Worried about being forced to have another scope

[Anxious855]

Despite having minimal symptoms since being on mesalasine, my nurse asked me to do a calprotectin level and said if it is over 50, I will have to have another colonoscopy and go on 6mps. Is this the done thing? I was only diagnosed in March and had a colonoscopy then which showed mild/moderate pancolitis.
Would I be within my right to ask to start 6mps, test the levels again and then if still high agree to a scope?

 

[Lady Organic]

I think it would be wise to have another scope to monitor the efficacy of mesalasine on you. This is a good service you are being offered and the best way to monitor IBD. Thats usually the way to do. A dr wont prescribe a medication such as 6-mp without evidence of active inflammation on endoscopy or imagery, especially not on a new and naive (new to the medication) patient. Calpro is not full evidence for a GI to change and escalate medication. It can serve as an indicator to scope or not.
A second scope after a diagnosis is not a luxury. It can also serve to get to know your specific case even better. The more your GI sees your insides, the more he/she will be able to target the best treatment for you.
If you are very affraid of full scope again,maybe you can suggest short scope (sigmoidoscopy) to your team and see what they think. THis procedure is much less trouble. Either way, we dont have much choice unfortunately and endoscopy remains the best way to monitor colonic IBD. Avoiding it can result in more trouble in the short or long term. we have to get used to it :yfaint:.

 

[my little penguin]

sigmoidoscopy (short scope ) is useless in new Crohns patients
Not worth it
Too much of the intestine is not “looked “ at an inflammation would be missed
A full scope would be required
So they know where they are starting in your intestine with the meds and whether 6-mp is working later

Ds has had many full colonoscopies since age 7
It’s necessary but a good way to monitor disease

Good luck

 

[Anxious855]

Well, my calprotectin came back as 7.8 and crp blood level was 4 so very low readings and normal so no need for a scope. I am surprised as I still have some symptoms but my consultant is happy. I am just in a state of shock.

 

[Lady Organic]

Well that good news! But I'd push for a scope if you still have symptoms, even if minimal, at least a short one. These symptoms need to be clarified, as chronic inflammation even if mild can lead to further disease activity or complications short or long term. Caprotectine and CRP are not 100% safe and secure measurements to say you have no disease activity. I have done rounds of calprotectine for several years now and we know now I am a better judge and expert than this measurement for evaluation of my state and condition when debuting a flare. CRP is useless too in my case. A scope with biopsy is really ideal to make sure your first trial medication is working perfectly.

 

[Anna's Bandit]

I had a lower GI and a flexible sigmoidoscopy 20 years ago. Both worthless tests as far as I am concerned. Doctors basically just sent me home. It was a long time as go but I believe they thought I had IBS. No doctor said, hey, why don't we do a colonoscopy! I had health insurance at the time. It was 8 years after this that I had my first colonoscopy. In between those years I had 2 rectal abscesses drained and one was really deep.

I would get a second scope if it were my choice.

Take Care.