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Had a MRI enterography in february. Attached is report.
From then to now (5 months) any symptoms are almost impossibly IBD and almost certainly IBS? Correct?


On today's study there are no segments of small bowel wall thickening or active
inflammation identified. No engorged vasa recta, fistulization or abscess
formation. No segments of cicatrizing bowel wall changes such as stricturing or
obstruction. Normal peristalsis demonstrated throughout. Colonic loops are
largely collapsed and unremarkable.
No signs of active small bowel inflammation on today's study.
 
Had a MRI enterography in february. Attached is report.
From then to now (5 months) any symptoms are almost impossibly IBD and almost certainly IBS? Correct?

You are correct that the MRI report is consistent with your not having active IBD. However, it does not necessarily mean that you have IBS. IBS has its own diagnostic criteria, much of which cannot be assessed by MRI.
 
If your calprotectin is that low, and the scopes were normal (BOTH upper and lower GI scopes) and your MRE is normal then there is no way someone would give you an IBD diagnosis at this time. Just for comparison, my son initially had a low calpro (but higher than yours) . At scopes, he had inflammation at some typical areas for Crohns, but biopsies said it was not Crohns "at this time." MRE found some wall thickening and CE found some ulcers, BUT he STILL is not considered to have Crohns, so there is no way someone with your presentation would be diagnosed. I assume they did both scopes-upper and lower right? Crohn's can appear anywhere from mouth to anus.

IBS is a diagnosis that can present in a bunch of ways and yes, they might give you that diagnosis. Did they run a whole battery of stool tests for things like parasites and various infections? A lot depends on your symptoms, etc. I assume at scopes they ruled out Celiac?
 
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Yeah I’ve had the whole shebang. IgE, IgA, celiac panel, CRP, ESR, FBC, Fe, upper and lower scopes, CT, MRE.
 
I thought you needed a biopsy during colonoscopy at the very best, for the most accurate diagnosis.

As I recall, after all examinations, doctor make best judgement based on all evidence collected, then a treatment is prescribed.
 
If there's a complete lack of inflammation, I can see a GI not bothering with a biopsy.

But if there's even the slighest sign of inflammation, granuloma, reddened lymphoid follicles, there should be biopsies for diagnostic histology. Plenty of foodborne infections and intestinal TB mimic crohn's.
 
If there's a complete lack of inflammation, I can see a GI not bothering with a biopsy.

But if there's even the slighest sign of inflammation, granuloma, reddened lymphoid follicles, there should be biopsies for diagnostic histology. Plenty of foodborne infections and intestinal TB mimic crohn's.

Can't biopsy also help detect previous inflammation episodes even if none is currently present?
 

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