Small bowel imaging comparison

[Khalid Saeed]

Hi guys,
I've been diagnosed with CD on this May, recently I've been experiencing symptoms (from what I've read from your great threads in this forum) am suspecting a stricture/narrowing.

Am passing normal sise stools, and no pencil sise ones, hence that may probably indicates that my stricture/narrowing problem, is for sure, is not in my colon and it is some where in my small bowel.

My question is: what is the most reliable/accurate imaging procedure (SBFT, CT, MRI,...) to give me the most accurate answers (to show narrowing/inflammation/scar tissues if any...)

I don't have medical insurance, so i don't want to go through a series of expensive tests.
Thanx in advance

Khalid

 

[Guerrero]

Hi Khalid,

I think MRI is the most accurate but maybe a bit expensive without insurance.

Also consider that usually it may takes time for stricture/narrowing to appears (months, years). So if you have been diagnosed and the disease started recently the narrowing and your symptoms could be cause by inflammation rather than scarring (long term inflammation lead to scarring of tissues and narrowing and strictures of the bowel).

You could then focus more on a good treatment, that will cure the inflammatory strictures, instead of repeat an endoscopic exam only 5 months after your been diagnosis, especially if you have medical insurance issues.

Hope you'll feel well soon.

 

[Khalid Saeed]

Thanks Guerrero for your response.
In may i started Pred at 50mg and now am at 15mg, i do taper 5mg each 3 weeks. I started Imuram on Sep 1st at 100mg. I’ve been feeling those symptoms more that a year ago which lead to my diagnosis with CD.
I did a colonoscopy/biopsy in May which showed a Mild Chronic inflammation.

My problem now is that non of my symptoms had improved after taking the medications (Pred) and am sure that Imuram is still needs some more time to kick in.

Thanks again
Khalid

 

[Lady Organic]

Hi and welcome.
you say none of your symptoms improved since taking prednisone.
About 5 or 6 months of prednisone is quite long and starting at 50mg is a lot for a first episode if colonoscopy showed ''mild'' inflammation...

What are your symptoms?

after 2 months of Imuran you should start seeing the benefits soon hopefully.

 

[Khalid Saeed]

Thanks Organic Lady for your response,
here are my symptoms:
-pain under my left rib cage immediately after whatever i eat or drink even water with a noticeable bulge in the same aea. (used to come and go, but now pain is constant for almost a month).
-constant bloating.
-a lot of burping.
-unable to pass gas.
-abdominal pain (mainly concentrated below my belly bottom) there is something weird about this pain, I feel as if am hardly passing food or gas through an area which generates that much pain. I had a blurred vision, numbness/tingling in my hands and feet, light headed, body shaking. And when i feel gas or food passes that area safely I feel relieved from those weird symptoms.
-upper back pain
-pain when taking deep breath
-acid reflex

A year ago, those symptoms used to come and go as an average of once monthly. But now they are always there specially when I eat or drink. These symptoms were the reason of my diagnosis with CD.

Thanks
Khalid

 

[Guerrero]

Hi Khalid,
I hope you'll feel better with azathioprin soon.
An MRI could help understand if you have inflammatory strictures or strictures from scarring that need to be removed through surgery.
Let us know how it evolves

 

[Lady Organic]

have you had an upper endoscopy for the stomach? That could also be interesting to do if you have the possibility.
I think if you ever have a repeat of the symptoms of blurred vision, body shaking etc, I would go to the Hospital emergency.
I would contact the gastroenterologist as soon as possible for those symptoms.
Wishing you well.

 

[ncman]

Have you ever asked for an abdominal ultrasound? In the right hands, it's just as good, if not better, than conventional small bowel imaging (MRI, CT). As you don't have insurance, it may be an option to consider?

 

[Khalid Saeed]

Hi ncman and thanks for your resp
Is this ultrasound accurate in terms of showing inflammation/narrowing...etc
Thanks
Khalid

 

[Jabee]

An Upper GI series with small bowel follow through can also give good imaging of any possible strictures.

 

[zHassanz]

I have almost the same symptoms as you, and having done an upper endoscopy, I was diagnosed with Crohn's in the stomach so I had to take Pentasa along with Imuran and Prednisone. This kind of helped calm things down, but I never got to be symptom free.

 

[ncman]

Hi ncman and thanks for your resp
Is this ultrasound accurate in terms of showing inflammation/narrowing...etc
Thanks
Khalid

Hi Khalid,

There's no issue in terms of accuracy, previous scar tissue was picked up on mine around the terminal ileum. If you have rectal disease, then those tissues are too deep to be seen, but you can get a good picture of the small and most of the large bowel.

In the end, it does depend on the skill of the person performing the procedure. But in the right hands, I was informed that it can pick up more than an conventional MRI/CT.