Normal Small Bowel Follow Through???

[lsites]

Hi everyone,

I am new here and looking for some advice. I have been having symptoms since January. It began with severe D, and then I was in the hospital twice in March for severe abdominal pain, vomitting and constipation.

I finally got into a GI in April and had a colonoscopy at the beginning of May. The doctor that did the colonoscopy told me right afterward that she was almost positive it was Crohn's and that I had 3 ulcers and a lot of inflammation.

The biopsy results came back as follows:

FOCAL ACTIVE ILEITIS.
- THESE CHANGES MOST COMMONLY REFLECT AN ACUTE
SELF-LIMITED ILEITIS OF INFECTIOUS TYPE; HOWEVER,
NSAID INJURY AND RARELY APHTHOUS LESIONS SUCH AS
SEEN IN CROHN'S DISEASE CAN SHOW SIMILAR CHANGES.

My doctor said she doesn't believe it is infectious since I have been sick since January and if it was infectious it would have resolved by now. I also rarely, if ever, take NSAIDs. She put me on Lialda, but wanted me to do a small bowel follow through x-ray series.

Today the nurse told me the results for my small bowel follow through were "normal", but didn't give any other information.

Does this mean I definitely do not have Crohn's or is it possible to still have it despite a normal small bowel test?

Thanks for your feedback!

 

[trebor-HI]

My understanding is that the SBFT's are not very exact or conclusive.

It seems to me that all these tests: CT's and SBFT are difficult to interpret. Makes a Crohn's diagnosis of the small bowel difficult and uncertain.

When they did the colonoscopy were they able to pass through the ileocecal valve and examine the terminal ileum?

 

[lsites]

Thank you so much for your reply!

Yes, they were able to get through to the terminal ileum and I had inflammation and ulcerations there as well.

I guess they were looking for additional confirmation with the small bowel. I got the actual results and the only negative it showed was a "moderate amount of chronic fecal matter" but I'm still unsure of exactly what that means, and my doctor doesn't have me coming back in for 1 month!

 

[trebor-HI]

Not sure about this: I think a SBFT can identify severe narrowing of the small bowel due to strictures. I don't think it can identify inflammation and ulceration. It would be interesting to learn the doctor's comments on this...

 

[24601]

I was diagnosed with a SBFT but that was because I had strictures - and because it was 1996. With the wide availability of MRE now I'd think that would be a much better choice as it can tell you about inflammation not just the narrowings. And if you have no strictures then you have the option of a pill cam which will tell you what your small bowel actually looks like.

How are you feeling now? Any symptoms still? Is there any chance of getting a follow-up appointment with the GI sooner?