I have one more quick question.....I posted earlier as my husband is still in diagnosis limbo for crohns. Initial bloods and biopsies were negative for crohns (biopsies from colonoscopy and EGD). We called another GI for a second opinion today as his current GI is very puzzled. The medical assistant for the new GI said that negative biopsies positively rule out crohns. We had a Prometheus test today and he was started on Budenoside because the current GI still is leaning towards Crohns (symptoms--duodenal ulcers, friability, severe anemia). I am at a loss! Does a negative biopsy positively rule out crohns? So frustrated with this process..... Thanks for reading. He does not want to do a capsule endoscopy until we have tried Budenoside and repeated scope in 8 weeks. Please help!
Negative Biopsy?
- Thread starter Kathy1109
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DustyKat
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Hey Kathy1109, so sorry for the late reply. :redface:
No, a negative biopsy does not rule out Crohn’s. A biopsy doesn’t just look at one thing, it looks for group of landmarks that match a disease profile. Because of this the pathologist needs to tick off each of those landmarks before they will commit to a diagnosis.
Take my son’s case for example. He had a scope and the biopsies came back as no convincing evidence of Crohn’s. The GI knew from looking at his bowel, plus a family history, that it was Crohn’s. Unfortunately he quickly developed complications that required surgery. As a result of the surgery the pathologists at the hospital had a 30cm of bowel to thoroughly examine. Now, everyone knew he had Crohn’s but lo and behold the pathology report came back as no convincing evidence of Crohn’s! Why? Because he didn’t have granuloma’s and because of that the pathologist would not give him the label of Crohn’s. The irony of all this is that about 50% of people with Crohn’s don’t have granuloma’s and yet it remains one of the clinchers in receiving a definitive pathological diagnosis.
Do you have a copy of the pathology report?
Did they tell why the biopsy was negative?
Dusty. xxx
No, a negative biopsy does not rule out Crohn’s. A biopsy doesn’t just look at one thing, it looks for group of landmarks that match a disease profile. Because of this the pathologist needs to tick off each of those landmarks before they will commit to a diagnosis.
Take my son’s case for example. He had a scope and the biopsies came back as no convincing evidence of Crohn’s. The GI knew from looking at his bowel, plus a family history, that it was Crohn’s. Unfortunately he quickly developed complications that required surgery. As a result of the surgery the pathologists at the hospital had a 30cm of bowel to thoroughly examine. Now, everyone knew he had Crohn’s but lo and behold the pathology report came back as no convincing evidence of Crohn’s! Why? Because he didn’t have granuloma’s and because of that the pathologist would not give him the label of Crohn’s. The irony of all this is that about 50% of people with Crohn’s don’t have granuloma’s and yet it remains one of the clinchers in receiving a definitive pathological diagnosis.
Do you have a copy of the pathology report?
Did they tell why the biopsy was negative?
Dusty. xxx
Were the biopsies read as normal or were there abnormalities noted? Was the endoscopy normal or was ulceration or other abnormalities seen by the doctor during the procedure? (Was there ulceration outside of the duodenum?)
Normal biopsies would mean that there is no inflammation in the biopsy and if multiple biopsies are negative, probably no inflammation in that part of the intestine.
"Negative for Crohn's" biopsies might, as Dusty pointed out, mean that there was inflammation but no granuloma's seen so the pathologist didn't feel certain of the Crohn's diagnosis.
Read the biopsy report to get more clarity.
Normal biopsies would mean that there is no inflammation in the biopsy and if multiple biopsies are negative, probably no inflammation in that part of the intestine.
"Negative for Crohn's" biopsies might, as Dusty pointed out, mean that there was inflammation but no granuloma's seen so the pathologist didn't feel certain of the Crohn's diagnosis.
Read the biopsy report to get more clarity.
