do you need biopsies to confirm Crohns ??

Hi, bit of a long story but 2008 I started with rightsided ileac fossa pain and consequently had my appendix removed which were later found to behealthy.The biopsies from my first colonscopy were suggestive of crohns. Since then it has been a downward spiral and have had many episodes of horrendus right sided pain, vommitting fatigue and low grade fever , headaches, mouth ulcers, dehydration, with mucus bloody stools and severe weightloss..which have lssted weeks/months.Gradually my illness has got worse to the point due to having soo many sick days from my practice nurse post I was finished. My consultant has been unable toget a concrete diagnosis stating its either severe ibs or crohns disease. I have had a small camera capsule which was inconclusive due to restricted viewing due to excess faeces even after the bowel prep. My last colonscopy was Nad, but I blame the length of time it took for the test to be completed and when taken I was fairly well. I have had 2 faecal calprotectin which were suggestive of crohns. I have been hospitalised so many times I have lost count for pain relief (morphine iv) and have just been discharged 2 days ago after a weeks stay due to being so unwell and dramatic weightloss. My problem is I have not been given a concrete diagnosis, bts do not show anything up. My question is can a diagnosis be given without biopsies?? I am currently on 9mg of budensonide that has had the desired effect. A consultant at the hospital said I should ask my consultant when I see him a Wcc scan???? and be given an operation as this illness has taken over my life and the length of time I have had these symptoms. Has anybody else has had similar experiences?? I just want to get my life back- or be given treatment to help as they are so reluctant due to lack of diagnosis. Please help??? Thankyou soooo much! x

Hi there, many thanks for your reply..originally I was given steriods and asaco Then I was given a new consultant who didnt think it was IBD and who Im currently withl. Im just at my wits end as feel as if I was labelled I would get some form of treatment as gradually over the years my health has detrioated and he gave me the budensonide for me to stay on a longer period as safer than predisolne but has not helped. I am now under the dietician due to severe weight loss and my diet consists of fortisips! Im sorry for moaning but would just love to get rid of even half of these symptoms and worried about the long term effect of pain relief im taking ( 75mcg fentanyl patch, buscopan, paracetamol, tramadol, amitriptlyne, and pregablin and then antiemetics). would be grateful for any advice.x

"Severe IBS"?

Please, get a new doctor immediately; if you are in the UK (which it sounds like) you are entitled to go to any hospital of your choice. Dunno where you live, but if it's in my area (Beds/Bucks), I'm happy to recommend my hospital/GI to you.

Sounds like you've been woefully mismanaged. Crohn's cannot be ruled on the basis of normal blood tests (not everybody's inflammatory markers rise) or even on negative biopsies (particularly as you've already had one set of biopsies positive for Crohn's in the past). Have you had any other tests, like CT/MRI scans or small bowel barium x-rays? Before having more tests, it would be a good idea to come off the Budesonide first, though, as that might skewer results if you're on it.