High Positive ASCA, everything else "normal"

[inkedandgeeked]

I've been experiencing chronic diarrhea, abdominal pains and cramps, spans of reduced appetite, occasional vomiting, and nausea for about 18 months now. All labs results except for ASCA came back normal. P-ANCA negative, and ASCA IgG 52.4 (anything above 24.9 positive), and ASCA IgA 97.8 (anything above 25 positive). No fevers, no skin rashes, no blood in stool.

An endoscopy found an ulcer and duodenitis. Colonoscopy found nodularities on terminal ileum and large amounts of bile in colon. All biopsies negative for crohn's. Could this be beginning stages of crohn's or is this all in my head????? Could you have crohn's but have normal white blood cell and red blood cell counts?

My GI keeps insisting IBS. I've altered diet and keep having symptoms. Any advice on next step or any other tests that could be done? Could this simply be bad IBS?

 

[Scipio]

I doubt that it is in your head. The positive ANCA tests are suggestive of Crohn's, especially the very high IgA ANCA. However, there is not much else here pointing to Crohn's. Which is why your doc is reluctant to diagnose it.

The bile acids in the colon suggest possible bile acid malabsorption, which can definitely cause diarrhea. Has the doc tried some bile acid sequestrant medication such as Questran?

The other possible thing to think about is Crohn's confined to the small where it can't be seen by any of the scopes. For that you should talk to your doc about possibly getting an MRI or capsule camera endoscopy to evaluate your small bowel.