How to check healing/remission/progress for CD while on medication or without med?

[OmShiv]

Hi,
Please redirect if this has already been discussed. I'm wondering when someone is on medication (Budesonide currently) for 1.5 months, when and what should be means to see progress (In CD outside symptom may not directly correlate with internal situation.) When should be next blood test, calproc be done? What other means to see if healing is happening. Also, what checks/tests people do while on medication and how often?

Also, is it possible to go on remission with Budesonide- how long that may take, anyone successful getting and then maintaining it for some time without going Biologics route?

 

[my little penguin]

Budesonide
Is simply a steriod
So as with other forms of steriods there are potential known side effects such as osteoporosis,glaucoma ,diabetes,Cushing syndrome etc….
Steriods are not long term options for treating crohns
They are only used until a maintenance med can take over keeping the inflammation at bay
Such as immunosuppressants or biologics

exclusive enteral nutrition (een) is using formula only with no solid foods
This induces remission but once solid food introduce again the inflammation comes back

There is also the cded (crohns exclusive diet )
That uses certain solid foods plus formula but is hard to follow and not a high rate of success
better when combined with meds

 

[OmShiv]

Thanks "My little Penguin", I'm not suggesting or thinking we go with Budesonide for long term, it's just for immediate relief since diagnosed. My question is more around tests/frequency/timelines to see progress and if healing is achieved with it, have someone successfully stretched longer duration using diets (SCD, IBD-AID or anything else)?

 

[Pangolin]

If things are fairly stable, I would expect the following testing:

General blood tests about every 4 months (counts, metabolic panel, etc)

Blood and poop tests for inflammation: ESR, CRP, calprotectin. Usually along with the other blood tests.

MRI (MRE) or other imaging: maybe once a year at first, or when there are major treatment changes

Colonoscopy: similar schedule to MRI. Some people may go 5 years between colonoscopies if things are good.

Intestinal ultrasound, at office visits, if your location does that

I think those are all the big ones. Keep in mind that each test gives you a slightly different piece of the whole picture. What you want is:

Mucosal healing, observed at colonoscopy
Histologic healing--normal biopsies taken at colonoscopy
Intestinal wall thickness normalization, observed on MRI and ultrasound
Normal inflammation biomarkers (esr, crp, calprotectin)

 

[OmShiv]

If things are fairly stable, I would expect the following testing:

General blood tests about every 4 months (counts, metabolic panel, etc)

Blood and poop tests for inflammation: ESR, CRP, calprotectin. Usually along with the other blood tests.

MRI (MRE) or other imaging: maybe once a year at first, or when there are major treatment changes

Colonoscopy: similar schedule to MRI. Some people may go 5 years between colonoscopies if things are good.

Intestinal ultrasound, at office visits, if your location does that

I think those are all the big ones. Keep in mind that each test gives you a slightly different piece of the whole picture. What you want is:

Mucosal healing, observed at colonoscopy
Histologic healing--normal biopsies taken at colonoscopy
Intestinal wall thickness normalization, observed on MRI and ultrasound
Normal inflammation biomarkers (esr, crp, calprotectin)

This is great info, thank you so much! I'll check with dr on next set of tests accordingly. Sometimes drs are not very keen on doing lot of tests, so this list is going to very useful!

 

[crohnsinct]

In our experience my daughters’ GI’s are very keen on testing but not the big expensive tests like MRI, CT, Colonoscopy. At the beginning they will pull the standard blood labs and calpro every 8 weeks and then slowly move out to blood labs every three months but usually keep calpro every 8 as it is a very accurate and specific test for my girls’ intestinal inflammation.