can someone interpret this for me

[florida2001]

can anyone translate/interprete this for me, the doctor is out of office by the end of the week

this is the MRE result

what reactive mesenteric lymphadenopathy means in this case?

Active inflammatory small bowel Crohn's disease involving the distal 15 cm ileum and
terminal ileum and ileocecal valve with short segment (2 cm) terminal ileal luminal
narrowing without upstream dilatation but with pseudosacculations. No sinus tract,
fistula, inflammatory mass or abscess identified in this exam.
Please note evaluation of the colon is limited due to underdistention and stool.
Reactive mesenteric lymphadenopathy.

 

[my little penguin]

Underdistention izs because she didn’t drink all of the barium .
Rest shows she is inflamed /has active disease
And narrowing in her small bowel .

when did she start her humira ?
Is she doing een (formula only ) to reduce the inflammation?
check with Gi they may want steroids

 

[florida2001]

Underdistention izs because she didn’t drink all of the barium .
Rest shows she is inflamed /has active disease
And narrowing in her small bowel .

when did she start her humira ?
Is she doing een (formula only ) to reduce the inflammation?
check with Gi they may want steroids

she started first Humira 2 days after MRI, so she just started.

Can narrowing be fixed?
she is not doing EEn,

How come someone can be inflamed and has no symptoms at all.
How do I know the Humira is working and how soon to see improvement? he blood work came 2 weeks ago totaly normal her CRP, ESR, her calprotectin was month ago almost normal range. just wonder how do I check the improvement or if something works if she has no visible symptoms and test are fine. so strange to me.

 

[my little penguin]

If narrowing is “just inflammation “ then that goes away with treatment
If it’s from scar tissue that does Not go away .
Only through surgery can remove it
Before biologics kids had a 75% chance of surgery within 5 years of diagnosis.

for your dd
Her fecal cal was high
And her tests —MRE /scopes showed active disease
Sometimes bloodwork looks normal
Understand humira is to keep the inflammation under control
But ….
Typically you need a bridge therapy -steriods or een or both until the humira kicks in (2-3 months )
Otherwise inflammation like a fire just grows out of control
Talk to her Gi
Ask about bridge therapy
Given her age -een is pretty easy at age 8 and no side effects
It can induce mucosal healing and let humira keep it that way .

as far as symptoms -she is only 8
She may have symptoms but not realize that isn’t normal since she may have never felt or remembered what normal GI feel like .
Some kids over report and some under report
Diarrhea and blood are not the only symptoms of crohns
Poor growth
Poor weight gain
Skin issues
Joint ,brain ,heart,eye issues
All can be from active crohns

 

[Scipio]

How come someone can be inflamed and has no symptoms at all.

One of the paradoxes of Crohn's is that symptoms do not always align with the actual disease activity - in both directions. The patient can sometimes have no symptoms yet the scopes show a lot of active inflammation, and conversely, sometimes the therapy and the gut is healed and healthy, but the patient continues to suffer some symptoms. That is why docs want to do scopes and not treat solely on the basis of symptoms. The doc wants to see how the disease is actually improving or not and does not want to rely on subjective assessments of how the patient is feeling.