How accurate is an MRE of small bowel?

[Ihurt]

Hey everyone.

As some of you already know, I had an MRE of my small bowel back a couple months ago. It came back normal and did not show anything. My question is, how reliable is the MRE in terms of seeing things( i.e. ulcers, inflammation etc...) I mean can the test pick up inflammation and or ulcerations??? I was told it was one of the better tests in terms of getting a good look at the small bowel aside from the pill cam which is suppose to be really good too. ( I did not opt for the pill cam since it only see's the inner part of the small bowel, nothing on the outside or other areas like the pelvic region..)

I am still having awful intestinal issues( pain and crampy soreness all throughout). I had to be on augmentin for like almost 20 days due to a UTI I got from the MRE and now my doctor wants me on the augmentin a very low dose for the month to see if it helps with keeping the UTI away. I also take many probiotics as well. But I am sure the augmentin is hard on my guts. I mean how many probitoics should one take while on antibiotics?? I take at least 100 billion in capsules per day and also take florastor and drink organic kefir.. I would hope this is enough.

Anyhow, JUst wondering how accurate an MRE really is?????

 

[PVail]

Sorry your not feeling good . I have had several scans MRE and none yet have seen any inflamation in the small bowel. Personally I think the pill cam would be better as it takes pictures of the surface and as far as i am aware this is where they will see the damage or inflammation. I am also in a lot of discomfort all day .
I do believe that alot of the meds cause similar problems like cramping and D. You should probably talk to a GI or a IBD nurse who can be more direct with your information and perhaps put your mind at ease.
Im sure there is alot of info on this Forum regarding the value of MRE.
Hope you get help soon

Peter

 

[Ihurt]

Thanks Peter for the response.

So you had an MRE and it did not show any inflammation at all? What test diagnosed you with inmflammed terminal ileum and appendix?

Did they take your appendix out?

I have not even been diagnosed with crohns yet. I was in the midst of doing tests and then had some complications from the test( MRE) so now my gastro doc has put everything on hold. He said any more invasive tests would likely cause more harm. It is so frustrating.

The tests I have had done are the MRE of small bowel, and stool calprotectin test and blood work( c-reactive protein, sed rate) and they were normal. Though I have had elevated C-reactive protein and sed rates on and off for the last 9 years( well before I had any real gut issues though).

I am sorry you also have pain and discomfort al day. That sucks. My biggest issue is that I also have IC( bladder disease) and I get chronic UTI's. Well I cannot get diarhea at all or else I end up with nasty Urinary tract infection. My doctor said it because I have the IC and because I am a woman and that woman who get the big "D" are at high risk of getting urinary infections. I hate being a woman!

 

[PVail]

I was diagnosed with Inflamamtion of the TI by Colonoscopy in which the GI actually showed it to me on screen. Didnt look like much ,just very red and barely open.The area around it was red and patchy also ). The appendix ,well thats a sore point literally. I have pain here 24 /7 . I was in hospital to have it taken out and through a administrative mess i got sent home . I have suffered with this ever since . My new GI says people can have this grumbling or inflammed appendix for years. No one wants to take it out until they are sure its the cause of the pain . A real conflict of doctors opinions . Unfortunatly I have lost faith in my GI and doctors .
Tests ,I have them all except the Pill Cam which I have requested. But nothing so far . I have learned to live with this no for three years . Been with 4 GI s . All of them agree that I cant stop taking the Asacol as it stops me bleeding and therefore keeps inflammation down, so basically thats what I do .
I have requested to see the GI in my local hospital to try and get some better treatment but to get an appendix out there is a 6 week waiting list unless you are critical.
The best I get from them is that I have IBD and they will not elaborate as yet .
I also get constant UTIs as I think its goes with the territory. My father also suffered with this for years until he ended up with a hole or fisure between bowel and bladder and had to have a section done. Fortunatley he recovered well and has little or no symptoms.
Good luck with your tests

Peter

 

[Ihurt]

Geez, that really sucks. Now I am really regretting having that MRE test! I mean if it did not even show your inflammation at all but yet the colonoscopy did, then I would say that this test is useless! It is very expensive too, they charged like over $6000 for mine with the insurnace! They should not be allowed to order these tests if they are not reliable in terms of seeing anything! And to think how that test messed me up it really pisses me off to think it is not even a good test! The only reason I decided to do that test was because everyone and everything I read up on it said it was suppose to be one of the better tests in terms of seeing the small bowel and terminal ileum!

I have not even been dx yet. My gastro keeps saying he thinks I have IBS. I question this though due to how much pain I am in. He said that he has patients who have IBS that are so bad off with pain they are on disability due to it. I guess I just do not know anyone personally who has IBS that is as bad off as I am. My symptoms are: when I am in a flare I get severe pain all thorughout my intestines, crampy and sore feelings all throughout the intestines, and just icky feeling inside. My stool is usually normal to soft and I go usually once a day( though I would likely go more but due to all the pain I am in I sit around a lot with the heating pad, if I was more active and moving around, I am sure I would be going more). I however always have that feeling like I am going to have to run to the toliet( cramping and such). I was going to do the colonoscopy but then my gastro said NO due to how badly I reacted to the MRE. It messed up my whole bladder and gave me a UTI and put me in an IC flare so he was afraid the colonoscopy would make we worse off.

Ughh, you also suffer from UTI's?? That sucks, and here I thought it was more of a woman's issue. They really suck. I mean for me the pain in my bladder is awful, it is the worst. I also have the IC so that could make it worse I guess. How awful for you. That is my worry, I am scared I have crohns and that it is just being kind of let go. My gastro gave me these samples of a med called pentasa. He said they use it to treat UC but it has been shown to help some who have IBS. He told me IBS can cause minor inflammation in the intestines. I however read that it has a salycilate in it which is like asprin and I cannot take any form of NSAID due to my having H-pylori in my stomach and upper gut issues so I did not take it. I just am at a loss.

Anyhow, Sorry you are dealing with this. I hear ya, It is hard to trust doctors when they all let you down....

I also have lost faith is doctors, long ago actually. I have seem many doctors over the last 9 years( I lost count how many) due to my chronic health issues. I gotta say that out of all of them, maybe only 3 were actually good! Sad it is.

I was diagnosed with Inflamamtion of the TI by Colonoscopy in which the GI actually showed it to me on screen. Didnt look like much ,just very red and barely open.The area around it was red and patchy also ). The appendix ,well thats a sore point literally. I have pain here 24 /7 . I was in hospital to have it taken out and through a administrative mess i got sent home . I have suffered with this ever since . My new GI says people can have this grumbling or inflammed appendix for years. No one wants to take it out until they are sure its the cause of the pain . A real conflict of doctors opinions . Unfortunatly I have lost faith in my GI and doctors .
Tests ,I have them all except the Pill Cam which I have requested. But nothing so far . I have learned to live with this no for three years . Been with 4 GI s . All of them agree that I cant stop taking the Asacol as it stops me bleeding and therefore keeps inflammation down, so basically thats what I do .
I have requested to see the GI in my local hospital to try and get some better treatment but to get an appendix out there is a 6 week waiting list unless you are critical.
The best I get from them is that I have IBD and they will not elaborate as yet .
I also get constant UTIs as I think its goes with the territory. My father also suffered with this for years until he ended up with a hole or fisure between bowel and bladder and had to have a section done. Fortunatley he recovered well and has little or no symptoms.
Good luck with your tests

Peter

 

[PVail]

Well im not saying that it wont find anything , just in my case it didnt . I think its primarily for finding strictures and very bad inflammation which would be visual . By all means have the tests ,in fact I would encourage you to ,as these are what they go by and I dont not have any medical qualification so i cant give you facts about this . Only my experience.
Good luck

Peter

 

[Ihurt]

Thanks Peter for the advice. I hope you are feeling ok...

Well im not saying that it wont find anything , just in my case it didnt . I think its primarily for finding strictures and very bad inflammation which would be visual . By all means have the tests ,in fact I would encourage you to ,as these are what they go by and I dont not have any medical qualification so i cant give you facts about this . Only my experience.
Good luck

Peter

 

[bozzylozzy]

Hi pvail.. just hopping onto this thread.. i had a grumbling appendix removed last year. so i kinda know how u feel (took a long time for them to decide on surgery)
I then had colonoscopy 6months later which showed inflammation around the area my appendix was removed. but biopsies didnt show anything.. so was told "unspecified inflammation" so.. my diagnosis was IBS.. lol!!

Ihurt-ive never had and MRE of the small bowel.. so cant comment on it. but what are your GIs next steps?

 

[Ihurt]

Hey bozzylozzy,

Well my gastro gave me a couple different meds to take. He gave me imipramine which is similar to elavil low dose. He said it can help IBS pain. The only bad thing is that I have other health issues which get aggravated by certain meds. Like I took elavil for my gut pain and it irritated my bladder so I had to stop taking it. Right now he and my regular doctor are in agreement that I should Not have any more testing that is invasive since the MRE messed up my bladder really bad and flared my interstitial cystitis. So I am stuck in limbo. I just cannot accept the fact that IBS can cause all this pain.. I mean my entire intestines are in pain and crampy and sore and always have that feeling like I gotta go. It is terrible. I have to literally sit with heating pad all day when I am flaring. I just dont know. I mean I totally get why they do not want to do the testing since it really made my other health issue flare bad. Now I have been on antibitoic augmentin for over 20 days and I have to be on it low dose for the month . It is just crazy.

My biggest fear is that if I do have crohns it will just keep doing damage and I will end up having to get fileted like a fish with surgeries. I just do not know what to do. I mean my gastro said that he just would hate to do the colonoscopy and it show nothing and then I am going to be worse off( which I am certain I would not tolerate the scope or prep well). I am stuck between a rock and a hard place..

I mean can IBS cause severe pain that is constant?? I just have a hard time believing it can be this bad...

 

[bozzylozzy]

I have a friend who really suffers with IBS.. she is in tears sometimes. but she has constipation... and no other IBD symptoms..

but i understand where you are coming from. have you never had a colonoscopy then??

 

[Ihurt]

I had a colonoscopy back in 2004( this was before I was having any real issues though.) At that time It was basically over-kill. The primary care doc I was seeing said I should do it since I was having some slight constipation issues. ( that was a joke, even the gastro who did the scope said it was total over-kill.

But No, I have not had a colonoscopy since having these symtpoms. I had an MRE of small bowel 2 months ago. This test really aggravated by bladder and caused a UTI that I have been fighting for the last 2 months since the test. You see I have a condition called IC( interstitial cystitis) which causes severe pain and inflammation in the bladder wall. I also get UTI's VERY easily. Well when I had the MRE the contrast gave me bad diarhea. Well that caused me a UTI. So my gastro doc said that doing a colonoscopy would likely cause more harm, I mean the whole clean out process causes massive diarhea and would likely mess my bladder up and cause a UTI. I cannot take many antibitocs either. I have had to be on a low dose one for the last 4 years just to prevent UTI's. Well that one stopped working after I had the MRE. Doctor said that the contrast and diarhea likely caused my intestinal flora to shift and become resistant to the keflex I was on to help prevent UTI and help with the IC bladder pain.

So that is why he has not done the colonoscopy. So I just had MRE, stool test to check for inflammation and infections, blood work. They all were normal. He was not willing to put me through the colonoscopy at this point. I just do not know what to do.

I mean I know IBS can be painful, but this is what I dont get. I mean if you look up IBS symptoms they are constipation or diarhea alternating. Also they say most people feel relief after a bowel movement. Well for me, I NEVER feel relief after a Bowel movement, actually I feel much worse afterwards and icky and crampy and sore all throughout my intestines. I have pain ALL day when I am flaring. I also do not suffer from too much constipation, I mean I have had it now and then, but it is not all the time. I do not get diarhea, though my stools can be very soft. They are always very light in color( light the color of coffee with lots of cream in it. ) I think maybe my stools are more formed due to me being on lots of probiotics due to having to take the antibiotics. Maybe the probiotics mask things, I just dont know..

So that is where I am at right now... It is so frustrating.

I have a friend who really suffers with IBS.. she is in tears sometimes. but she has constipation... and no other IBD symptoms..

but i understand where you are coming from. have you never had a colonoscopy then??

 

[bozzylozzy]

You really are in an awkward position arent you?? !! I had 2 colonocscopies and 1 sigmoidoscopy in 6 months!! An each one showed something different (1 was normal, 1 showed small inflammation, 1 showed bleeding that got cauterised)

If he offered to do a scope.. would you have it? sounds so awful IC.. ive suffered many UTIs before but thankfully dont have IC..

 

[QueenGothel]

In my personal experience and the information my daugther GI told me that am MRE is a good show of inflammation. This was how they diagnosed her with UC after a failed prep for colonoscopy. I hope to god they were telling me the truth bc we removed the colon. When it showed her colons inflammation it was very obvious that it was only in the large by the pictures taken.

I think IBS is a cope out for Doctors not having a clue why someone feels the way the do. Not saying they don't feel it but I think it is a diagnosis of we don't know what is wrong with you and why you feel this way here take this drug. A friend of mine took meds for IBS every day for years then needed to get her gallbladder removed and (poof) no IBS.

Coincidence? Doubt it. I hope your feeling better and are UTI free for a long time!

 

[Ihurt]

well if he said he really thought I should do the scope I would. I mean I wont lie, I would be hesitant due to the whole bladder issue, but I would like to know what is going on too. I see my gastro doc in January for a follow up appt and will talk to him. I am sure he will NOt want me to do it though unless I got really bad( like if I was having massive diarhea, well then it wont matter at that point as I would likely get a UTI anyhow. I swear no matter how clean I am I get them. I mean when I have diarha I shower after every BM and wash with soap and water but I still get it. My doctor said that it is impossible to be clean when you have diarhea. She said all it takes is a little drop to splash anywhere down there and BAM you can get a UTI, especially if you are prone to them. OH GOD, the IC is horrible. Lets put it this way, it is like 1000 times worse than your worse UTI. It literally feels like I have battery acid in my bladder. The pain is unbearable. I remember when I was seeing a urogyne doctor for my IC, the nurse told me that I CANNOT get diarhea. She is like it will put you in a whole world of hell. I guess I know what she meant by that now. I

So that is why I am so scared to do anymore testing and likely why my gastro does not want to. I mean he knows that if my IC gets flared, there is nothing that I can take to help it. I have done ALL the IC treatments ( which are not many really) and they have not helped me. The only thing that ever helped was certain antibiotics. I honestly think my IC is bacterial in nature. But I unfortunately cannot take many antibitoics that treat UTI's. I either have severe reactions or allergic to them. This is why things are so complicated.

What do you think? I mean what would you do??? My gastro doc is very knowledgable, I mean he has been in the business for like 30 years. I live in Chicago Il and am going to the BEST hospital here. They are the only hospital in and near Chicago that even offers stem cell transplants for for with IBD so I would hope my gastro doc is doing right by me. I just dont know though. I mean I have lost a lot of faith in doctors over the past 9 years after having such bad experiences with some of them.. It is so hard.

You really are in an awkward position arent you?? !! I had 2 colonocscopies and 1 sigmoidoscopy in 6 months!! An each one showed something different (1 was normal, 1 showed small inflammation, 1 showed bleeding that got cauterised)

If he offered to do a scope.. would you have it? sounds so awful IC.. ive suffered many UTIs before but thankfully dont have IC..

 

[bozzylozzy]

Hmm... i honestly dont know what id do. but if you were to be diagnosed with IBD from the scope/biopsies.. and then management of it could stop the D and lessen the chances or UTI etc..

but obviously i think its good idea to try other tests first like the pill cam etc..

 

[Ihurt]

yeah, that may be an option. I think that you still have to do the whole bowel prep though and if I had to do that I might as well do the scope. I just dont know. I mean I did the MRE and they found nothing, and now I am stuck with all the aftermath. I guess I will have to talk to the GI doc when I see him and see what he says...

I mean It is crazy that you had 2 scopes and sigmoid test within 6 months and they were all different. I mean that makes me even think that the scope is unreliable! I mean one day you could be ok and then a week later you can be inflammed. How the heck are they suppose to get a accurate dx?? No way I could even afford to do that many scopes in that time frame, in fact my insurance would likely deny it.

So when they saw the inflammation with your colonoscopy, they still say you dont have IBD?? I thought that was the tell tale sign of crohns. They always say IBS does not cause inflammation. But my GI doc said it can cause minor inflammation. There is controversey about that theory so not sure what to believe. What did they give you for pain or treatment?

Hmm... i honestly dont know what id do. but if you were to be diagnosed with IBD from the scope/biopsies.. and then management of it could stop the D and lessen the chances or UTI etc..

but obviously i think its good idea to try other tests first like the pill cam etc..

 

[Ihurt]

Thanks for the reply Myreinhard,

Yeah, I think they like to throw the Diagnosis IBS around a bit to much too. They really have no clue about IBS, crohns, or any of these diseases it seems.
Wow, they actually removed your daughters colon? How old is your daughter? I mean what were their reasons for removing her colon?? She must of been severe. I am so sorry to hear that. Is your daughter symptom free now due to having her colon removed?

In my personal experience and the information my daugther GI told me that am MRE is a good show of inflammation. This was how they diagnosed her with UC after a failed prep for colonoscopy. I hope to god they were telling me the truth bc we removed the colon. When it showed her colons inflammation it was very obvious that it was only in the large by the pictures taken.

I think IBS is a cope out for Doctors not having a clue why someone feels the way the do. Not saying they don't feel it but I think it is a diagnosis of we don't know what is wrong with you and why you feel this way here take this drug. A friend of mine took meds for IBS every day for years then needed to get her gallbladder removed and (poof) no IBS.

Coincidence? Doubt it. I hope your feeling better and are UTI free for a long time!

 

[QueenGothel]

She turned 5 year old yesterday. No drug ever helped her. Even the predisone stopped working. She went from diagnosis of mild UC at age 3 to complete pancolitis, proctocolectomy with diverted ileostomy w/jpouch to takedown in 7 months. It's kinda crazy. But yes beyond dealing with a bout of c.diff right now she has been good since takedown. We just got out of the hospital for this CDI she was there for 8 days.

Her story is here...http://www.crohnsforum.com/showthread.php?t=44003

Heres a joke for ya... You know you have been in a hospital setting for too long when your smart phone changes all you normal word to acronyms for medical terminology.

Keep you chin up.

 

[QueenGothel]

I know this sounds costly but I is totally worth it I think... We have a CoCo Bidet to clean up the diarrhea. She goes a lot without a colon... It has helped a lot. Might be very helpful for you. It has heated seat and water too. Even a butt dryer.

I even like it. Shhhh

 

[Ihurt]

wow, so does she still go to the bathroom, I thought she would have a bag with the removal of the colon. Poor little thing, that is just too young to have to go through all this. I feel so bad for her and for you being a mom and seeing her go through all this. How did she get C-diff? I thought you could only get this if you had a colon? Do you have her on probiotics at all? They say florastor is good for helping with C-diff infection.

I know this sounds costly but I is totally worth it I think... We have a CoCo Bidet to clean up the diarrhea. She goes a lot without a colon... It has helped a lot. Might be very helpful for you. It has heated seat and water too. Even a butt dryer.

I even like it. Shhhh

 

[QueenGothel]

They actually constructed her a new colon out of her small intestines. It's called a J-pouch, if all goes well it should work for her for the rest of her life and is the cure for ulcerative colitis. She did have a bag for 3 months.

You totally can get c.diff in the small intestines. Is it rare yes! Who'd figure. Yes she actually was taking 400 billion probiotics 1sachet of VSL daily and now we are giving her Florastor but seems to upset her belly. I think what happen is she got a small food blockage and the c.diff grew from there. They did a fluoroscopy and found nothing wrong. Called it an ileus from the c.diff. Anther rare thing to get.

She likes to keep them on there toes I guess. She Defies the odds all the time. I hope we can manage to get rid of this c.diff for she is just now starting preschool and I had to pull her out last year and I don't want to do that to her again.

She's a trooper. Don't feel bad. We all have rough roads with different bridges to cross. I have learned that there are people going through even more stuff than us. I used to pray for a cure for her every night and this is the cure so we are good with how things turned out.

Nce talking with you.

 

[bozzylozzy]

wow... Myreinhard.. your little girl has had to deal with a lot! hopefully, like you say - the newly constructed colon will do the trick and in the future.. all of this will be a very distant memory.

@ihurt - in regards to the scope.. i was admitted to hosp sept'11 and was told they were 99% sure i had crohns - i was put on IV steroids/antibiotics (they based this on my symptoms and a CT scan)
i was discharged, and went back in 2wks later with the same symptoms - they then said they thought it was my appendix.. but not sure... so they decided to do a laparoscopy which found my appendix in a right royal mess!

however... my symptoms of pain, D with urgency persisted. and 3 months later they did a colonoscopy - which was clear (however i had been tapering off pred for the 3 months!!) - this was feb'12

then in june'12 - i was admitted back into hosp with rectal bleeding. they did a sigmoidoscopy which found the bleed (cauterised it) it was an Arterio venous malformation. so because they found something.. they followed up 1 month later to check the full colon - which found inflammation around the site where my appendix used to be..

sorry its long story.. but had to explain it to show why i had 3 scopes in short period of time!! haha.. obviously this was all on the NHS.. ive been really impressed with them

 

[UnXmas]

yeah, that may be an option. I think that you still have to do the whole bowel prep though and if I had to do that I might as well do the scope. I just dont know. I mean I did the MRE and they found nothing, and now I am stuck with all the aftermath. I guess I will have to talk to the GI doc when I see him and see what he says...

I mean It is crazy that you had 2 scopes and sigmoid test within 6 months and they were all different. I mean that makes me even think that the scope is unreliable! I mean one day you could be ok and then a week later you can be inflammed. How the heck are they suppose to get a accurate dx?? No way I could even afford to do that many scopes in that time frame, in fact my insurance would likely deny it.

So when they saw the inflammation with your colonoscopy, they still say you dont have IBD?? I thought that was the tell tale sign of crohns. They always say IBS does not cause inflammation. But my GI doc said it can cause minor inflammation. There is controversey about that theory so not sure what to believe. What did they give you for pain or treatment?

I've never heard of IBS causing inflammation! I thought that IBS is a diagnosis of exclusion - when there's no sign of any actual disease or medical problem, they call the symptoms IBS. So by definition it can't be IBS if there's inflammation.

There may be other things besides Crohn's and colitis that can cause inflammation in the bowel though. After an endoscopy I was told I had an inflamed stomach and eosphagus but that some of it was due to chronic bile reflux. I'm not sure if there can be other causes of inflammation in the colon.

I also thought I'd read that even when Crohn's isn't currently flaring, biopsies taken during scopes can detect if there's been inflammation in the past, and so would still work for diagosising Crohn's. I can't remember where I read that now, but I think that's why they always take biopsies as well as just looking with the scope, and biopsies are more accurate than just viewing the inside of the bowel when they need to differentiate between different causes of inflammation.

 

[Ihurt]

I think what my gastro meant is that there can be microscopic inflammation in the bowels with IBS, I dont think it is visible to the eye, and if it is, it would be very minor. I was told this by my gastro doc. They are doing trials now where they treat IBS patients with pentasa and some have gotten benefits from it. ( this is a large teaching hospital here in Chicago IL, suppose to be the best hospital here), they are always doing research of some kind. I know this hospital is the only one who offers stem cell transplants for crohns in and near Chicago.


I just dont know. I do know that I am in a lot of pain right now. I see my gastro doc next month and I seriously need some answers and help. Sorry but there is no way in hell all this pain is IBS, no way...I just cant believe it.

I've never heard of IBS causing inflammation! I thought that IBS is a diagnosis of exclusion - when there's no sign of any actual disease or medical problem, they call the symptoms IBS. So by definition it can't be IBS if there's inflammation.

There may be other things besides Crohn's and colitis that can cause inflammation in the bowel though. After an endoscopy I was told I had an inflamed stomach and eosphagus but that some of it was due to chronic bile reflux. I'm not sure if there can be other causes of inflammation in the colon.

I also thought I'd read that even when Crohn's isn't currently flaring, biopsies taken during scopes can detect if there's been inflammation in the past, and so would still work for diagosising Crohn's. I can't remember where I read that now, but I think that's why they always take biopsies as well as just looking with the scope, and biopsies are more accurate than just viewing the inside of the bowel when they need to differentiate between different causes of inflammation.