to 5-6 times a day with urgency immediately after eating and the urge to go but inability to go as well. So my GI ordered a colonoscopy to check for colitis, crohn's, and any other issues. He took 7 biopsies (6 colon and 1 small intestine) and a polyp. I'm a 29 year old female so I was surprised I had a polyp! Everything came back perfectly normal but the D did not stop so I was sent for a CT scan to rule out lymphoma. I don't have lymphoma and my gall bladder and pancreas look great but the CT scan found probable crohn's near the end of my small intestine only. The doctor had only taken one small intestine sample but he thinks the CT scan was a false positive. Is it possible to miss it on a colonoscopy? I have recently discovered nuts cause severe watery diarrhea with undigested food. Could that just be regular IBS or is that a sign of Crohn's? My serum IgA was high I thought that was typical in celiac but I'm reading that is not typical in Celiac but elevated serum IgA does occur in crohn's is this true? For the record I am psycho strict on my gluten free dairy free diet and the entire family has gone g-free with me and we replaced nearly everything in our kitchen to avoid cross contamination.

 

[SCCrohnie]

Nearly the same thing happened to me. Had a colonoscopy and an upper GI with no sign of active CD but had a CT scan afterwards which found active CD in the ileum, which is small intestine near where it intersects with the large intestine.

To answer your question, yes.

 

[Essieluv]

Absolutely. While colonoscopies are a great tool for finding and diagnosing IBD, they are not infallible. My scope came out completely clean right before I was diagnosed with severe Crohn's disease. Get some other tests done like an MRE, a pill cam endoscopy, a small bowel follow through, and some more blood work. Have you had your CRP and SED rate tested? That and a fecal calprotectin may be a good place to start.

 

[Honey]

Hi there,
I agree with the above. I was misdiagnosed as having Diverticulitis until pill cam showed Crohns colitis in the ileum. It depends on consultant looking at the camera! Best wishes.

 

[Too Many Bum Steers]

Yes I think it is possible. I've had doctors do the weirdest things during colonoscopy. I fear it would be TMI though. They once missed an active blockage (the kind of thing they'd need a balloon to open) and didn't even put it on the report so I couldn't even take that to my doctor and say "look there was something wrong."

I much prefer CT/MRI and I'll swallow barium any day. Just no more poking because they never tell me what I want to know. They have to convince me that they need a tissue sample before I'll submit now. I'm no longer cooperative and pliant. Nobody ever offered me the swallow a camera treatment... maybe I should go be a pest and see if they offer it to me now.

The gluten free is of interest to me... I've been thinking to post my GF brownie story. Maybe I will, but the lesson was, GF isn't a ticket to comfort. I had been following SCD for a long time. And then I decided to "cheat" with a box of choc GF brownie mix from King Arthur flour. The tapioca starch alone was a HUGE red flag. But it was a nice break from almond flour baked goods.

In 24 hours I had a raging yeast infection and a minor flare. So I paid for it. Every person is different. But what I'm saying is, there might be more you're reactive or allergic to than just GF and dairy.

 

[Essieluv]

Nobody ever offered me the swallow a camera treatment... maybe I should go be a pest and see if they offer it to me now.

To be honest, I had to ask my previous GI a few times before she even considered a pill cam. I definitely pestered her about it, but I did finally get it.:tongue:

 

[edcolumbiaMD]

Have you or did you get an IBD expanded panel blood test

checking all the 5 antibodies

ALCA
ACCA
AMCA
ASCA

I my self - no one found anything but had problems I genetic tested my self and carried 4 genes for gluten in the HLA DQ- and 2 for type 2 diabetes doesnt mean I will get both .. I dont have celiac but I found that I was high in AMCA = which is mannon /canidida albicans -yeast/fungus which looks like the gluten protein to the body when the immune system is down or your overloaded with yeast.... Docs dont look at yeast.. how many yeast infections have you had,,, yellow toe nails in corners , headaches... bad sleep or brittle nails

try the IBD expanded panel your gastro or GP can do you may be surprise of what comes back in one of these....they all mean something --- yet everyone quick to jump on meds