What should be the course of action?

A couple of days ago I took the colonoscopy(finally after delaying it multiple times for over a month always thinking I am gonna take it next week or next that day or next week again etc).As everyone suggested that test for crohn's diagnosis and or tumor/cancer in large bowel.

The report says everything all right and ok.No crohn's or polys there.regular mucosa,lining etc.
No biopsy taken.

So now I am thinking my abdominal pain maybe coming from small intestine.
It could be stricture in small intestine or fistula in small intestine due to crohn's or abscess due to crohn's.I really have no idea.But as the pain has gradually intensified over the last two years.I wonder what else it could be.

The pain is mostly in the right upper quadrant between right ribcage and navel.Sometimes when the pain is intense it feels something touching/digging my abdominal peritoneum(abdominal wall membrane or something like that inside)if i am describing it right.And also I feel quite a bit of pain in my eyes/eyes feel fatigued/eyes feel a lot of pressure.

Does anybody with small bowel stricture/blockage/fistula/abscess due to crohn's also feel this type of eye pain/fatigue/pressure in the eyes?


After reading through some other posts I understand there are tests like SBFT(Small bowel follow through), SBS (small bowel series) ,CT Enterography ,MRI Enterography which can show strictures
in small bowel.There I also read there is chance even all this test might miss the stricture if its very small or something like that.

Now I am kind of confused which test should I request my gastroenterologist.Which one test of the above four tests would be best for diagnosing stricture and related blockage and or fistula in the small bowel.

Any suggestion on which test should I go for next?

Also in the last 2 years a few times I have done that CBC test a few times and noticed some results are outside the reference value like ESR test results and some other test like mch or mcv can't remember the name right.Do they have any relation with crohn's ?Doctors who ordered this cbc tests seemed to ignore those test results or might have not thought it was relevant or important enough or something at that time.
I dont know does this two tests have and relation with crohn's disease or not.If you want I would get back with the specific results later.

Also I wonder whether some kind of hernia of small intestine(superficial or other type) or intestinal ulcer of small intestine or intestinal tuberculosis can cause above symptoms?I suspect these diseases also.Just not sure how do I go for diagnosing these types of diseases.Read somewhere intestinal tuberculosis is a diagnostic challenge because it can mimic many other kinds of abdominal diseases including crohn's disease.

Thanks for reading

Post Edited (arachnids) : 3/11/2017 1:48:35 PM (GMT-7)

gumby44 said...
You can become anemic with Crohn's due to bleeding ulcers somewhere in the digestive tract. So if the CBC shows some abnormalities, they can take more extensive bloodwork to look at your iron stores like ferritin. They also can get a stool test called fecal calprotectin that can look for inflammation markers in your stool which might be indicative of IBD. If your sed rate is elevated (ESR) that indicates inflammation somewhere in your body, but not necessarily Crohn's. A marker called c. reactive protein is also sometimes elevated. All of the blood and stool test just give clues. Without positive biopsies it is unlikely you will get a Crohn's diagnosis. I imagine that along with the blood tests, an MRI or CT can look for abnormalities in your abdomen. If it's not Crohn's they might see something else amiss. Sorry you are going through this. Sometimes Crohn's takes awhile to make itself known so you can get an accurate diagnosis. My first round of testing was all normal with the exception of anemia, and it took another 6 months before we figured it out.

Thanks for the reply.yes more tests are necessary.

Just want to add here this which i am adding with the original post too.so no one misses this.

Also I wonder whether some kind of hernia of small intestine(superficial or other type) or intestinal ulcer of small intestine or intestinal tuberculosis can cause above symptoms?I suspect these diseases also.Just not sure how do I go for diagnosing these types of diseases.Read somewhere intestinal tuberculosis is a diagnostic challenge because it can mimic many other kinds of abdominal diseases including crohn's disease.