Colonoscopy/biopsy/pred Q's

[lsgs]

Hi,

Had a endoscopy and colonoscopy on Thursday which was clear (not got biopsy results yet) and wanted to ask a couple of questions.

1) Can IBD show up on biopsies but not on the scope? Is there a chance the GI could have 'missed' it due to patchy disease?

2) My GI and the anaesthetist who sedated me for the procedure have been pretty horrified at the pred dosage my rheumatologist has had me on. Could this 'mask' the disease and make the scope a bit useless? I had a kenalog 80mg IM shot 4 months ago then a taper from 50mg to 15mg, back up to 20mg.

3) Prior to going on pred, I had a high ESR of 51 (which could be because I have sjogren's syndrome, we just don't know) which dropped to 2 after my injection. Also had a high faecal calprotectin, but this hasn't been tested again since. The ESR suggests to me that the inflammation, if related to the inflammation in my bowel and not sjogren's, wouldn't show up in the bowel?

For information, my 'working diagnosis' at the moment is inflammatory bowel disease due to symptoms and calprotectin but finding it is proving to be difficult. I am a complicated case.

Thanks

 

[Jennifer]

Trust me, you're not the first to have clear scopes. If the disease is affecting you in the small bowel then they wont be able to see that. They can look into the TI but can't do biopsies in the small intestine. Even with a clear scope though if the disease is active in the area they took the biopsy then they may find microscopic inflammation or Granulomas which tend to be found during the beginning stages of Crohn's. Prednisone can mask what's really going on so a lot of the time GI doctors try to do scopes while you're on few to no meds (especially steroids). Have you had a small bowel follow through yet or done a pill cam?

 

[hainman]

hi lsgs.i think the dose of steriods could be putting you in remision as when i was on them i was pretty clear with scopes even though i had the disease....
chances are the biopsies will provide some answers...although i think the biopsies might be to check for other things.I think they are checking me to keep an eye on BC as with IBD your more suseptable(excuse the spelling) to the disease...

 

[lsgs]

GI is planning MRI scan if all is negative. I just hope it hasn't been a waste to do it on pred... It seems fairly logical it would be covering up some inflammation.

I have had quite a number of negative GI investigations in the past but there are two problems with that - my symptoms changed dramatically in August (most notably nocturnal diarrhea, more bleeding and a change in nature and severity of pain) and when I had pillcam done last November in hospital I was experiencing no diarrhoea (and didnt for 3 months after that) and didn't do a prep! So I guess we are really treating it as a clean slate after August since that's when the inflammation showed up. Hope that made sense!

 

[hainman]

I had a wee spell a few months ago when i was having the D nearly every hour at night or more,but daytime wasnt AS bad...I had tests done and my fecal test results were through the roof.I also had MRI but came back clean but they were looking for fistula's more than anything else.I got colonoscopy last week and its looking pretty bad,op for me soon.
I hope you get sorted soon...

 

[lsgs]

I had a wee spell a few months ago when i was having the D nearly every hour at night or more,but daytime wasnt AS bad...I had tests done and my fecal test results were through the roof.I also had MRI but came back clean but they were looking for fistula's more than anything else.I got colonoscopy last week and its looking pretty bad,op for me soon.
I hope you get sorted soon...

Sounds nasty!!!

Hope you get sorted for surgery soon if it will help.

I'm just terrified they're not going to treat me if they can't find the cause of the inflammation. I can't keep pushing through this tbh.

Oh and I see you're from the same neck of the woods as me