Positive colonoscopy and biopsies showing inflammation

[moose185]

Hi there,

I had a positive colonscopy and biopsies both showing inflammation from my terminal ileium which the doctor thinks it might be crohns disease.

I had a mri scan of my small bowel today and my doctor has told me to keep an open mind till I get results of this.

Is a positive colonoscopy and biopsies not enough to diagnosis crohns disease?

What should I ask him in the next appointment if he says they have found nothing from the scan?

I've been sick for years and I really want to feel even a little better.

 

[Clash]

Biopsies that show granulomas are generally considered the gold standard for "checking the box" for Crohn's Disease. Here is an exert from a site about biopsies and Crohn's Disease:

Colonoscopy. This test allows your doctor to view your entire colon using a thin, flexible, lighted tube with an attached camera. During the procedure, your doctor can also take small samples of tissue (biopsy) for laboratory analysis, which may help confirm a diagnosis. Some people have clusters of inflammatory cells called granulomas, which help confirm the diagnosis of Crohn's disease because granulomas don't occur with ulcerative colitis

Source

I hope this information helps you.

 

[kiny]

How long since the biopsies though, it needs to be put under a microscope, someone specialised in histology will look at it, crypts are sometimes isolated, sometimes they stain it and check for bacteria, etc. They might take pictures and show other people for second opinons. It can take a while.

 

[moose185]

The biopsies took 3 - 4 weeks to come back. The doctor sent me a letter saying the biopsies suggest this might be crohns disease that is all I have been told.

 

[jamesr]

Hang in there Moose! Autoimmune disorders are very difficult to diagnose due to their remissions and flare ups. Basically you have to looks inflamatory markers in the blood ( CRP and ESR), histology, symptoms, and family history. I had a genetic testing done as well as everything else, but there is not a marker that points directly at crohns just a "high risk" gentic marker. it is really frustrating to wait on tests and appts etc esp when you are in a lot of pain. In short there are definitive clinical markers ( such as thickened sections of bowel) but these indicate advanced disease and early treatment can help avoid these problems. And when things are just getting started they can be much more difficult to get a firm diagnosis on.

 

[moose185]

Thanks. It's really difficult to deal with. So far they found inflammation and blood in my stool, inflammation in the terminal ilieum, and positive result on the biopsies taken for crohns, so that's 3 so far.

All of my blood tests appear normal though except for a low platelet count which I've been told is hereditary, do you need to have abnormal blood tests for crohns.

Another thing I want to note is that I've been taking daily vitamins for 4 years now and I don't know if these have changed my blood tests I also take iron tablets.

 

[jamesr]

Seems like that would be enough evidence to support some type of initial treatment. Inflammtory blood markers come and go. When I had what I considered a bad flare up my C-reactive protien was a little high but nothing spectacular same with the ESR . You might need to make more of a fuss with your GI doc. 3 weeks to a doctor is a small amount of time esp if they have a busy practice, but when you are in pain it seems like an eternity.

 

[moose185]

I am seeing the doctor on the 22nd hopefully they can give me some treatment will have to wait and see.