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Finding a correct diagnosis between UC and Crohns

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Ulcerative Colitis
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Posted 12/13/2017 12:45 AM (GMT 0)
When I first started having symptions of UC 5 years ago, I had a colonoscopy done. The GI wasn't sure what was wrong but said it looked like UC so that is what she diagnosed me with. A few years later, another DR (who is a Proctologist who also treats patients with UC and Crohns) did a scope and said it looked more in line with Crohns disease.
Now I'm at a new (highly recommended GI) who hasn't done a scope, but makes sure to tell me I don't have Crohns, it's UC.
I tried to tell him what the prior Doctors have said. He tells me sternly "You have UC, Not Crohns, that's why I have a medical dregree and you don't" Then says to stay off the internet - ***? Who doesn't look at the internet that has a GI problem???
I want to tell this guy to take a hike but I need the Lialda prescription too bad. I don't disagree with his logic, but at the same time I am struggling to deal with someone who is so closed minded. Good GI's are so hard to find here in STL that are available to see. I only got in to this Dr. because my Family Physician called in a favor and asked he add me to his patient list.
Just wondering if anyone else is struggling with a clear diagnoses of either Crohns or UC. I understand they can be very different but also they can seem very similar as well and can evolve through correct diagnosis.
Posted 12/13/2017 1:06 AM (GMT 0)
What it looked like is probably not as important as what the pathology says, but both are important pieces of the puzzle. Often UC and Crohn's can be difficult to distinguish. In most cases, UC presents consistently throughout from the rectum, to higher up - but stays within the colon/rectum. Crohn's can be patchy and can show up anywhere from mouth to anus. The new GI sounds cocky, but perhaps he had information you do not, like results of blood work (which generally is not seen as accurate but it's another piece of the puzzle), the pathology, thinks he saw something in the pictures that made it clear to him. You can request copies of your pathology to take a look yourself. Might shed some answers. Actually which it is, isn't that important, as the treatment at this point will likely be the same. It becomes important to differentiate when things when you've run through a lot of the medications and you need options. Crohn's has different treatment options available. Also, if you ever had to consider surgery, you would need to know at that point.
Posted 12/13/2017 2:38 AM (GMT 0)
I see an IBD specialist at a well known teaching hospital and he thought I had UC at first because it started out as proctitis and uniformly spread upward. Now it looks like it might be Crohn's as it skipped some areas upward. The pathology did not determine either way and my doc said at this point it doesn't matter just like NSG above said. The treatment is the same for now and my doc said the main difference is the type of surgery if needed (pray not!) So for now he thinks I have Crohns instead of UC but who knows?? Sometimes its not so clear cut. I don't like how your GI sounds either, I had an seen one like him before and I got rid of him. I know how hard it is to get in with a good doctor. I have a great doctor and he doesn't always have all of the answers either, but none of them do. UC/Crohn's -- don't want either of them..... ugh
Posted 12/13/2017 2:47 AM (GMT 0)
Do you have your colonoscopy report and biopsy reports? It'd always go by what they say regarding diagnosis...
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