Psychosomatic stricture or just not visible on an MRI?

[canary]

Am I imagining my symptoms or is what I'm experiencing just not visible on an MRI enterography?

With the help of biologics and immune modulators I have been close to remission for eight years, but I experienced what I thought was a stricture two weeks ago. It was a textbook case - a few hours after eating I was writhing on the floor in tears, but with time peristalsis continued and the pain disappeared. I switched to full liquids that day and have stayed on a liquid diet since, but I am in pain with more than two bites of any soft food.

I have been preparing for another surgery until I got back the results from my barium MRI last week - COMPLETELY UNREMARKABLE in the area where I feel pain! This is not just referred pain - it is sharp in the upper left quadrant and then, later, in the lower right quadrant where I have an anastamosis. Do I just have an excellent imagination? Does this sound like adhesion trouble, and wouldn't an MRI pick that up? I FEEL CRAZY. Any advice gratefully received.

Backstory: Crohn's patient for 18 years, 2 resections, 5 abscess removals, lotsa drugs, currently on Humira & Azathioprine.

 

[afidz]

any type of imaging can be just as ineffective as it is effective. You could move ever so slightly and make the MRI completely miss something. The best way to see whats going on is do a scope. Don't back down, its your body, its YOUR pain that you are feeling. If one test shows everything is fine, then insist on the next until you find answers. You've had Crohn's for 18 years, you know your body, you know the disease.
Oh, and WELCOME!

 

[Cosmojo]

I'm a big believer that symptoms and test results don't always match up, some doctors will argue that the inflammation disease originate not on the visible part of the bowel but deep in the tissue. MEANING: symptoms can appear that don't show up on scopes or MRI. That being said, a stricture by definition are narrow, which with scope you would see. You may have experienced a very bad round of cramping. There are many more options than stricture and its all in your head to explain your symptoms.

 

[Scaryman]

I wish I had more information and I'm concerned that I am scheduled for a MRE in November. My Doctor wont do a scope after last Novembers Colonoscopy fiasco. He did the scope himself and less that 34 hours later I'm admitted into the same hospital for inflammation as a result of the scope. He mentioned " I've never seen this before." All classic signs of a flare where present except the bloating and cramping. They did the SED, CRP tests that showed high levels of inflammation. CT scan pin pointed it at whats left of my transverse colon.

The scary part of this is when a world leading expert performs a exam, test himself then he see's what happened to me, "I've never seen this before." that scares the S&%T out of me." He thought it was Ischemia.

So naturally for my annual check up I asked " can you admit me this time, since I'm coming in from out of state?" He says that is not needed we are going to do a MRE on you, and not a scope. Then to read this thread that MRE's are meh not that great on imaging and can miss things- bothers me as I'd rather have the scope done.

Thoughts on this?

 

[canary]

I wish I had more information and I'm concerned that I am scheduled for a MRE in November. My Doctor wont do a scope after last Novembers Colonoscopy fiasco. He did the scope himself and less that 34 hours later I'm admitted into the same hospital for inflammation as a result of the scope. He mentioned " I've never seen this before." All classic signs of a flare where present except the bloating and cramping. They did the SED, CRP tests that showed high levels of inflammation. CT scan pin pointed it at whats left of my transverse colon.

The scary part of this is when a world leading expert performs a exam, test himself then he see's what happened to me, "I've never seen this before." that scares the S&%T out of me." He thought it was Ischemia.

So naturally for my annual check up I asked " can you admit me this time, since I'm coming in from out of state?" He says that is not needed we are going to do a MRE on you, and not a scope. Then to read this thread that MRE's are meh not that great on imaging and can miss things- bothers me as I'd rather have the scope done.

Thoughts on this?

Ha! I love it when the doc tells you that. My favorite scoping was when the nurse gasped when she looked at the screen. I've always had a flair for the dramatic and apparently my guts do too.

A night in a hotel is much cheaper than a night in a hospital, and MREs are approximately 80 times more desirable than scoping in my experience. if you're not scheduled until November you're (hopefully!) not bad off enough for your GI to think you'll need to be admitted immediately after. The MRE prep is a mere hour - maybe two if you've got strings of pearls - and has a fraction of the cramping and pain than I feel with GoLytely. It sounds like either your colon is an extremely delicate flower or your doctor isn't confident in his scoping skills. Either way, do not fret! MREs are great at visualizing non-invasively most of the time, and are a generally low-impact tool in the box. Better to go with the least painful, least time consuming, and least expensive diagnostic tool first, right?

 

[nogutsnoglory]

I have had times where I have had sharp pain and it's been okay so I don't know what those times are about. I have also had times where I thought everything is fine and I had to have emergency surgery. I wish i could advise you more but you know your body best and keep searching for answers if you feel something is wrong.

 

[Scaryman]

Ha! I love it when the doc tells you that. My favorite scoping was when the nurse gasped when she looked at the screen. I've always had a flair for the dramatic and apparently my guts do too.

A night in a hotel is much cheaper than a night in a hospital, and MREs are approximately 80 times more desirable than scoping in my experience. if you're not scheduled until November you're (hopefully!) not bad off enough for your GI to think you'll need to be admitted immediately after. The MRE prep is a mere hour - maybe two if you've got strings of pearls - and has a fraction of the cramping and pain than I feel with GoLytely. It sounds like either your colon is an extremely delicate flower or your doctor isn't confident in his scoping skills. Either way, do not fret! MREs are great at visualizing non-invasively most of the time, and are a generally low-impact tool in the box. Better to go with the least painful, least time consuming, and least expensive diagnostic tool first, right?

Thats the thing about this Doctor- He is a world leading expert on the disease. This was last November. 1 year ago I had my extended right hemicolectomy. So the obvious course is to have strict regular checkups as we all know Crohns COMES BACK! ESPECIALLY at the surgical site.:ymad:

They did find Crohns coming back- so personally I could give two s*%ts about the expense of this. If they need the most expensive exam/test- then do it. I fly out of state to a leading expert for a reason. I work at one of the largest software companies in the US for a reason other than to support myself. Its the unbelievable insurance coverage.

This is the first time in 10 years I can say without worry or concern after they want this test, or that test, or meh if they admit me I don't care. I only wish other people could have this benefit. This disease has bankrupted me 2 years ago. I am STILL trying to recover. It will take years. But none the less this forum is full of other stories similar in the own way like mine. So by god I want the most accurate test- to give the best results regardless of cost. Because over $200k last year in surgical and ER's and testing, drugs- I'd like to avoid that craziness in the future.

 

[canary]

This is the first time in 10 years I can say without worry or concern after they want this test, or that test, or meh if they admit me I don't care. I only wish other people could have this benefit. This disease has bankrupted me 2 years ago. I am STILL trying to recover. It will take years. But none the less this forum is full of other stories similar in the own way like mine. So by god I want the most accurate test- to give the best results regardless of cost. Because over $200k last year in surgical and ER's and testing, drugs- I'd like to avoid that craziness in the future.

I'm coming to work for you. Do you need a botanist? I'm good at things. Just give me benefits and I'm on the next plane.

Bankruptcy scares me. I've paid for all my medical procedures with student loans. That's probably why I should never ever graduate.

Sounds to me like you need a scoping, then! I'm just a whippersnapper but I'd put up a fight to get a scope. MREs will only get you so far. Sorry, friend. Good luck!

 

[Scaryman]

Canary-
I didnt get to where I am at without it having a negative side effect. I have no credit- I cant get loans. I am screwed for at least 8 years.
I wish I can argue for a Scope- But I do not have that luxury. As I mentioned my Doctor is the end of the line when it comes to this- if he wants a MRE rather than a scope then by god, thats what its going to be....lol

 

[*yvonne*]

I've had MRI's before too but not sure if they always detected what was going on as they usually do CT scans on me when I'm bad.

I have had the exact same reaction to a scope. I was in hospital in Sep 2010 and my CRP was low 100's and after the scope it was 238 I ended up in for another 2 weeks after the scope and felt horrendous, sometimes I think it can aggravate things but that's my opinion.