Anyone had a diagnosis change from UC to Crohn's? also Humira?

After being diagnosed 2 year ago with left sided UC, I switched to a new GI (due to many things).  I have never achieved remission really and I have developed iritis (eye infection).  So, I have a new scope and she discovers that I have a stricture (narrowing) at about 4 inches from my rectum.  The inflamation is 9 inches total from rectum up.  I had a CT scan and my small bowel is fine.

That said, my GI is concerned that I have Crohn's and not UC due to the stricture.  So, she wants me to start Imuran and perhaps even Humira.

I don't want to underreact but I don't want to over medicate either! 

Just curious if anyone else has had a diagnosis change and also any feedback about Humira.

Thanks!

Hey Kelly!  According to my GI, it is very rare for UCers to have strictures.  She said in fact, they usually present with the opposite a ballooning effect that can lead to perferation (sp?).  Anyway, she consulted the other GI's on her clinic (they are an Inflammatory Bowel Disease Clinic at Vanderbilt University) and she said the general consensus was Crohn's.  That said, I am not a doctor, but my issue starts at the rectum and is straight inflammation for 25 cms (about 9 inches) the narrowing halfway up- 4 inches.  She is worried that the narrowing could get worse and I would have a blockage.  It is not presenting as Crohn's and that has me baffled (I and think the doctors).

Very interesting stuff.  I am to have one more blood test and then most likely proceed to the Imuran/Humira route.  I guess not matter what I have- the stricture needs to be addressed.  I had two previous scopes with my former GI.  All UC and when I switched for a second opinion the new scope (one year later that my last) show this narrowing.

I just pray we are all in good hands, you know!  We are at the mercy of doctors.

Good luck to you!

The overlap is called indeterminate colitis.

I agree that we're at the mercy of our doctors....not all doctors are good or have their patients' interests at heart. 

Strictures do happen in UC, although not a high percentage of patients get them...it's imperative they are biopsied..for many can possibly be a symptom of early cancer.   However, it seems it happens more often in those who have had it for a very long time rather than newly diagnosed. 

One interesting factor that anyone who has strictures should be aware of.....high fibre is contraindicated, so the diet should be adjusted.

I found this article that might be of interest..it's 6 pages:

http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1844640&pageindex=1

quincy

quincy said...

The overlap is called indeterminate colitis.

"Indeterminite" implies "we don't know which you have." The impression I got from my doc, a fellow at a world-class teaching hospital, was they're starting to explore the possibility that people might actually have both or that the two are not such separate entities... not a case of we haven't determined which one you have yet. I found it interesting because I've always felt instinctively that digestive illnesses are more of a continuum than separate conditions. I'll see if I can get some supporting information from him.

Kristen~

FYI, if the test you are having is the Prometheus test, your insurance may not cover it.  I was stuck with a bill in excess of 400 dollars for mine.  It seems that this happens to most people.

I doubt there is much of an "overlap" primarily because of this....

Dr. Kathrine Siminovitch and her team discovered (in 2004) one of the genes that predisposes development of crohns disease...The gene is located on chromosome 5 and normally produces a protein that sits on the cell surface and controls movement of specific substances in and out of the cell...when altered (scratched), the gene produces a protein that functions improperly, allowing toxins increased entry into the cell...

This gene alteration is primarily observed in crohns disease and so, as a direct result of Dr. Siminovitch's discovery, doctors can now use an assay (laboratory test to find and measure the amount of a specific substance) of this gene to distinguish between crohns disease and ulcerative colitis.


:)