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If small bowel MRI is negative, what's the next step.

Location
Scotand
Before you say to me to ask my doctor... I am in the UK so I use the NHS, we don't have the luxury of just calling up a doctor and getting 2 minutes of their time, we need to wait 3-4 months each time to see our consultants and if you've had a test done that time can be way further extended, so I have to make use out of free online resources.

I'll recap the test results and we'll see what you can make of them. I had a blood test and it showed a raised WBC, specifically monocytes (this is a sign of chronic inflammation). My GP suspected IBD, so ordered a faecal calprotectin, the result was 1700. A few months later I had an upper and lower scope. The initial results of the colonoscopy was a normal colon and mild granulation of the terminal ileum (it looked like a tongue with the white gunky stuff on it). A few months later the biopsy results showed a normal terminal ileum, acute inflammation of the right colon. The surgeon who preformed the colonoscopy told me it could be a diagnosis of mild Crohn's. But the biposy results did not reveal a secure crohn's diagnosis. An MRI of the small bowel (MRE) was scheduled. I then had a repeat faecal calprotectin which had a result of 130. I just had the MRI today, I don't know anything apart from the scan being successful.

With all that info, say if the MRI was to be negative for anything, what would be the next step be?
 
Location
San Diego
What are your symptoms? Also, what medications are you taking? The drop in fecal calprotectin suggests that the medication is working. If no medication then what is the doctor's explanation for the drop in fecal calprotectin?

Assuming that your symptoms are suggestive of IBD the next thing might be a further evaluation of the small bowel via capsule camera endoscopy. That's how my Crohn's was finally diagnosed.

You may also wish to look at some additional blood tests such as CRP and sed rate to get a fuller picture of the current degree of inflammation.
 

Lady Organic

Moderator
Staff member
The next step would really be to see a gastroenterologist for an analysis of your situation and for him/her to propose appropriate tests for fallow-up and treatments if necessary. Even if the wait is long, thats the doctor you really need to see. A surgeon and a GP are not IBD specialists and their knowlegde and comprehension about your situation is limited. Hoping you get to see a GI soon! The scopes you got are the best tests you can get to understand the situation in your ielium and large bowel.
 
It is worth bearing in mind that biopsies don’t show the classic diagnosistic features of Crohn’s in a (majority?) of cases. My biopsies did not show Crohn’s but I was diagnosed with it anyway based on the visual appearance of my bowel during the colonoscopy by my gastroenterologist.
 
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