Is this cure or remission?

[hm86]

Hello all, I hope everyone is doing fine so here what I need to know. To begin with, In OCT 2013 my symptoms were : frequent D ( no bleeding at all ) , nocturnal D , mild stomach pains. In NOV 2013 went for colonoscopy and biopsy showed cobblestone pattern indicative of crohns disease , started taking prednisone ( for 3months ), pentasa (3 months ) and Imuran ( till date ). I was asymptomatic within a week and was fit as a fiddle.In FEB 2014 MRE was taken and it was clean then I started a regular diet including spicy food and then I reintroduced smoking ( 7 to 10 cigarettes a day ) and alcohol ( once a week ). Gained 20 pounds within 2 months.
In DEC 2014 went for the second colonsocopy and since last year I was 30 pounds extra. This time biopsy showed focal ileitis and my blood work was clean. GI said he wants to put me off from Imuran in JULY 2014 so I will be med-free. My GI believes that 15% of crohns patients get cured !!!! and that I am mostly among those types. By the way I stopped smoking since a month now. My questions are:
1) Do i really have crohns? If so am i in remission or got cured? or even misdiagnosed?
2) How can a biopsy show another diagnosis this year ( focal ileitis)?
3) Should i really stop taking Imuran? what if crohns come back and hit me really bad?
4) Do I need to get a second opinion?
5) If its crohns, do I need a surgery sometime in my life?
6)As it involves only my terminal ileum, does it progress to my colon or other areas?
7) Is 15% cured from crohns true statement?
Thanks for taking time to read my post. I appreciate your responses
Stats:
28 yo ,
DX : crohns (NOV 2013)
Currently taking Imuran (150 mg)

 

[theOcean]

1) Crohn's manifests differently for everyone, including even being asymptomatic. You can still have inflammation despite that. There is no cure for Crohn's, only remission.

2) I guess it would depend on how it's manifesting and where. Doctors aren't infallible; I was misdiagnosed originally with Ulcerative Colitis when I have severe Crohn's.

3) Imuran prevents future inflammation. I wouldn't recommend stopping it if it's been this successful. It's a long-term maintenance medication and going off of it puts you at risk of flare-up.

4) From what your GI is saying (if he thinks patients can be cured of Crohn's) I would definitely look into another opinion, and perhaps another GI.

5) If you have uncontrolled (medication-free) Crohn's, then yes, you put yourself at risk of flare, which may lead to surgery. Staying on medication would help prevent this, though some forms of Crohn's (which it doesn't sound like you have, so far) are inevitable to get surgery for. It depends on the case.

6) Not entirely sure, but it can progress to other areas if I'm remember correctly.

7) Absolutely 100% false. There is no cure for Crohn's, much as I would like to believe it.

Hope this helps!

 

[hm86]

the ocean : Thank you so much for the great info. You answered all my questions in a perfect way. I have another question now, if I do not stop taking Imuran as my GI suggested then till when should I continue taking it? is it gonna be forever or I can stop it after a year or two?
To add, my GI said last year he couldn't see the whole small intestine due to the inflammation but this year he said there were no inflammations and he could see way too much of the small intestine.

 

[theOcean]

You would be on Imuran indefinitely. It's a fact that some people have a difficult time with, but it's for the best. I would definitely rather be medicated than sick, which would be so much worse. I'm on its sister drug, 6mp, which is pretty much the same.

I had a colonoscopy in February, and I was doing so well that my GI said that it looked as though I never had IBD. Lovely as that would be, the only reason it looked that way was because I'm in remission, and was fortunate enough to not have any scarring or other problems with it healing. So even though you may not have inflammation now (you can thank your Imuran for that!), that doesn't mean it won't come back, later.

In case I misunderstood, and you meant you have inflammation in the small intestine now: you may have had it before, but he may just have had issues getting to the small intestine. If I'm remembering right, it can be difficult to access at times unless a GI uses different methods of looking at it (like a pill cam).