Test results when asymptomatic?

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Hi, I am new here and posting on behalf of my husband who has had symptoms of what seem like IBD for nearly ten years and currently undiagnosed.

My main question....if a person is scoped between flareups, will the biopsy most likely be normal, or will there still be evidence of past inflammation?

My husband had both endoscopy and colonoscopy 2 years ago, and by the time he could get in to see a GI to have it done, he was no longer symptomatic and they said everything looked normal. He has recently been going through another flareup...the worst he's ever experienced and he can't get in to the GI for another month. Our concern is that he will be in remission again by that time and that they will not find anything. Is that usually the case?

Thank you.
 
Here's what I suggest:

Colonoscopy with Biopsy.
Fecal Occult
Blood Work

I'd had multiple colonoscopies without success. I honestly believe the doctor I'd seen was a MORON NOW.

I don't know where you are in the world. Check out Cleveland Clinic (Several U.S. Locations) or Mayo Clinic. Cleveland Clinic has been treating me and I'm a train wreck. Took 20 years to get diagnosed and my health is screwed. Care there is excellent.

Best of luck.
 
Thank you. We're in New Mexico, the most 3rd world part of the country, so very doubtful that we will find great care here. He went to UNM to see an associate professor there 2 years ago, and he was less than satisfactory. We were not happy. He said he probably just has gastroparesis, but how do you then explain the several bouts of watery diarrhea per day for 10 years that come with abdominal pain, vomiting, fever, chills, drastic weight loss, weakness that have on several occasions caused him to pass out on the bathroom floor? It's just mind blowing. He has lost so much faith in doctors over the past several years, that he is just about to stop pursuing help and a diagnosis. It's very sad too, as both of us work in the medical community.
 
I'm going to cut and paste my story... Make you shake your head:

I saw at least a dozen doctors before finding ones willing to listen at Cleveland Clinic in Ohio. Quack after Quack called me a hypochondriac or said IBS.

Cleveland Clinic has been a godsend.

Apparently, over 120 pounds of weight loss (I was obese) from 230 to 110, complaints of extreme fatigue, nausea, inability to hold down food, nonstop trips to the restroom, extreme pain (kidney was filled with LOTS of stones), low potassium, anemia, and low vitamin d meant nothing. All in my head...

I hate to say that there are plenty of incompetent doctors out there, but it's true. You need to see Top Docs to get help. Now, Cleveland Clinic is trying to undo 15-20 years of damage from the neglectful care I'd received.

DX: Crohn's of Terminal Ileum

Past 10 Months: 22 Trips to Cleveland. 7 Surgeries Related to Kidney Stones. 4 Emergency Room Visits. Loads of Medications to (Entorcort EC, Potassium, Vitamin D, etc)....


1) Colonoscopies
2) Rapid Gastric Study (Junk)
3) Treatment for IBS (Junk)
4) Treatment for Celiac (Junk)
5) Called Hypochondriac in a few words. IE nothings wrong

Cleveland Clinic

Told me the Drs. I'd seen before were USELESS

Tests:

1) Bloodwork (CBC, Metabolic Panel, etc)
2) Fecal Occult - Showed Leukocytes in Stool (Sign of IBD)
3) Colonoscopy Done Properly Showed:

Terminal ileum, biopsy - Patchy active ileitis with focal pyloric
gland metaplasia. - Not 100% conclusive but coupled with ALL the above.. He was certain when adding A + B..

Entocort EC has helped. I now am around 125 pounds and can eat again. I'd stopped eating all together. Not anywhere near "cured" but getting better slowly.
 
Wow! I see this over and over. There are some definate "yes" items where it is 100% conclusive. I have been harping to get more of a spectrum for bowel diseases. It certainly isn't ALWAYS Crohn's. But the issues and treatment are very similar. Kawasaki syndrome, or like me, immune globulin deficient. I have all the symptoms, but a clean colonoscopy when looking for "disease".
 
My Docs now are great.

Entocort has given me an appetite back, though I still have enough bad days. Just not EVERY SINGLE day in the restroom. The EXTREME nausea is gone mostly. Still get sick though on "bad days".

I've gained 15 pounds back in the last few months. If you seen folks on death's door, food repulses them. I honestly quit eating because sight of food made me sick and I couldn't hold any down. So by the time I hit Cleveland Clinic, I was pretty bad off.

Long story short: Doc Said Colonoscopy Result (Not 100%), but Positive Fecal Occult (Sign of IDB), Kidney Stones (oxalate Sign of IBD), Low Potassium (Sign of IBD), Low Vitamin D (IBD), Anemia (IBD)= Crohn's when added to the Patchy and Active Ileitis.

I don't think tests are always 100%, but it takes Dr.s putting the clues together and a little intuition to help patients.
 
So, does one have to be symptomatic and going through a flareup for Crohns to be detected on bloodwork and colonoscopy, or is there always residual evidence left from the previous damage during remission?
 
Ask for Fecal Occult. Try to submit during Flare Up, though I don't know if it matters. Dr. Found Leukocytes in mine. Basically you have a bowel movement, collect with a stick, then swab on paper.

Bloodwork will show abnormalities. If you have ongoing diarrhea for periods, you tend to be low on certain substances. So even if he's not in a flare, things should show.

Colonoscopy can show Damage and Inflammation. Don't forget, Crohn's causes damage to lining. So Doc can see what's going on and take biopsies. Mine wasn't evident on colonoscopy but through biopsy only.
 
Thank youbfor you reply and sharing your personal story. He is currently doing the occult blood test and also some other stool tests to check for ovum and parasites because infectious causes are more prevalent in healthcare workers. His pcp also ran some bloodwork to include a sed rate and cbc and I hope the CRP was included in that. We'll hopefully have the results by the end of the week. But his appointment with the GI isn't for another month, and getting in so late is what concerns me. I wish there was a way seeing a GI could be expedited.
 

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