Questions about CT scan

Did you just have the CT scan done? What else, if anything, did it show?

Is that the first CT scan you've had? Have you ever had a colonoscopy before?

It's very possible you've had mild Crohn's all these years; but to know for sure, you'll need more tests. The most important will be a colonoscopy that includes taking biopsies, specifically biopsies from the terminal ileum. That can often be done with a 'routine' colonoscopy, but sometimes it can require a more specialized colonoscopy.

Since your CT scan also says thickening in the cecum, a biopsy from there may be sufficient -- and that's easy to reach, usually.

Anyway, yes, the stereotype for Crohn's patients is diarrhea, but it's certainly not always the case. Many of us have more constipation than diarrhea. I've had a few bouts of bad diarrhea over the years, usually a few years apart, and in between I'm either fairly regular or a bit constipated.

As for what you can eat, it's highly individual and requires some trial and error. If you're constipated, you want to drink lots of water. And you want to eat fiber - but some fiber can be a problem. Find what you can tolerate - bananas? apples? oatmeal? Nut butters? Maybe fiber supplements like Metamucil (start slowly with smaller doses if you start it)?

The general advice is to avoid nuts, seeds, popcorn, etc, but if you can eat them without pain, then they're ok. I go through phases where I'm fine with foods and phases when those foods can bother me.

If none of those work, you can try Miralax. It's safe and can be used daily if needed. I sometimes use a half dose a day for a few weeks at a time.

Good luck!

The oral contrast, plus enema contrast, plus IV contrast in your veins, will all lead to much better pictures than a CT scan without them.

It's possible that's why these things showed up this time but not last time. You probably had a little bit of it before but not enough to be evident without using the contrast to get better pictures.

The findings you describe sound pretty likely to be Crohn's - it's the most common location for it to occur (at the junction of the small bowel and the large bowel, ie, the colon), and you have wall thickening (from active inflammation, scar tissue, or a combination of both), plus narrowing of the inside of the "pipe" at the end of your small intestine with the segment immediately behind that bulging a little. Those are all classic findings of Crohn's.

A scope is definitely in order when you get back to the states. Get copies of your CT scan and the report and present them to your GI or primary care doctor, and they should know that a scope is needed.

Kaiser has lots of GIs. Try to get to one that focuses on IBD (inflammatory bowel disease) like Crohn's and UC. I know some Kaiser GIs focus on that and others don't.

Soups are probably a good thing to eat. I'd avoid nuts, seeds, probably salads and raw veggies, as I mentioned above. Veggies cooked to be mushy/really soft might be ok. Applesauce, yogurt, soups, bananas, broiled or baked or grilled fish or chicken, potatoes, white rice, probably all ok. Fruits may or may not be ok. Avoid their skins and you might tolerate them. Nut butters are probably ok.

If you find yourself getting pretty sick (fever, vomiting, pain, blood in stools), you can ask a doctor for prednisone. It's cheap and readily available. It will help you feel better fast but isn't a long term solution due to side effects that accumulate over time.

Post Edited (beave) : 8/13/2019 11:28:19 PM (GMT-6)

I got the colonoscopy a few days ago. They took biopsies from the iliocecal valve...couldn’t make it into the terminal ilium. They also took from other parts of intestine, though only the valve area had ulcerations. No results yet but the doctor wants me to have more imaging, I don’t want another CT scan since I just had one last month. If he can’t open or see that one, I’ll choose an MRI. I imagine they are good enough. Any thoughts on that? What would the biopsies show?

I chose the MRE because no radiation. Hopefully I'll get some answers. Still no results from biopsy. But i have so much pain if i eat that i know the food has a hard time passing. No poop tells me this.
Ugh...i am in limbo and need to consult with the GI, who i met the first time when he gave me the colonoscopy. I need a treatment plan and i need it soon!