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Questions regarding inflammatory markers CRP and ESR

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Ulcerative Colitis
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Posted 11/27/2014 2:31 AM (GMT 0)
My UC was in remission for a few years until recently... it coincided with me weaning off cymbalta and a lot of stress in my life. I weaned off cymbalta cause I thought it was not adequately controlling my fibromyalgia pain but now I wonder if it was early warnings of inflammation.

My GI dr retired so I'm between drs.

I asked my regular dr to order inflammatory marker tests. I am 2 days out from what seemed to be a GI virus (vomiting and diarrhea for 24 hours) and I am taking the equivalent of 10mg prednisone currently (for adrenal issues).

My CRP tested today at 91.5. The range given is 0-9.9
My ESR tested today is 7. The range given is 0-15

Back in July my CRP was 1.1 with no symptoms.

So.. can your CRP be elevated from having a GI virus (I had 100.4 fever) or does this confirm a bad flare... have had bleeding (minor) for last 2 months now. Bleeding is not so bad currently but addition of mucous and frequency and looseness is worrying me.

Any advice greatly appreciated. Thanks.
Posted 11/27/2014 5:10 AM (GMT 0)
CRP is just a general marker of inflammation, nothing specific to the gut. And yes, a GI infection (or any infection for that matter) will almost certainly increase CRP.

Just to clarify though, your CRP is 91.5?
Posted 11/27/2014 5:29 AM (GMT 0)
Yes, was 1.1 in June, now is 91.5...... have yet to hear from the doctor who ordered the test but it's Thanksgiving time, so will probably not be until next week.... aaargh.
Posted 11/27/2014 1:28 PM (GMT 0)
91.5 is quite high for CRP. But I know some people can go in to the hundreds. Mine was 39 a few weeks ago when I was flaring and now its under 1 as its been controlled by steroids.
Posted 11/27/2014 8:16 PM (GMT 0)
Hi I have been for a blood test today after being in flare for most of the year after doing pred for a while and starting to feel better. But since finishing the pred I feel things are starting to decline again. I have been using steroid enemas along with taking Asacol 4.8mg a day. Anyway my nurse requested I have a blood test today to see how things are. My question is they only checking my CRP levels and not my ESR levels as where before my GI Doc used to check my ESR levels which at one point were at 60 in April this year going down to 10 by September.

I asked today if the could check my ESR levels but was told that because the nurse had not requested it they would not do it.

Which is the better marker to check and why?
Posted 11/27/2014 8:30 PM (GMT 0)
I think CRP as that checks inflammation in the blood. Might be an idea to request a fecal calprotectin test to check inflammation solely in your colon. As CRP detects any inflammation in the body not just colitis.
Posted 11/27/2014 9:16 PM (GMT 0)
Thanks for your reply Happychick

I have had a stool test which detected active inflammation in my colon about three weeks got the results on Monday. That's why I was in for a blood test today.

I was not sure as my Gi always checked my ESR I thought that might have concentrated more on the gut but like I say I'm not sure. I suppose the nurse knows what she is doing its just that she is new to me so I just want to make sure I am getting the right checks as she is saying I may have to go on another course of pred and move from Asacol to Aza. Which I am a little concerned about.

Thanks again for the reply
Posted 11/28/2014 10:18 PM (GMT 0)
I get really high CRP with acute viral infection, much higher than with moderate UC. When my CRP was at 160ish last year with a virus I was advised to re-check in a week and it had come down. So CRP doesn't confirm a flare, especially if you have other symptoms, but your bleeding and other symptoms would seem to? Unless you have c diff?

ESR is a general reading too, not gut specific. Not so infection specific.
Posted 11/29/2014 1:33 AM (GMT 0)
Talked to dr today. he said it's sounding more like crohn's than UC flare so will have to scope again... back on Lialda and steroids for control until I can get in for an appt. Argh. My labs seemed fine today though, but they didn't retest CRP. My concern that I had a high CRP after 2 days on doubled steroids.... so it would have potentially been higher...
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