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lab results and MRI

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Posted 3/15/2016 11:13 PM (GMT 0)
My GI called today to tell me all my labs looked normal, and if I wanted he could schedule either an MRI or colonoscopy to see if I have inflammation that isn't showing in my tests.

I'm confused because my CRP is 1.01. The last time I was in a flare it was .72. So that seems high to me. I don't have the results in on my fecal calprotectin number yet; just the GI telling me it was normal.

I'm loathe to do a colonoscopy because that almost always sends me into a flare. Is the MRI worth doing? I was under the impression they don't show much.

Thanks everyone!
Posted 3/16/2016 12:29 AM (GMT 0)
A CRP of 1 is really not high. Depends on what version of the test was used, but if it was the non high-sensitivity one (which many labs in America and Canada seem to use), then it is slightly high. If it was the high-sensitivity version, then your CRP is actually impressively low.

MRIs are quite useful, though I'm not sure how much of the colon a small bowel MRI would show (beave? where are you when I need you?).
Posted 3/16/2016 1:49 AM (GMT 0)
The lab ranges always say that >3 is normal but that again depends on the version of the test they use. I think you would need an MRE and not an MRI to see into the intestines. Check thishttp://m.hopkinsmedicine.org/healthlibrary/test_procedures/gastroenterology/mr_enterography_135,61/. There are other sources explaining this procedure online.
Unlike you, I prefer colonoscopies rather any other procedure because they put me to sleep. I understand they could trigger a flare up. So, check w them what the contrast is. The last time I had a dynamic MRI as I was severly constipated, the contrast caused me non-stop vomiting and cramps for 3 days.
Posted 3/16/2016 2:00 AM (GMT 0)
Hmm. That's helpful. I'll ask about the CRP when I call tomorrow. I'm not sure what version it is. The lab report says:
C-Reactive Protein [H] 1.01 mg/dL <0.75

I know that's not super high, but I'm sensitive enough that I think it could be telling. Especially since the last time I flared it was .72.

Hopefully I'll get to talk to him tomorrow and find out more about the MRI and why he doesn't think the numbers are high.

Thanks!
Posted 3/16/2016 2:38 AM (GMT 0)
C-Reactive Protein [H] 1.01 mg/dL <0.75

It's the non high-sensitivity test - I thought it would be. The high-sensitivity test would have units of measurements in mg/L, which is 10x more sensitive.

CRP is only a general measure of inflammation and there are many causes of an elevated CRP, most of which are only temporary - infection, burns, surgery, the autoimmune diseases we all know and love on this forum.

Have your symptoms changed or got worse? If not, then I wouldn't assume you're flaring on the basis of a slightly high CRP.
Posted 3/16/2016 5:54 AM (GMT 0)
I would say that's a nice and low CRP. The last one I had was 24.3, with the same standard range of 0.00 - 0.75 mg/dL. That and SED rate for me are usually great indicators of how my disease is behaving, but my symptoms always go hand in hand with it as well. But yeah, I don't think I'd worry about those results. I think that's good news!
Posted 3/16/2016 12:18 PM (GMT 0)
We all seem to react to these tests differently, so it is really hard to figure out. Even when I had a full on bowel obstruction my CRP didn't elevate. The specialist at U of Chicago told me that there is a genetic component and some people's CRP never elevates. My sed rate is a better tool for my body. I never had an MRE, only CT scans, so I can't help you there. Most importantly, if you feel worse, they need to try to figure out what's going on.
Posted 3/16/2016 12:30 PM (GMT 0)
I feel like I've been getting worse since Christmas, and really not the same since my gall bladder surgery in August. The GI thinks it's IBS. I urgently have to go after a meal. I haven't had a solid stool in month, and the frequency has increased. I'm worried because I'm not on any meds; I kept having bad reactions to all but pentasa. Pentasa never seemed to do anything, so the GI agreed I could stop. I don't want to fool around. If this is a hint of CD coming back, then I want to give Entyvio a go.

Thanks everyone. It helps me understand where my GI is coming from. Hopefully I can talk to him today and make a good decision about the MRI versus scope.
Posted 3/16/2016 2:01 PM (GMT 0)

gumby said...
The specialist at U of Chicago told me that there is a genetic component and some people's CRP never elevates.

My GI said something similar to me once. Didn't mention the genetic component but did say that some people's inflammatory markers don't rise, which makes it harder to tell when they're flaring up. He said that I was one of the ones whose inflammatory markers do rise.

sparkleplenty said...
I feel like I've been getting worse since Christmas, and really not the same since my gall bladder surgery in August. The GI thinks it's IBS. I urgently have to go after a meal. I haven't had a solid stool in month, and the frequency has increased. I'm worried because I'm not on any meds; I kept having bad reactions to all but pentasa. Pentasa never seemed to do anything, so the GI agreed I could stop. I don't want to fool around. If this is a hint of CD coming back, then I want to give Entyvio a go.

It seems like a consequence of your gallbladder surgery to me. Have you tried any bile-minding meds like Questran?
Posted 3/16/2016 11:54 PM (GMT 0)
I haven't tried Questran or the like. My GI doesn't think it's related. I can eat a burger and fries and be fine, and then eat grilled chicken and rice and be in the bathroom for 30 minutes. I should ask again though.

I have a CT enterography scheduled for Monday so hopefully that will provide some answers.

As always the support here is appreciated. Sometimes non-Crohnnies don't always understand either my worries. :-)
Posted 3/16/2016 11:59 PM (GMT 0)
I agree that how you feel trumps all blood tests! I've been on Questran for some 12 years now because of having my gallbladder out. It really does make a huge difference for me. Over the years I've been able to figure out what is a flare and what is just bile salt issues. In that nothing works when I'm flaring badly, Questran or not. I think it's worth bringing up to your doctor, although I haven't found too many GI doctors that want to prescribe it. My GI still thinks it's not needed even though I tell him how much it helps. So my GP gives it to me.
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