Is this biopsy enough for an official Crohns diagnosis?

[friendlylili]

Just got the biopsy results back. Colonscopy showed aphtous ulcers (didnt say with inflammation) in ileum. And a continous inflammation in colon and rectum along with erosions.

These are the biospy results.


1- Ileal mucosa within normal limits. (Ileum biopsy)

2- Minimally inflamed colonic mucosa with scattered, non-necrotizing epithelioid granulomas. (Ascending colon and cecum biopsy)

3- Minimally active follicular colitis. (Left and tranverse colon biopsy)

4- Moderately active colitis with a few questionable microgranulomas. (Sigmoid and rectum biopsies)

Notes:

• No dysplasia seen.
• Crohn disease should be excluded in first place.

Is this a death sentence? Ive no idea what to expect im new to all this. I will be going to a gastroenterologist next week.

Important (ig): No one in my family has Crohns. Not on my moms side or dads side. But on my dads side, we have Behcets disease. Which also causes inflammation.
But not Crohns. Ive no idea where this came from.

symptoms: loose BMs tho sometimes good. (1 BM a day)

Gas.

Sometimes mild abdominal pain.

Epescleritis (i think, not diagnosed)

I had blood in toilet water once (whichs why i got the colonscopy in the first place), its good now, stopped happening.

Thats probably it.

Im mostly normal. Like 95% of the time i pretty much am in a decent shape.

No fatigue.

I actually gained 5kgs in last month and a half.

Blood work good. No anemia.

Calprotectin: 442.

CT will be done in feb.
Appointment to gastro this month on the 28th.

Ive no idea what to expect. I sure hope to God its not Crohns. But if it is, what kind of treatmrnt should i ask the gastro to put me on guys. I heard biologics have cancer risk.

 

[my little penguin]

First breathe
Crohns is not a death sentence
Under treated crohns can cause cancer
Biologics are fine
My adult college age “child” was dx with crohns at age 7
Biologics at age 8
No issues living the normal life and in college now .
That said bechets can be intestinal bechets which mimics crohns /colitis in some folks so be sure to visit a rheumatologist as well and let the Gi know you have a family history of bechets .

For the intestinal version of bechets or for Crohn’s disease both are treated with the same meds
Immunosuppressants (methotrexate or 6-mp/imuran )
If those don’t work they tend to move onto biologics -remicade /humira /stelara /entvyio

Good luck at the Gi
They may order imaging
MRE (mri with entography ) and capsule endoscopy (pill cam)
These tests give full picture
Hugs

 

[friendlylili]

First breathe
Crohns is not a death sentence
Under treated crohns can cause cancer
Biologics are fine
My adult college age “child” was dx with crohns at age 7
Biologics at age 8
No issues living the normal life and in college now .
That said bechets can be intestinal bechets which mimics crohns /colitis in some folks so be sure to visit a rheumatologist as well and let the Gi know you have a family history of bechets .

For the intestinal version of bechets or for Crohn’s disease both are treated with the same meds
Immunosuppressants (methotrexate or 6-mp/imuran )
If those don’t work they tend to move onto biologics -remicade /humira /stelara /entvyio

Good luck at the Gi
They may order imaging
MRE (mri with entography ) and capsule endoscopy (pill cam)
These tests give full picture
Hugs

thanks for the answer bro. Can the biopsy indicate anything other than Crohns? Or are granulomas exclusive to crohns disease.

I actually feel like it might be UC. Cus of the continous inflammation and the involvment in Rectum (Crohns inflammation is often patchy and spares rectum). Also no inflmattion in ileum apart from few apthoids (which might be cause by something else completely.).

But i heard granulomas only occur in Crohns and not UC. But it doesnt sound like Crohns to me. Especially since the inflammation is continous and invlolves the rectum too.

Ive sent the biopsy to three Docs. All three said: "you have a mild inflammation that doesnt necesarrily mean Crohns, but docs should rule out Crohns too".

How come they didnt say its Crohns as granulomas are present? Any idea?

Thanks and may God bless your sons heart and give him health and wealth.

 

[my little penguin]

For some pathologist they will only check the “crohns” box when non caseating granulomas are present. That is specific to crohns. When other signs of inflammation and other granulomas are present they leave that decision up to the Gi .
Only 30% of crohns cases have non caseating granulomas found on biopsy .
My kiddo was one of them .

Given the Bechets family history
Ulcers found with mild inflammation…..
Definitely look under that rock first .

 

[friendlylili]

For some pathologist they will only check the “crohns” box when non caseating granulomas are present. That is specific to crohns. When other signs of inflammation and other granulomas are present they leave that decision up to the Gi .
Only 30% of crohns cases have non caseating granulomas found on biopsy .
My kiddo was one of them .

Given the Bechets family history
Ulcers found with mild inflammation…..
Definitely look under that rock first .

Im so depressed atm. Specially after reading up on all the crohns cases that had to go thro multiple surgeries and ER visits etc.

I dont want either of those diseases...
My dad has Behcets and hes barely able to see.....

My cousin has it either and is required to get infusions eevery now and then ...

My grandpa had it as well and had to take blood thinners throughout his whole life.

What a miserable existence.

 

[my little penguin]

Your cousin or grandfather have crohns ?
Or have bechets ?
For crohns surgery used to be the norm
With biologics that risk is no extremely low .
My kiddo has had crohns for 14 years
No surgery
Most parents of kids with crohns I know
No surgery
Biologics changed that
Used to be 75% in 5 years
Stop googling
Wait for the Gi appt
Mild crohns doesn’t equal surgery
Bechets especially intestinal Bechets can be managed very well with the same drugs as crohns
So wait for the doc
Get the diagnosis
Then come ask questions
New is scary
But overtime things settle and your just enjoying life

 

[friendlylili]

Your cousin or grandfather have crohns ?
Or have bechets ?

Behcets.

Noone in my whole fam has crohns. Not even distant fam members. My fam is probably like 1000 members, probably even more (including my grandpa and grandma kids and their kids.)

I have asked. Many of them. No one has it. Absolutely noone. Cant be me. It just cant.

Contrary to that tho Behcets seems to be a common ocurrence within my family on dads side.

 

[my little penguin]

there are many types of bechets
Including intestinal bechets
Which show as ulcers in the gut and inflammation.
Definitely talk to your Gi
See a rheumatologist since they mostly treat bechets and get a second opinion from a Gi who treats intestinal bechets (may be a harder to find )

Another child (adult we know ) was dx at first with UC . Then that dx was taken away .
Finally with bechets (including intestinal bechets )
So it is important to get the right dx .
I think knowing a disease is easier
No one in our family has crohns yet my child was dx at age 7
Sick since birth .
Crohns seems easier than bechets
But it just depends on which you are familiar with

 

[friendlylili]

there are many types of bechets
Including intestinal bechets
Which show as ulcers in the gut and inflammation.
Definitely talk to your Gi
See a rheumatologist since they mostly treat bechets and get a second opinion from a Gi who treats intestinal bechets (may be a harder to find )

Another child (adult we know ) was dx at first with UC . Then that dx was taken away .
Finally with bechets (including intestinal bechets )
So it is important to get the right dx .
I think knowing a disease is easier
No one in our family has crohns yet my child was dx at age 7
Sick since birth .
Crohns seems easier than bechets
But it just depends on which you are familiar with

They both suck.
I will update you guys when i get my answers from officials.

I truly feel for your son. I hope they find a cure to autoimmune diseases soon enough and put an end to this misery that our own bodies put us through.

 

[my little penguin]

So you can hope
He has been on biologics since age 8
Now 21
Scopes all show nice pink healthy intestines .
So healthy looking more than once crohns dx wasn’t questioned
But in his case biologics are key
Doc appts twice a year
Scopes every 5-6 years and blood work every 3-4 months
But busy living a normal life

I only help here since others before me did the same for us when Ds was first dx .