Does this look like Crohn's? Desperate for diagnosis

[Scalzale]

Hi everyone-

I had my pillcam yesterday and I kept looking at the images on the device and noticed tons of white spots in a certain area. My pill was in for about two or three hours and everything looked fine, and it reached a point for another hour or longer where it was covered in what looks like ulcers. My mom said she thought they were marks of mucus or stool, not anything indicating Crohn's. i attached two photos of my device from yesterday and am hoping someone can tell me if it looks like Crohn's or not.

I'm nervous because this test is my last resort. My CRP and SED are elevated, I tested positive for Saccharomyces cerevisiae, IgG, a CT scan showed enlarged lymph nodes near my intestines, and I've been plagued with mouth ulcers since I was 15 (I just turned 25). On the other hand, my colonoscopy and endoscopy showed inflammation but the biopsies were negative and I'm overweight, which my doctor said means I most likely don't have Crohn's. I had C. Diff two years ago and my stomach never returned to its normal state. I still have a lot of pain and I have flareups of D about every four weeks. If this test doesn't show Crohn's, I'm fated to a diagnosis of IBS, and I think this is more serious than that. I'm always tired, my eyes and joints always hurt, and my stools are always a six on the Bristol-Meyers chart.

So, does this look like Crohn's? I know I'll get my results in a few weeks, but the waiting is honestly the worst part of this whole thing. Thank you!

 

[Jabee]

Hi Scalzale:

It’s hard to tell from the images, but in the first one they could definitely be apthous ulcers. You have all the classic symptoms of crohn’s. What does your GI think is causing the inflammation he saw via endoscopy and colonoscopy? IBS doesn’t cause inflammation. I suspect he wants the biopsies to show granulomas but only 30% of crohn’s patients have granulomas; it’s an old diagnostic tool which should have been (and often is) replaced by visual inflammation, test results, and patient history. It’s also not true that you can’t be overweight and have crohn’s. There’s a support group for just that issue here on the forum. The other issue will be how your GI interprets your pill cam results—just like the granulomas issue. Can you press him on what he thinks is causing the inflammation and high CRP and sed rate? It’s easy to dismiss patients if they don’t tick all your “crohn’s boxes” but every patient presents differently and your GI should know that. Could he do a trial of one medication or another to see how you respond? I have small bowel crohn’s so I never have “classic” symptoms and most of the time the ulcers can’t even be biopsied! I’m sure someone else will be along to offer better advice too! Good luck!

 

[eleanor_rigby]

Hey, I am sorry for what you are going through. I agree with everything the other poster said and just wanted to concur the first image appears to show apthous ulcers.

 

[Lady Organic]

Hello. Indeed, it doesnt look like a healthy intestine unfortunately, but I am no expert with pill cam images, never had one. If your GI cant give you a diagnosis and treatment, I would really go for another opinion and repeat the colonoscopy with another GI when you are having symptoms. A referral to a rhuematologist for your joint pain could also be of interest. The high CRP and sed rate indicate inflammatory condition going on in your body. A doctor must find what cause these to be elevated.

 

[Scalzale]

So the pillcam results came back clear, except for some gastritis. I think is this the end of the search for me. In my heart I know there’s some autoimmune condition going on, but I can’t seem to find the cause. It’s so disheartening but at this point I don’t know what’s left to do.

 

[lgpcarter]

Are you able to seek a second opinion? That first image you posted looks a lot like what I have seen in my colonoscopies.

I am also overweight (thanks Prednisone!), so that is definitely not a deciding factor. Have they done a fecal calprotectin test? CRP shows inflammation but it is not specific to the gut, where FCP is.

Hang in there - keep pushing for answers. You know your body best.

 

[Caz2004]

Hi, Ive been rooting through to see if someone views their pictures from Capsule endoscopies. I was diagnosed with Crohns colitis in 2004. I had colon removed and now have a permanent ileostomy. I have classic symptoms of flare ups in my small bowel but all tests are coming back that there’s no crohns in small bowel. These are some pictures I’ve took off mine. I cant seem to add any others. Ill try separately.

 

[Caz2004]

Now I didnt think this was normal but apparently it is