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Standard of care for dx

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Crohn's Disease
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Posted 1/25/2015 10:27 PM (GMT 0)
Hi, I've been lurking from the UC forum and am wondering what the standard of care is to establish a dx for crohn's. I've read many testimonials from former UC patients actually having crohn's. This past year my UC has been a hosebeast and I'm concerned.
Posted 1/25/2015 10:37 PM (GMT 0)
You need a colonoscopy with biopsies to diagnose Crohn's - although it is very difficult to distinguish between the two, the treatments are typtically the same. If Remicade isn't working, maybe they could add something to it?
Posted 1/25/2015 10:43 PM (GMT 0)
I've had a recent colonscopy with biopsies that showed cryptitis. A member of another group I follow mentioned that the pill cam is the only reliable method. Is that incorrect?
Posted 1/25/2015 10:48 PM (GMT 0)
What symptoms are you having that make you suspect it may be Crohn's? I've had a GI try to change my dx to UC even though I have fistulizing disease. My surgeon thought my GI was nuts, though.
Posted 1/25/2015 11:15 PM (GMT 0)
Scifigal: I met with my GI recently and forgot to ask about adding something but I will when I see him in Feb.

JaSanne: The symptoms that are abnormal are 24/7 nausea since October, epigastric discomfort, feeling full quickly and a late symptom in Dec. was the inability to complete a bowel movement which required manual assistance and I wasn't constipated. I've had a recent EGD, no ulcers and I take dexilant. I've also been worked up for gallbladder disease in the last year because I had unexplained pancreatitis. Those tests were negative as well. Because of my rather vague upper GI symptoms, my new GI doc treated it as proctitis. He said some patients present that way. Shortly thereafter, I had a full flare requiring hospitalization and IV steroids. I think I'm concerned because I've never presented this way. I typically start with cramping, then D, then try to manage at home while on PO prednisone. I'm also considering a lap colectomy with j-pouch and wouldn't consider it if I had a crohn's dx.
Posted 1/26/2015 1:36 AM (GMT 0)
That sounds a bit like gastroparesis (feeling full). I understand why you want to have this. The problem with not having BMs is that the pill cam could get stuck and won't come out. That would be a big problem requiring surgery to remove it and the risk of septic shock.

My UC was changed to Crohn's when I got my first abscess that turned into a fistula.
Posted 1/26/2015 2:23 AM (GMT 0)
Yes, that is exactly what my new doc said. He described it as "gastroparesis of the colon." I'm familiar with the typical definition but didn't realize inflammation of the colon/rectum could cause similar symptoms. As far as the BMs, it was a temporary problem that has not occurred again. I think I'll sit tight for now and not worry about it unless I decide to have surgery. Thanks for the feedback.
Posted 1/26/2015 3:50 AM (GMT 0)
I meant gastroparesis of the stomach (I have that).....but I guess it makes sense that it could happen in the colon. Basically it just means that the gastro tract is paralyzed. Food is moved out of the stomach and through the GI tract through contractions.

I was diagnosed by a stomach empty test (I think that's what it was called). I ate radioactive eggs and an hour later they did an x-ray to find out where they were.

But I am glad that you are doing better! :)
Posted 1/26/2015 3:59 AM (GMT 0)
How does that test help with diagnosis? Does the diseased area light up because of radioactive eggs?
Posted 1/26/2015 3:08 PM (GMT 0)
No, it shows where the eggs are. For me, after an hour, they were still just sitting in my stomach and hadn't moved anywhere. This is a test for gastroparesis, not Crohns.
Posted 1/26/2015 4:57 PM (GMT 0)
I've never heard of gastroparesis of the colon...I always thought they just called it slow motility.
I had gastroparesis (stomach) when I had an active c.difficile infection, and it resolved when the infection cleared. The stomach emptying test is not a test for Crohn's disease.
Posted 1/26/2015 8:30 PM (GMT 0)
Ok, that makes sense about the stomach emptying test. I guess I should clarify about the gastroparesis. My symptoms did sound like gastroparesis in the true sense of the definition but the back up was/is due to inflammation in the colon and the rectum as opposed to dysfunction of the stomach. He had me take zofran 4x/day for the nausea and because it acts as a prokinetic. Sorry for the confusion.
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