Confused about my diagnosis

[katertot]

Hi Everyone,

I was just diagnosed on September 1st of this year. These were the results of the biopsies from my 8/28 colonoscopy:

Diagnosis:
A-B. Terminal ileum and right colon, biopsies: Patchy active chronic
ileitis and colitis.

C. Left colon, biopsy: No significant abnormality.


My CRP and ESR are slightly elevated. I'm on 200mg of Imuran (have been on it now about 5 weeks) and 9mg of budesonide (between that and my short course of prednisone, I've been on steroids about 7 weeks). I had an MRE last week and my doctor called my to discuss the results. He said it showed 5-10 cm of thickening at my terminal ileum. He said he thinks I'm on a good treatment and thinks it will work.

I was curious about the results, so I requested to see them myself. Can someone help me understand the results? It says:

"there is minimal wall thickening and enchancement involving the terminal ileum spanning a 5-10 cm segment leading to the ileocecal valve. There is no mucosal hyperenhancement or hyperemia to suggest active inflammatory bowel disease".

Later on, in the findings, it says "Minimal wall thickening and enhancement involving a 5-10 cm segment of the terminal ileum, consistent with sequela of Crohn's disease. There are no findings of active or fibrostenosing Crohn's disease" they also found "innumerable gallstones". Everything else was unremarkable.

Does this mean I was misdiagnosed, or could I have possible gone in to remission in just 2 months? My bowel movements have gotten a lot better, no more diarrhea, but still have some abdominal pain. My doctor has reassured me that he would not have me on the meds I'm on unless he was sure of the diagnosis. We ruled out NSAID use (didn't use them much) and other things. But then I wonder why he didn't mention the inactive part from the results? Could it be that my inflammation is so mild the MRE didn't pick it up? I have a follow up with him on 11/13 and will ask him then, but wanted to see if any of you had any advice.

Thanks.

 

[Clash]

If you have been on steroids before the MRE then it could've dampened the inflammation. Also CD is cyclical so it waxes and wanes out of an active state.

Since an MRE doesn't offer the possibility of biopsies you can't be certain there isn't still inflammation at the cellular level. My son's last scope everything looked pristine yet biopsies cam back for active disease/inflammation.

From the report it looks as if the past inflammation had cause narrowing but that inflammation now wasnt severe enough that it was giving visual signs on MRE. So maybe no inflammation or healing inflammation that would still show at the cellular level.

 

[katertot]

Thanks for the response, Clash. I ended up needing to see my GI sooner and just saw him today. He basically said the same thing you did, that it could be I didn't have much visible inflammation. He said he's going to send a message to the radiologist to get some clarification about the report.