MRE thoughts

[greypup]

My daughter had a routine colonoscopy this past month with good results. She had, however, had significant constipation before the procedure. Her anastomosis was in good shape w/out much scarring :dusty: Since the scope she has been able to poop regularly.

The GI wants to do a MRI to make sure she isn't missing anything. I appreciate the thoroughness (she had strictures and an obstruction at diagnosis) but also want to minimize procedures as much as possible. I left a message w/the office asking if we can do a fecal calprotectin as an alternative to MRI. She also had blood work done that looked good.

Do you think it's necessary to do the MRI?

 

[crohnsinct]

Great news! Glad she is doing so well!

I would feel the same as you and I have to say our GI who has never looked at O's small bowel is doing the first follow up colonoscopy since dx 3 years ago in March. He said if it comes out good and Fecal calprotectin are good and based on her presentation which is fantastic (bloods, gaining weight, growing etc) he does not plan to look at the small bowel.

However, I do like thorough and would always wonder. Also the MRE is not invasive and doesn't require anesthesia no radiation...just the awful drinking and a lot of time.

So there ya go! A nice clear cut answer! Sorry but I waffle on this topic. Doesn't help that my younger daughter had an MRE and it didn't even pick up what the doc saw during scopes or what the biopsies confirmed

 

[DustyKat]

Good to hear all went well with the scope.

I would look at things objectively:

First up you know your daughter better than anyone and if you sense all is good then…

If she presents as well, her clinical markers indicate that and the scope has reinforced it then no. I also agree with a FC just so you have the icing on the cake.

If on the other hand you have a spidery sense that something may be lurking there then push forward with the MRI.

Points to bear in mind:

• As cic has said, imaging may have its limitations as does all testing
  
• FC is questionable as a reliable marker for small bowel disease. If however it has worked in the past then take that as a positive that it will now.
  
• You already know the nature of Crohn’s but as a general rule of thumb when and if disease returns it normally will appear first on the proximal side of the anastomosis. Since the scope will have visualised this area and I assume biopsies would also have been taken at this site then that will provide you with more information than an MRI.

Matt is also due for a routine scope this year. The GI will do FC along with it but I have the impression that if all is well and clinical and objective markers marry up he won’t push on with further testing.

Dusty. xxx