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CT and MRI Scans for Crohn's

Hi guys,

I have crohn's since 2008 and i had my ups and downs, currently I'm having possible inflammation while using vedolizumab but this is not my issue here.
Through the years I have been asked to do CT or MRI scans and every time i do it, it doesn't provide enough information for my doctor to take decision. they usually asks for colonoscopy or some blood test for my medicine anti-bodies, is there any one here who have similar experience or know what these scans provide about our beloved disease?

Thank you very much, wish you all lengthly remission to the point you do not remember your doctor name😂
 
MRI can be extremely useful for seeing the length of inflammation in the small intestine, for seeing where and how much intestinal thickening there is, and for visualizing strictures, fistulas, and abscesses.
 
I understand that the scan gives information regarding these issue but does it give enough picture to take decision? change of medicine or need of surgery? my doctors will always ask for colonoscopy after the scan to take one of these decisions.
 
Well if they see an abscess, for example, then something else needs to be done about it. Strictures and fistulas may also need other treatments like surgery.
 

my little penguin

Moderator
Staff member
Most Gi required both MRE and colonoscopy /upper endoscopy.
It’s not that the MRE does give enough information
But the gastrointestinal tract is very long
Crohns can affect from the mouth to the anus .
Scopes only look at a portion of the Gi tract and MRE scans look at the portion the scopes can’t see
Some also use a capsule endoscopy
The Gi needs to see the entire Gi tract in order to present the best options to the the patient

it’s not one or the other .

they do both at the same time for ds
Scope first then MRE (but he needs admired for MRE due to contrast allergy )
 
thank you very much, this makes sense. I didn't know the scope of MRE and colonoscopy, I wish my doctor explain this to me instead of giving vague response. what do you mean by contrast allergy? :unsure:
 
Contrast allergy refers to the gadolinium, or similar, drug injected to allow the intestines to be visualised via MRI.

It's not generally known, but ultrasound - when used by those with the correct training - can show equal, if not better, images of the intestines. It's a shame it's not more widely used at diagnosis / early stage disease leaving the more invasive procedures for when they are really needed.
 
they never EVER diagnosed or saw my Crohns in CT's/MRI's....probably they are as good as the guy who reads them....last year after several blockages I got the "golden standard" MRI....everything normal says Dr!!!....no, it is not.....I have cramps and nausea with a minimum residue diet....so I kept pushing until he agrees to colonoscopy....bad Crohn's in terminal ileum and 3mm stricture at site of previous anastomosis (where I had the ileostomy)
 
Contrast allergy refers to the gadolinium, or similar, drug injected to allow the intestines to be visualised via MRI.
Excellent information!

The contrast agents mentioned above should be discussed to your satisfaction pre -procedure

Diabetes or liver/kidney issues will require a very thorough risk/benefit analysis of the type of procedure performed and the contrast agents used



It's not generally known, but ultrasound - when used by those with the correct training - can show equal, if not better, images of the intestines. It's a shame it's not more widely used at diagnosis / early stage disease leaving the more invasive procedures for when they are really needed.
Excellent point!

I can tell you've been down the rabbit hole on this topic.

Imaging is necessary for a good understanding of your particular clinical presentation prior to formulating a solid, sensible and sustainable treatment plan.

Without specific imaging data, treatment will be based on a lot of "guesswork" ... not a good way to approach treatment!

Imaging (of differing types) must also be repeated at appropriate times during treatment to asses progress / the efficactisocosity of medications.

I am amazed at how underutilized some techniques are here in the USA that are commonplace in other countries

I've been having some impactful extra intestinal manifestations (arthritic and vision) and imaging is paramount to assessing root cause.
I've been reading about the various imaging approaches and the types of results can be expexected from each technique, as well as the challenges they bring to the table

... lotttsa study data, many different options and opinions on those options...

I have to admit to being waaay out of my depth when reading many of them ... pretty technical stuff!

this one caught my eye
study on imaging outcomes

... not so much for the study or it's conclusions but for the "conflict of interest" statement

holy cow, that's a looooooong list

[sceptisism on]
Can't help but wonder what stocks are in the portfolios of those authors (lol, double lol, and lol from the beach in Bermuda lol )
[/skeptisism off]

One thing to always bear in mind is that there is much we can do as patients to ensure success in many areas of our treatment.

Do your research!

Ask Questions!

Advocate strongly for your self on selecting the type of test and it's timing when you discuss things with staff.

Prepare yourself for the procedure as best as you can
(soft / low residue diets as well as stopping certain medications and the like)

Finally, relax!
These folks do it for a living and they are good at it
... put yourself at ease, ask more questions/joke with them whatever you gottta do

Make it plain you want the best possible results and will do whatever you can on your end to achieve them!
Once you develop a repoire with them they will *generally* exceed your highest expectations!




tl;dr;

imaging is expensive/impactful
MAKE IT COUNT!
 
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they never EVER diagnosed or saw my Crohns in CT's/MRI's....probably they are as good as the guy who reads them....last year after several blockages I got the "golden standard" MRI....everything normal says Dr!!!....no, it is not.....I have cramps and nausea with a minimum residue diet....so I kept pushing until he agrees to colonoscopy....bad Crohn's in terminal ileum and 3mm stricture at site of previous anastomosis (where I had the ileostomy)
i'm in the same position, I have active crohn's in the anastomosis but currently with limited symptoms because i use vedolizumab every 4 weeks (i used to take it every 8 weeks). what medicine do you take?
 
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