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High Calprotectin, Negative MRI

For about a month now, I've been experiencing what feels like a Crohn's flare (i've had it for 5 years -- for me the symptoms are a mix of diarrhea, constipation, night sweats, fatigue, abdominal pain). I just recently went through a ton of stress -- got laid off from my job and had to move to a new state. Now that I've started another job, I've been constantly sick. =/

Anyway so I see my GI doc, and they order the fecal protectin stool test. It comes back positive, at 369, indicating intestinal inflammation. So he then orders an MRI, but the results of the MRI (which only looked at the small intestine) are completely normal. Totally mind boggling. Anyone else ever experienced that? Could it be that my Crohn's is acting up in my large intestine rather than my small intestine?

Once the MRI was taken, I had been on prednisone for about 4 days but I was still very sick. Let's say the inflammation did come down -- would the intestine really heal that fast and show no damage at all? We're thinking of investigating again with a colonoscopy.

Very confused....would appreciate any insight at all if anyone has some.

I am sorry to hear about your difficulties. I have had a completely normal MRI and CT scan but my colonoscopy showed inflammation and ulcers. The colonoscopy is the gold standard for showing the real picture of what is going on. I feel you will have a better idea afer this.
San Diego
Prednisone acts pretty fast, but I doubt that the lesions and swelling normally detectable by MRI would be completely healed after only four days on the drug.
It certainly could be inflammation in the colon....if you really want to know then a colonscopy is needed. My son started with Crohns in ileum only. Then about 4 years later it was all over the colon. That can happen....however your FCP is certainly high but not crazy high....my son has been as high as 1400 at times. Maybe ask for Uceris which is budesonide for the large intestive and see if the FCP goes down since you just started a new job. Then do a scope when the timing is better to really see what is going on. Another thought is to see if they will do a video capsule endoscopy...that may show more or different things than MRI.

I hope you feel better soon and that your new job works out to be a gift in disguise!
I just finished my participation in the Qu Biologic study. When I was at my sickest my Cal protectin level was at 6800 (yes I was that sick and it was UNBELIEVABLY painful and up to 30 plus bowel movements a day). It dropped to a low of 180 and then spiked up to 1780. But my disease for the most part(read my blog on the Qu Biologic thread) is gone. My Gastro told me that sometimes the FCP tests can be misleading but didn't know why my FCP levels jumped so much when my scope showed a HUGE improvement. Did you also have a high sensitivity CRP test? This will also help to determine what's going on.
Young daughter showed huge fcal improvement (up over 3600 at one point, rarely below 600 - down to a 150 thereabouts). Labs and MRI good. Dr. was suspicious based on a discrepancy of recent fcal results so we scoped. She was clear in all of the regular areas (TI, colon, stomach) but the disease had moved into duodenum. It tends to be asymptomatic in that area until things get pretty bad....He told us that fcal isn't too reliable there. But there was enough to make him wonder. Anyway, hope that helps. MRI didn't pick it up.