Can one child have Crohn's and the other UC????

[tannersmom]

My son who is 15 has been diagnosed with Crohn's disease since the age of 7. My daughter who is 22 was just diagnosed a little over a year ago with Crohn's. She moved not long after her diagnoses and had to change doctors. They just did her 6 months lab at the new doctor and they just left a message telling her the labs show UC not Crohn's and that he will want to redo labs and probably do a colonoscopy himself. She was diagnosed with Crohn's thru colonoscopy with biopsies. My daughter's Crohn's isn't near as bad as my son's and since hers isn't really bad she doesn't concern herself with learning about her disease like she should and she doesn't ask questions. So I have no idea what labs they did that show this new diagnoses. Any ideas??? Another worry

 

[krika]

A hard situation. Luckily she isnt as bothered by the CD at this point that she sees the need to get too much info, but if it changes, then she is forced to and will get info. Hope she dosent get worse, so she can lead a full life.
If she is on meds and they are working, then its a good thing.
Maybe she is just so tired of this illness when her brother has it, so she just wants a break from it until she is ready. Nothing wrong with that. The most important is that she knows that you are there when she is ready to deal with it.

 

[tannersmom]

Well she just spoke to the PA. One set of labs shows Crohn's, the Prometheus lab work shows UC. Can you have Crohn's and UC? They gave her an appointment to come back and that is all I know so far.

 

[DJW]

Hi. I've read no. But I would think it would be extremely rare if both did show up in the same person.

She would need to talk to the specialist to know for sure.

 

[Tesscorm]

You don't have Crohns and UC, however, you can have Crohns Colitis which means your crohns is located in the large intestine.

There are others who can explain it a bit better than me but here's a bit of description of the differences...

- UC is limited to inflammation ONLY in the large bowel; crohns can have inflammation anywhere in the intestinal system (but is usually limited to specific areas, such as the large bowel, small bowel, esophagus, rectum, etc. not the ENTIRE intestinal system)
- UC inflammation is located only on the surface of the intestinal wall; crohns' inflammation extends within the intestinal wall
- (not 100% sure on this one...) inflammation in UC is a continuous segment; inflammation caused by crohns can be patchy

There are also some differences in symptoms, however, if you are comparing UC and Crohns Colitis, I'm not sure if the symptoms would really vary much as it is the same area being affected.

(Sorry your daughter has to deal with this and you have more worries. :ghug

 

[krika]

I dont think it is possible, strange that the docs can be in such disagreements. However, from what I have read from others experiences, somethimes a person get UC diagnose and after CD diagnose, when the doc was wrong. And this somethimes happens after years of receving the first diagnose.
It is possible to have CD all the way, I have CD in the small and large intestine. I dont know how they would categorize this where you are, but here it is code 50.8 and I just found this, dont know if its helpfull

"K50.80 Crohn's disease of both small and large intestine without complications
ICD-9 Code: 555.2" from http://www.worklossdatainstitute.verioiponly.com/icd10/bp/k50.htm

 

[kimmidwife]

I understand that some doctors are now saying that there is no such thing as ulcerative colitis that there is only Crohn's or Crohn's colitis and what some doctors are saying is that what appears to be UC is just Crohn's colitis and it can eventually spread up to the rest of the intestines or if the person is lucky it will stay in the large intestine and not spread. A friend of mine with UC was told this is the newest thinking and I think others on here have mentioned it as well. I will see if I can find some literature on it if I find it I will post.

 

[kimmidwife]

I can't find any info on it but this is an interesting article On The differences seen between the two
http://radiopaedia.org/articles/crohns-disease-vs-ulcerative-colitis

 

[Maya142]

I don't think that bloodwork can accurately distinguish between Crohn's and UC and I'm pretty sure that the Prometheus Test is not 100% accurate.
I think scopes with biopsies would be the best way to accurately figure out which one she has.

I'm tagging DustyKat and my little penguin because they know everything!

 

[DustyKat]

I am not overly familiar with the Prometheus Diagnostic Tests. Whilst they can help differentiate between IBD and other disorders and also between Crohn’s and UC they are not foolproof. It doesn’t replace the gold standard of a scope with biopsies and no doubt since the blood test has raised this doubt the new GI wants to see for himself. Do you have access to the original scope and biopsy results?

It most certainly is possible to have one child diagnosed with Crohn’s and the other with UC, we have a couple of older threads on the forum regarding siblings and IBD that show the mix of the two that can occur in families.
As to having Crohn’s and UC concurrently, there are reputable studies out there that do report the rare phenomena of patients presenting with both. It is possible as diagnostic tests and techniques improve over time that the classification of the diseases may change, as as been alluded to by Kim.

Dusty. xxx

 

[Patricia56]

The prometheus IBD testing is less than perfect and, based on reports I've seen on the various forums, most doctors appear to use it (if they use it, ours does not as he says it is unreliable) as a piece of additional evidence to sway them one way or the other when they were already uncertain of a diagnosis.

Given that much of the medication treatment for UC and CD is now similar I'm not sure it would make a difference in her care except perhaps that they might add a 5ASA med to her treatment plan. It might make a difference in the future if she were to have severe symptoms since colectomy is a more acceptable option with UC than with CD.

It's probably not a bad idea for her new GI to do a scope and investigate her diagnosis. But to rule out CD he would need to do imaging and/or pill cam of small bowel. So hopefully this would be included in the workup.

And yes, UC is almost always a continuous section of inflammation (for example the entire ascending colon) where CD is supposedly pretty patchy with section of inflammation amid areas of healthy tissue.