Comparing tests to visualize the bowel

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kimmidwife

kimmidwife

Joined
Sep 19, 2010
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MRE vs pill cam vs colonoscopy?

Is it worthwhile to do more then one of these tests at a time?
I know the colonoscopy they can take biopsies so microscopic disease could be seen but can anyone do a comparison of the three and help me figure out is it worth to push for another one besides the MRE?
 
I don't know the strengths and weaknesses of each per se but C's GI likes to have the colonoscopy/MRE and Fecal Cal done at the same time to compare.

Another friend of ours has an 8 year old that was just diagnosed and the doc told them he likes to get MRE/colonoscopy and pill cam if problems arise as he feels that gives the most complete picture.
 
For us DS had mre/colonscopy done at once both times .
This last time was colonscopy/pill cam but that was since he never had one done.
I would push for a colonscopy/pillcam since the prep can be done at once and you can get all the results at once .
 
Do you think we should push then for a colonoscopy or pill cam? The GI we saw said he has found that the MRE results really correlate with the findings on Colonoscopy and he didn't feel it was worth pushing for a colonoscopy. What do you think? I just am at my wits end right now trying to figure this out!
 
So he thinks an MRE and colonoscopy tell the same story? The only difference would be the small bowel. A colonoscopy can't reach that but an MRE and/or pill cam can, unless of course the pill cam gets stuck and never makes it that far.

I think I'd maybe go for the pill cam...?
 
The tests generally correlate. The pill cam can just see the mucosal lining so it can't tell anything about deeper inflammation. The colonoscopy can't seem most of the small bowel. The sensitivity of these tests depends on who's doing and reading them. In some cases, one of these 3 tests finds something that was missed with the other two.
 
That is what I was thinking also a colonoscopy's biopsies can see the microscopic stuff that I would think the other two can't see.
Anyway we got the GI motility test back and it cam back borderline. Now we are waiting to see what the GI says.
 
Trying to figure out why she is having pain and nausea every time she eats for the last three weeks and for the past week also feeling very weak and yucky.
 
Yes biopsy could show microscopic inflammation that is not seen on MRE or pill cam but does microscopic inflammation cause a lot of symptoms?

I think gi motility can be transiently abnormal due to viruses, meds, metabolic abnormalities (hypothyroidism) etc. so would be cautious about ascribing her symptoms to a borderline test.

Hope they figure out what's going on soon! (((HUGS))) to both of you!
 
Microscopic inflammation causes severe issues for my daughter. That's why this disease is so tricky. Hope you can find the source of her problems very soon so she can feel better!
 
I am finally home for a night and able to check in. I hope she is feeling better soon. We just had a scope on the 23rd and then an MRE today. I haven't gotten the results as of yet. Never have did a pill cam, with Rowan I would be worried it would get stuck in there. She has a lot of adhesion issues though. According to the doctors I talk with the MRE is a very good test but I do think it vastly depend upon the person reading it and whether they are very conservatives or not. After all I have been through I think I would ask the results be read by two different hospitals. If you get the MRE get a consult from another hospital. You wouldn't even have to travel they could write it up and tell you their opinion. I find it kinda crazy how much each set of eyes sees things.
 
Mary,
That is an interesting thought. I will have my husband pick up a copy of the MRE. Though the doctor said the radiologists who read it are very good here but you never know. He told us that their readings consistently match his findings if he does a colonoscopy afterwards.
 
Has she had a fecal calprotectin test? I think in this case it can give you a picture of whether you're dealing with inflammation. For Jae, it is the one consistant test that we've had that confirmed what she was feeling and how she was healing. I'm sorry that she is feeling bad again. Your sig looks like she was doing so well... :(
 
Carolin,
we did an FC. we have not yet gotten the results. we did it before she was in the hospital.hopefully results will be available tomorrow. mean while they have diagnosed her with gastropoesis. they said get gi motility is all out of whack. a normal persons motility should pretty much look like a straight line on a graph with a slight curve at the end. Caitlyns looks like a sawtooth pattern. ( for all you non medical people that means it goes up and down and up and down in a jagged pattern that kind of loss like sharp teeth)
 
What motility study did she have? I just googled and found this http://www.chop.edu/healthinfo/gastroparesis.html from Childrens hospital of Philadelphia. IThey write

"Most published literature describes gastroparesis as delayed gastric emptying without a mechanical obstruction.

At The Children’s Hospital of Philadelphia, our definition of gastroparesis is stricter. We consider gastroparesis to be a gastrointestinal (GI) motility disorder when there is objective delay in gastric emptying in the absence of any of the following:

Mechanical obstruction
Biochemical disorder (electrolyte imbalance, diabetes, hypothyroidism)
Gastric infection (e.g. H. pylori gastritis, cytomegalovirus (CMV) gastritis, bacterial overgrowth)
Medication side effect
Significant non-infectious gastroduodenal inflammation (e.g. eosinophilic gastroenteritis, lymphocytic gastritis, celiac disease, Crohn’s disease, vasculitis) "

So I'm not sure why they make this distinction. Could Crohn's inflammation cause this, and therefore treatment of Crohn's would be the primary treatment vs the treatments for gastroparesis of other causes? Did she have upper scopes?

I hope her doctors quickly figure out an effective treatment for her.
 
Kim,

I'm sorry Caitlyn is still not feeling well! She been going through this for a while!! - I hope some treatment is coming soon!

Just a couple of questions... would FC reflect microscopic inflammation? Do they know what is causing the gastroparesis?

I hope something can be done quickly to alleviate her pain/discomfort.
 
Xmdmom,
They did not do upper scopes yet. If the erythromycin doesn't help they will do them tomorrow morning. Everything else looks normal so far.
Tess,
They did not give us an explanation of why she might have it but he said it could have been caused by a virus. I read online that it is sometimes seen in people with Crohn's disease after they go into remission. I am not sure what the link is.
I think the fecal calprotectin would reflect microscopic inflammation. I am hoping we get those results tomorrow.
 
Erythromycin has not done anything yet! Still having severe nausea. :( I am not sure how long it will take to work but she is going to go ahead and have the endoscopy tomorrow.
 
Reading is dangerous... Articles are almost always about the worst cases. The less dramatic cases are often not written up. Hoping her issue is transient and easily amenable to therapy.
 
Just checking in. I hope all went well with the endoscopy and the FC results come in today. Hugs.
 
So I'm not the only one sitting around anxiously awaiting other kids test results? :)

Hope it went ok today and you got some answers.
 
Hi all,
The scopes went well. To the naked eye all looked normal. It will take three days to get the biopsies he said. He will call us if anything abnormal. He said the FC was normal but my husband forgot to ask the exact numbers. I will try to call and see if I can get them tomorrow. Meanwhile she still feels sick every time she eats. The erythromycin is hurting her stomach. I don't know what to think anymore. Good news is she is home! The doctor said they weren't doing anything more at this point at the hospital so she may as well come home.
 
Glad all went well and she's home. Kim, it's been a long while but I remember Caitlyn's dealt with pain before, I'm pretty sure she even went to a pain clinic??? What was causing the pain before?? Was the cause ever determined?? Just wondering if it could be something that was never treated such as a small area of scar tissue???
 
Tess we never did find out the cause. I also thought of scar tissue. I just don't know. she was really upset tonight.she is sick of medicine. sick of not feeling well
 
Poor thing, I can't imagine how tough it is for her and for you! In Stephen's last MRE, there was a note about angulation, when I asked about it, his GI was fairly vague so I don't have a really precise description of what it is but, from what I understand, it's when the loops can form a sharper turn/loop than it normally would. I think scar tissue can form the angulation. When I asked Stephen's GI if this could cause an obstruction, he said possibly but he really did shrug it off, possibly because a severe or concerning angulation would be noted as 'severe'. But, perhaps, there's something like that, not necessarily angulation, but something small enough to not be easily seen on an MRE but enough to cause her pain??? But, I have no idea how you can find that out if the MRE's don't show anything??? Is it possible to ask to have the MRE read by someone else?? Or even by the same person but with the perspective that the pain continues so a 'closer' look could be beneficial??

I wish I had something more to suggest. :ghug:
 
Tess,
That is an interesting thought. I do know several radiologists but am unsure how much experience they have with this. I will ask.
 
Mehita said:
So I'm not the only one sitting around anxiously awaiting other kids test results? :)
Click to expand...

Haha...nope! But Clash takes it a step further. There was a time when many were waiting test results on the same day. Poor Clash was checking and worrying all day about everyone. She got hers...he got his...she got hers. End of the day... Now there was somebody else I was waiting to hear about...who was it...oh yeah! It was my own son!
 
Hi all,
Things are status quo. She is still having pain and nausea after eating. Really not sure how to proceed form here :(
Trying to figure things out. Have some inquiries in to a few people. Meanwhile she is continuing to take the erythromycin. We will see if it does anything.
 
So sorry she is still having issues, I hope you get some answers and relief for Caitlyn soon!

And CIC is right, I was frantically waiting for several results of some kids here on the boards and completely forgot I was awaiting C's results...yikes!:blush:
 
Kim- I'm really sorry that Caitlyn is continuing to feel ill and you are dealing with this uncertainty. Unfortunately, I don't have any answers just questions...

What did the hospital doctors advise on discharge? They knew she was still nauseous-- did they think the erythromycin would start working later? Did the heart-rate issues resolve?Was the ECHO normal? Do some foods ( liquid or solid) or amounts or frequency work better for her than others? Has she lost a lot of weight with this?

Sending [[[HUGS]]] and hoping she feels better soon!
 
Xmdmom,
She lost 6pounds in the past three weeks. They hope the erythromycin will kick in. The Echo was normal but during the endoscopy she continued to have a very slow heart beat so we have an appt. with a cardiologist next week. She also keeps complaining of dizziness and feeling short of breathe. She complains of nausea as soon as she eats and or drinks anything.
 
New results

Rowan had two scopes and an MRE at her last week. Visually on the scope everything looked ok the called it polopy like a diverted bowel. 3 days later had an MRE and it show extreme chronic inflammation. They did another scope for biopsies a day later and all of it looked ok but pathology came back chronic inflammation. So visually it looked good from a scope and it wasn't good at all. Starting hydrocortisone enemas tonight.
 
Hey Kim,

Sorry for the late chip in. How is Caitlyn getting on?

Matt had a CTE in conjunction with his scopes. In his case it was very useful in pinpointing the extent of disease in his small bowel and his surgical pathology proved that it was spot on in determining the exact length of diseased bowel.

Dusty. xxx
 

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