Posted 11/1/2018 2:32 AM (GMT 0)
Low hemoglobin sometimes indicates gi bleeding, but it sounds like in your son's case the low hemoglobin is from low iron. Often they can tell from blood tests whether any anemia is caused by low iron, by low b-12, by low folate, or by bleeding. His restricted diet, plus possible limited absorption, might be why his iron was low.
Two small ulcers seen on the pillcam means there is mild Crohn's activity going on. I agree with the doctor that it's a 'mild concern.' The question is, is it the beginning of more active inflammation, or is it just a couple of small ulcers that will go away on their own? The answer is that it could be either, but for now it's mild activity.
For what it's worth, I've had a pill cam show several small ulcers in the small bowel at a time I was feeling fine. So that certainly happens.
Since there is some inflammation/ulceration seen, it should be watched. It sounds like that's already being done, which is good. I'm surprised (and a little jealous) your son got a capsule endoscopy approved instead of an MRI. I keep wanting another capsule endoscopy because it's the only thing that has really shown something for me. But insurance won't approve another after the first and will only approve MRIs or CT scans to check my small bowel. Those tests can see big things but can miss little things like two little ulcers.
Anyway, I'd say it's not much to worry about, just have him keep getting regular blood work, iron as needed, and maybe a small bowel MRI or another capsule endoscopy in another year or two.