Colitis and no diarhoea?

[protitis]

surely if you had the illness you would be getting at least some diarhhea no? is it possible to have a flare up and no diarhoea? does diarhoea mean watery stools or unformed? because im sure many people have unformed stool and this could be normal

 

[theOcean]

IBD is highly individualistic, so you don't actually have to get diarrhea to have it, no. Some people actually get no symptoms at all when they're in flare, which is scary because it means they can have inflammation without knowing about it. If you're concerned, maybe get some blood testing done.

Diarrhea means loose, water bowel movements, though. I wouldn't call it normal, unless you had some intestine removed.

 

[protitis]

so the calprotectin would show up the inflammation would it ?

 

[Cross-stitch gal]

What ocean says is true. Here is something I found that may explain a little better. I'm afraid it's got a lot of info. But, I'm hoping you'll get the jest of what we're talking about. Good luck

http://www.med.unc.edu/gi/specialties/ibd/about-ibd/the-names-ulcerative-colitis-crohns-disease

 

[protitis]

i hope that once i get the calprotectin, ill get the answer i need

 

[Cross-stitch gal]

Please keep us updated!

 

[Clash]

My son has Crohn's it was most severe in his small intestine at the ileo cecal valve but did have some inflammation in the colon. He was completely asymptomatic as far as pain and there was no disturbance in his bowel movements, normal once a day or every other day. This was not indicative of the active disease going on in his GI tract.

His blood work is not a good indicator of active inflammation but fecal calprotectin has been.

 

[protitis]

My son has Crohn's it was most severe in his small intestine at the ileo cecal valve but did have some inflammation in the colon. He was completely asymptomatic as far as pain and there was no disturbance in his bowel movements, normal once a day or every other day. This was not indicative of the active disease going on in his GI tract.

His blood work is not a good indicator of active inflammation but fecal calprotectin has been.

so how high was the calprotetcin?

so what symptoms did he have?

 

[Clash]

His highest fecal calprotectin was 1700 so a definite flare. At one point it got down to 300 which would suggest simmering inflammation which was also verified by a colonoscopy and MRE done at the same time. Since his meds were unable to fully take care of the inflammation he had a resection.

He had no symptoms before the surgery but remission isn't determined by absence of symptoms since inflammation can still be doing damage with no symptoms present.

 

[protitis]

His highest fecal calprotectin was 1700 so a definite flare. At one point it got down to 300 which would suggest simmering inflammation which was also verified by a colonoscopy and MRE done at the same time. Since his meds were unable to fully take care of the inflammation he had a resection.

He had no symptoms before the surgery but remission isn't determined by absence of symptoms since inflammation can still be doing damage with no symptoms present.

so how much calprotein would a normal person have do you know? should it be 0?

 

[Clash]

Nope not zero. It depends on the lab doing the test as to what the normal reference range is. Quest labs NRR(normal reference range) is <163.5 and labcorp NNR is <50. But fecal calprotectin stool test doesn't just indicate CD. You can have a raised level due to infection, overuse of NSAIDs, bowel cancer. But it's a good first step in tools to dictate what other tests may be necessary, such as colonoscopy, endoscopy, MRE and pill cam.

Edit to add: I don't have CD but did have a fecal calprotectin stool test and my level was a tad above the normal reference range like 167. Further testing came back normal and so no IBD for me.

 

[protitis]

if you have some form of IBD does it come up high even when you are not in a flare up?

 

[Cross-stitch gal]

I don't know. But, I would think that the results would be lower or maybe even not show anything if you happen to be in remission (or not flaring).

 

[Dackelmann]

Had calprotectin tests done when I thought I was in remission- can't remember the figures but it indicated there was still inflammation, albeit at low level.

 

[protitis]

Thats good. At least that means the test is accurate and useful.

 

[Clash]

If you are in remission it can be normal. My son's lowest fecal calprotectin level was 48 which mirrored imaging at the time, and is within the NRR for labcorp and quest labs.. So it can be normal in those that have CD but don't have active disease.

 

[Dackelmann]

Yeah- I'd agree Clash, I think in my case psychologically and physically I felt better but obviously hadn't really gone into remission as have had minor flares since the last test.

 

[protitis]

if the lowest is 48 thats still near the cutoff of 50 and obviously the highest level would have shown that he had inflammation.

If you take more than one test and it comes out at 0 both times Im pretty sure it means you dont have IBD.

 

[protitis]

A normal person who has a 48, would be suspected of IBD and asked to do the test again anyway. So i think the calprotein test is accurate and useful.

 

[Clash]

No, protitis, his level while in remission was 48. If a normal non IBD patient took the test a level of 48 would not be considered for IBD because normal is NOT zero, normal is less than 50 if labcorp lab, and less 163.5 if Quest labs.

Normal people without IBD will still have a numerical result such as 17, 36, 48 and in some cases 52 or 63 since even an infection can be picked up by the test

Edit to add: This test is a good first step tool. GIs will certainly want to investigate further if you have a result that falls out of the norm like 200 but if it comes back under 50 then the GI may not be apt to order further testing such as scopes or imaging.

 

[protitis]

well there are different views on what the cutoff point of normal is. I have seen a cutoff of 50 on one test. What I said is if the result comes out very low on a number of times, then its very unlikely he has IBD. At the lowest level you said it was showing 48. What was the highest? if he did the test many times obviously at some point it would be pretty high. So it is a accurate test. The results can be hard to interpret in some cases but if you came out with 5 or 6 each time you did it, then how can you have IBD? its unlikely.

 

[protitis]

This test is a good first step tool. GIs will certainly want to investigate further if you have a result that falls out of the norm like 200 but if it comes back under 50 then the GI may not be apt to order further testing such as scopes or imaging.

Exactly. That is the point of the test. To avoid and cut down on colonoscopies which are much more costly and very unpleasant for the patient.

 

[Clash]

Protitis, his wasn't used to determine further testing his was used to gauge inflammation after diagnosis so his highs were during flares and lows during remission.

For a patient that hasn't been dx'ed it's generally used as an indicator for further testing and a 48 wouldn't indicate further testing was needed. So there probably wouldn't be multiple fecal calprotectin tests done unless you could convince the GI they were needed.

Also, it is often not covered by insurance in US

 

[Catherine]

I have had faecal calprotectin both times the result was 19. I do not have Crohn's but I do have chronic gastritis and ibs.

My daughter has Crohn's disease her highest reading was 610 and lowest 82. She has never had has bowel symptoms. Her symptoms are low ferritin, anemia and period of severe stomach pain.

She has small bowel disease.

 

[Jmrogers4]

My son has Crohn's and has had 3 fecal calprotectin tests done after diagnosis, they were from Quest lab and under 169 is considered normal.
First was 90 and was followed by clean scopes 3 days later, he was determined to be in remission at that time. A year later it was 395 followed by 493 a month later and confirmed inflammation in small intestine and terminal ileum as seen on MRE.
Diarrhea has never been a symptom of my son, he is mostly asymptomatic and normal lab values the entire time. Failure to thrive has been his biggest symptom in the past.