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how do they check for CD before surgery?

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Ulcerative Colitis
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Posted 3/3/2011 3:24 PM (GMT 0)
I've posted a lot of questions lately and really appreciate everyone's feedback so here's another one...  I'm 95% sold on getting j pouch surgery.  I want to be as sure as possible that I do not have crohn's.  Do I need an endoscopy done or can they tell with a CT scan if I have inflammation beyond my large intestine?  When I was given a colonoscopy in October, the doc said some of my ulcers were deeper and they stopped and started in a weird place.  Doc said indeterminate colitis/crohns.
Posted 3/3/2011 3:27 PM (GMT 0)
There is no definitive test pre-surgery. Have you had an upper and lower barium test? The best thing you can do is take all your GI records with you to your surgeon consultation. He/she will be able to help in the determination. My GI swore I had Crohn's, I knew I had UC; the surgeon agreed with me and here I am 10 years later healthy as a horse with a jpouch.

Sue
Posted 3/3/2011 3:33 PM (GMT 0)
they don't check pre-surgery- it's the GI & surgeons best guess, based on your symptoms. My GI swears I have UC, every surgeon I've met with thinks it's Crohns. I am not a candidate for a j-pouch- before you have your heart set on a pouch, I'd be darned sure a surgeon will do one on you!

Posted 3/3/2011 3:35 PM (GMT 0)
My pathology reports indicated UC, as did my blood tests. My surgeon sent my reports to his own pathologist to be more sure and they still said UC. Even after surgery when I had inflammation in the small intestine, they still said UC. Now I am diagnosed with CD.
I don't think the inflammation extended into the small intestine until after surgery so they really couldn't be sure
Posted 3/3/2011 6:57 PM (GMT 0)
Sue, I haven't had any barium tests.
Posted 3/3/2011 7:13 PM (GMT 0)
Ask your GI for the upper and lower barium contrasts. If you have CD patches may appear in the small intestine. This is a normal test for differentiating between the 2 diseases although it's not 100% conclusive but nothing is. Everyone who has had surgery for UC lives under the cloud that one day CD might manifest...like in Pam's case.

Sue
Posted 3/3/2011 7:45 PM (GMT 0)
I don't think they really ever know 100% but there are certain things that make dr.'s lean to one or the other. I had a test called a small bowel series. I drank the icky white stuff...they took a series of pictures...waited an hour...took more pictures...waited and hour...so on and so on. The test is long...it took about 4 hours but they were able to rule out Crohns pretty quickly after studying those films.
Posted 3/3/2011 8:56 PM (GMT 0)
as far as o know there is a new non invasive way to check the small intestine: you indigest a small camera and that makes fotos (thousands) on your small intestine. they are processed after. i've heard it's far much accurate than an endoscopy.
here in romania it costs about 1000 euros.
Posted 3/4/2011 2:58 AM (GMT 0)
Oddly enough, I am happy I was misdiagnosed. Had they known I had CD then, I would have only been allowed to have the ostomy surgery. Because they thought I had UC, I have a j-pouch. Yes, I had a pretty terrible year. I was very sick. I was in the hospital a lot. But having an ostomy was even worse for me, and there is a chance that I can keep my pouch for a long time. I had to have my colon out either way so I'm glad to at least have the chance at keeping a j-pouch

I don't think a pill cam or anything would have made a difference for me before surgery since I don't believe the small intestine was affected at that point
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