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pos promethius test

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Crohn's Disease
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Posted 8/18/2007 9:50 PM (GMT 0)
Does anyone know just what a pos promethius test for Crohns really means?  What if it doesn't show up on scopes/radiology tests?
Posted 8/18/2007 10:59 PM (GMT 0)
The only info I ever got from the promethius test were bills my Dr never gave me results But I was Dx with CD in 1987, so it would be odd if it were neg for me
Posted 8/19/2007 2:52 AM (GMT 0)

The Prometheus IBD Serology 7 test looks for serum markers that are found in those with inflammatory bowel disease [IBD]. Here are some statistics:

Sensitivity - The likelihood of a positive test result among those who do have the disease:

IBD = 93%

CD = 88%

UC = 93%

Positive Predictive Value - The probability that a positive test result is correct:

IBD = 96%

CD = 96%

UC = 89%

So, yes one can have a positive test result and NOT have the disease. But, the majority that have a positive result do have the disease. I am not familiar with you and don't know what tests you have had. Some questions: Did you have a colonoscopy and did they take biopsies during the scope? Have you had a capsule endoscopy? If the disease in present in the small bowel, it does not always show up on xrays or CT scans. I hope this information has helped.

Posted 8/19/2007 3:19 AM (GMT 0)
I have had NEGATIVE results on the promethius test yet ALL my scopes in the past 10 years have ALL came back positive for crohns. So... the promethiesu test is not all that reliable as far as I can see
Posted 8/19/2007 4:49 AM (GMT 0)
prof - Yes, a person can have Crohn's and a negative serology test. The reason is that not EVERY serological marker for inflammatory disease has been identified and/or a test developed for it. The subset of those that have CD and test negative on serology tests is growing smaller as more work is done in this area. Hopefully, we will soon see a 100% reliable test and spare the long diagnostic rollercoaster trip.
Posted 8/20/2007 4:54 PM (GMT 0)

I had a positive Prometheus test for CD, capsule endoscopy that showed edema and 'red splotches' in my jujenum that was indicitive of CD, colonoscopy that showed swelling and ulcerations indicitive of CD, and biopsies that came back positive for colitis/CD....but since I had a clear scope with biopsies last month, my GI now wonders if I ever really had CD...

 

I'm sticking with the CD dx.

 

:)

Best,
M.

Posted 8/20/2007 6:39 PM (GMT 0)
Mandolen you are very wise to stick with the CD diagnosis. The meds are just working for you, hence the clear scope. When all the other tests were done, they alone proved you have Crohns. Good Luck to you.
Posted 8/24/2007 1:38 AM (GMT 0)
I have had all the tests I think they can do including the capsule endoscopy and the colonoscopy. They say they can't see anything. Yet the upper abd pain has continued for 9 month and the frequent loose stools and now a vit D defieciency. (I am redheaded and live in the deep south so it is not from lack of sun). I have had blood in my stool twice in the last 3 weeks. and I have whole body joint pain. The Drs. just say they don't know what is wrong. I am trying a nutritional product called Reliv and it seems to be helping. all the markers for inflamation are coming back normal. I just dont know how this all fits together. (Family hx of Crohn's : my brother, my uncle and my cousin)
Posted 7/1/2008 3:43 AM (GMT 0)
They did a promethius ibd on my son-he has had bleeding when he has a BM for about 6 months.  He had been to the doctor a few times and they said it was a rectal fissure that should heal on its own.  When it did not, they sent me to a specialist who did this test.  They said it indicates he has an IBD-which I have a hard time believing.  He has none of the other IBD symptoms that I have read about. Is it possible it is a false positive?
Posted 7/1/2008 4:39 AM (GMT 0)
Yes it is possible to have a false positive. That said, a rectal fissure that does not heal is one of the symptoms of IBD. we have a couple members here that have had a fissure as their only complaint. If your son's stools are not excessively hard or large, and all the fissure treating meds have been tried, and he still is not seeing any healing - then further investigation might be in order.

What further tests is the gastroenterologist recommending?
Posted 7/1/2008 7:49 AM (GMT 0)
My GI (Cleveland Clinic) told me that she wanted me to have the IBD7 so that she could decide how aggressively to treat my probable Chron's. The scope, biopsies and history indicated probable Chron's. The IBD7 only showed one of the 7 as positive. GI doc said that she would have treated me more aggressively if that test had come back positive (3 or more of the 7 positive). My understand is that you can test positive on the IBD7 and even though you don't have active Chron's. But not many people would be spending that kind of money if they weren't symptomatic. Blessings!
Posted 7/1/2008 9:27 AM (GMT 0)

The serology 7 test is pretty darn accurate if you have Crohn's.  I was first diagnosed through the capsule study, but have never yet had a positive diagnosis through biopsy.  This is really common because sometimes people only have active disease where the scope can not reach.  On the original Promethius Test, I came back as a negative.(Many years ago), but when the Serology 7 Test came out, I came back with a extremely positive rating 2 times.  I still have had many recent scopes that have come back as clean with some inflammation, but the Serology 7 results have come back the same to 2 different G.I.'s.

This a minor pet peave of mine, but everyone Crohn's Disease is not spelled Chrons or Chron's. I am not trying to hurt feelings, but we have got to learn everything we can about this wonderful disease that we have. tongue

Posted 7/1/2008 2:04 PM (GMT 0)
They are recommending EGD and colonsocopy. What other treatment for anl fissures are there other than stool softeners and hemmrhoid cream.
We are waiting on the results of his stool studies.
Posted 7/1/2008 5:31 PM (GMT 0)
I have mentioned before, my GI went to med school with the doc who invented the test and doesn't think it is accurate enough to even bother with.
Posted 7/1/2008 11:06 PM (GMT 0)
nb - if the only thing the doctors have prescribed for the fissure so far is hemorrhoid cream and that is not working, then shame on them. If your son is having a great deal of pain when he passes stool, then he might be reluctant to go, holding back, thereby making the stool harder and larger. Then the fissure is further aggrevated. There is a Lidocaine gel that comes with a rectal applicator that is used prior to having a BM. The lidocaine temporarily deadens the area and makes the BM painfree.

What type of hemorrhoid cream did they give him? If it is over-the-counter, then there are prescription creams that are stronger. Protosol is one that comes to mind. It is a strong steroid pintment that comes with a rectal applicator. There are other brands available. The key ingredient is the prednisone in prescription strength.

If steroid ointments do not work, then the doctor might try nitroglycerin ointment. It works by allowing the anal sphincter to relax and reduce pressure. That allows the edges of the fissure to come together and heal.

If those do not work, some people have had success having Botox injections in to the sphincter.

From the results of the Prometheus test, doing a colonoscopy sounds like a prudent course.
Posted 7/2/2008 1:06 AM (GMT 0)
That is the thing...he has no pain but when the GI Specialist looked at him she said she did not see a fissure, so she did blood tests, BM studies and included this promethius ibd which they said was positive. We are waiting on the results of the stool tests but he will be scheduled for the egd and colonoscopy.
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