Small Bowel Series Results & Questions

[kdlalib]

I had the colonoscopy 2 weeks ago and the biopsies were negative. The level of insertion was ileum to cecum.

Today, I had a small bowel series. The radiologist said he found what he thought was evidence of an inflammatory disease or process in the "last part of the small intestine." He also said that the barium wasn't moving through that last part properly. He won't give his final report until next week, so he has time to look at the images more carefully.

How can I have had a normal colonoscopy, but an abnormal small bowel series? The colonoscopy supposedly explored the ileum, but the small bowel series showed a problem in the last part of the small intestine which is where I thought the colonoscopy ventured as well.

On the screen, the last part of my small intestine that the doctor was referring to looked different than the healthy part of my small intestine. The healthy part was a strong solid block of color, while the "abnormal" section looked wispy or feathery. It definitely did not look like the other parts of the small intestine. Does this mean anything?

I won't find out my final results until Thursday, so I'm a little stressed and impatient. Any input would be so helpful! Thanks!

 

[Jennifer]

A colonoscopy does not show much of the small intestine. They look through the opening into the ileum but they do not venture forth into the small bowel/ileum (hence the name colon-oscopy). That's why they do a small bowel series so they can actually see the small intestine because the scope cannot venture through the small intestine. Your colon and opening into the ileum may have looked normal during the scope but that doesn't mean your small intestines look just as healthy. The ileum is rather long and if there's inflammation there that would cause the barium to move more slowly.

Welcome to the forum!

 

[silveyk]

So, each imaging modality has its pros and cons. A small bowel series or GI follow-through is best at looking for areas of inflammation or stricture. It's looking at the big picture. The colonoscopy only sees a small part of the ileum and is looking more at the architecture of the lumen (or "wallpaper" of the ileum and colon). The strong block of color equals good flow through the GI tract. Wispy color equals slower flow due to inflammation or stricture. I hope that helps.

Dr. S (spouse of Crohn's sufferer)

 

[maxibear]

ct enterogrophy , also known as small bowell series is a good test and will confirm problems down there

 

[kdlalib]

Thanks so much everybody! Your answers have cleared up a lot of my confusion. I hate how mysterious doctors are with information that is rightfully mine, since it is after all, my body. I won't find out the final results until Thursday. The wait is driving me nuts.

Like I said earlier, my colonoscopy came up clean, which my GI was surprised about. I have almost all of the extraintestinal symptoms and family history. I have severe psoriatic arthritis, which led to me taking humira and prednisone. During those times, my bowel issues resolved, which makes me think something inflammatory has to be going on. My doctor was pretty convinced it was Crohn's, but he wavered when my colonoscopy was normal. He decided to do the small bowel series anyway, because of the extraintestinal symptoms and the fact that I've improved on prednisone and humira. I'm also taking arthritis drugs now that are also used to treat Crohn's, which my doctor said could've influenced the colonoscopy results.

Hopefully what the radiologist saw on the small bowel series will help me finally find an answer. He did hedge his bets a little bit. He said since he was only looking at the results while they were live on the screen, he'd have to review the print outs or whatever to give a more accurate opinion. Like I said in my earlier post, he said there looked to be some inflammatory process happening in the last part of my small intestine and the barium wasn't feeding through that segment properly. I asked him if there were a chance when he looked at the scan later, if it might be normal, and not Crohn's. He said there was a chance, though he didn't seem overly optimistic about that possibility.

It sounds crazy, but I'm so worried that like the colonoscopy, the doc will find nothing remarkable on the small bowel series when he gives his final report. I've been suffering with this for 8 years. I want an answer!

 

[Jenny06xx]

awww good luck with getting some answers !!
i know exactly how u feel coz ive been suffering 7/8 years with ibs ibs ibs until this week i finally got my diagnosis through my pill cam.
my bloods showed inflammation
my ct scan showed inflammation
i couldnt eat for 3 weeks until put on prednisolone
then my colonoscopy showed problems in my illeum but biopsies fine!

thats when he reverted back to his severe ibs diagnosis until my pill cam results whick showed ulceration and a stricture that the pill cam is stuck in after 1h 40m !! it never went any further for the whole 8 hrs .
im glad im finally free of the ibs diagnosis it has been a long ride let me tell u!
now though im not fighting the docs anymore an begging for tests an help im a bit lost and things are finally sinking in, its quite lonely to b honest knowing that no one else knows what your going through unless they have it even family members have doubted me at points, thats y this forum is a godsend without this place and all the lovely ppl on here diagnosed or undiagnosed theyve all been in the same position and are willing to explain and help others, i wouldnt know what any of my results meant without the ppl on here lol
i hope u get the answers u need but if not just keep fighting for it dont give up xx
jen xx

 

[tinabop]

I just got done with my small bowel series, It was gross. Anyway, they couldn't tell me anything. My GI specialist has to tell me the results, I'm not sure when that will be. But I have been suffering from this for 12 years now. I have the same thing. He did a colonoscopy and an endoscopy and he said everything looked fine. Didn't even say anything about inflammation. I didn't know there were blood tests for that. I have been diagnosed with severe ibs as well and am only taking peppermint oil at night and immodium after my episodes. It's torture not knowing when it's going to hit. The doctors were suprised that they didn't see crohns. But I'm hoping that they can see something further with my x rays. My biopsies came back fine as well. The only thing they could tell me was that my test went really fast, it was only an hour when most patients are there for 2-3 hours. So it moved really fast. I wasn't too happy about that. I figured it would go fast though, because that's how everything is. Food just goes through. They haven't tried any medication with me and I am going nuts. I'm hearing stories of people getting help with different things and I don't know what to do. My general doctor is more of a natural path (just barely found that out, so will be switching soon) and she just wants me to take herbs and go off a bunch of foods. I have lost 10 pounds in the last 2 months. I'm so over this. I also have Hashimoto's which I have been told doesn't relate to any of this that is going on, but if this comes back normal like everything else, then I am seeing a thyroid specialist, because then It has to be related. Living this way can't be normal.