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Question: I have a question regarding Crohns. I was diagnosed last year after sharp abdominal pain. I have been on Humira for 9 months. This week I had a protectin test done and it came back at the lowest level. How is this possible when an MRI this month showed no real reduction to inflammation and fistula?
Brief Answer:
Please follow..
Detailed Answer:
Hi and thank you for asking.
I read carefully all your concerns and I can say as follows :
1. You are reporting to have been diagnosed with crohn disease 9 month ago.
I need to know more about your recent symptoms like :
- do have any improvement after humira usage
- do you have diarrhea and blood on stools.
2.You are reporting to have done calprotectine test and MRI. Please can you upload the reports to me so I can check them by myself.
3. The gold standard to evaluate the bowel inflammation is colonoscopy and not MRI.
Hope it was helpful to you.
Dr.Klerida
Please follow..
Detailed Answer:
Hi and thank you for asking.
I read carefully all your concerns and I can say as follows :
1. You are reporting to have been diagnosed with crohn disease 9 month ago.
I need to know more about your recent symptoms like :
- do have any improvement after humira usage
- do you have diarrhea and blood on stools.
2.You are reporting to have done calprotectine test and MRI. Please can you upload the reports to me so I can check them by myself.
3. The gold standard to evaluate the bowel inflammation is colonoscopy and not MRI.
Hope it was helpful to you.
Dr.Klerida
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response. I had two doctors who diagnosed me. One mentioned inflammation near the ilieum, but when I spoke with him he said he did not see Crohns. The other doctor two months later came up with more severe findings. I do not have diarrhea, I have one bowel movement in the morning. The Humira did not seem to have any effect. When I eat good foods, it really seems to help. The doctor who did the second exam told me that an MRI was better than colonoscopy. I am very confused. Calprotectin and CRP came back normal. The doctor who did my second exam said "I have fistulizing Crohns which places me in the top 10% of most severe cases." I think this is ridiculous. If I was that bad, I would really be feeling it right now, right? I will upload the findings from the exam tomorrow. Thank you.
Brief Answer:
Please follow...
Detailed Answer:
Hi back,
I read carefully all your medical data and I can say as follows:
1. The best diagnostic exam for Crohn disease is endoscopy and colonoscopy plus biopsy, and not MRI.
2.Your diagnosis of Crohn is really doubt. To my opinion you should repeat colonoscopy plus biopsy of the ileum and other parts of large bowel to definitely rule out/ confirm IBD and Crohn disease.
3.Fistulae from Crohn has a more dramatic and specific symptoms. You are not
describing any symptom ; Your bowel movement is normal and any thing else.
At the end I am really interested to know your test results and I am waiting from you to upload them.
All the best!
Dr.Klerida
Please follow...
Detailed Answer:
Hi back,
I read carefully all your medical data and I can say as follows:
1. The best diagnostic exam for Crohn disease is endoscopy and colonoscopy plus biopsy, and not MRI.
2.Your diagnosis of Crohn is really doubt. To my opinion you should repeat colonoscopy plus biopsy of the ileum and other parts of large bowel to definitely rule out/ confirm IBD and Crohn disease.
3.Fistulae from Crohn has a more dramatic and specific symptoms. You are not
describing any symptom ; Your bowel movement is normal and any thing else.
At the end I am really interested to know your test results and I am waiting from you to upload them.
All the best!
Dr.Klerida
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I should have mentioned before that the first Dr who did my colonoscopy did not even mention a fistula. The 2nd Dr two months later said he saw fistulizing crohns. I read about the symptoms and it I dont have any of those symptoms. If I did have a fistula that was diagnosed back in Apr 2015 and the MRI in XXXXXXX 2016 shows that it is still there, why wouldnt my current Dr do anything about it? Isnt that dangerous?
I also remembered that the first dr. came back and said that crohns was within the differential diagnosis. What exactly does this mean? By the way, how many follow up questions do I get for my initial payment? Thank you very much for your responses, they are very helpful in trying to figure out this difficult problem.
I also remembered that the first dr. came back and said that crohns was within the differential diagnosis. What exactly does this mean? By the way, how many follow up questions do I get for my initial payment? Thank you very much for your responses, they are very helpful in trying to figure out this difficult problem.
Brief Answer:
Please follow...
Detailed Answer:
Hi back,
With regards to fistulae, it is a dangerous situation and needs immediate medical attention.
To my opinion your doctors have suspected for Crohn disease but not confirmed it. this is why your first doctor said you that crohn was within differential diagnosis.
As per follows ups , you can make 3 of them included in first payment.
Hope it was helpful
Dr.klerida
Please follow...
Detailed Answer:
Hi back,
With regards to fistulae, it is a dangerous situation and needs immediate medical attention.
To my opinion your doctors have suspected for Crohn disease but not confirmed it. this is why your first doctor said you that crohn was within differential diagnosis.
As per follows ups , you can make 3 of them included in first payment.
Hope it was helpful
Dr.klerida
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I uploaded some documents for you to look at. History and prognosis shows what the Dr. found during the second examination. Blood test shows that my during my time in the hospital stool sample was heme positive. Your advice has been great, I hope I can find a Dr. in my town who will listen to me. I am in military and they are trying to separate me based on the diagnosis of Crohns.
I found these websites which talk about other things that can mimic Crohns.
Please tell me if this is valid:
- http://www.annalsgastro.gr/index.php/annalsgastro/article/view/1004/742
- http://www.medhelp.org/posts/Digestive-Disorders---Gastroenterology/IBD-DisguisesDiseases-That-May-Mimic-Crohns-Disease-and-Ulcerative-Colitis/show/228624
- http://www.consultantlive.com/gastrointestinal-disorders/mimics-inflammatory-bowel-disease
I found these websites which talk about other things that can mimic Crohns.
Please tell me if this is valid:
- http://www.annalsgastro.gr/index.php/annalsgastro/article/view/1004/742
- http://www.medhelp.org/posts/Digestive-Disorders---Gastroenterology/IBD-DisguisesDiseases-That-May-Mimic-Crohns-Disease-and-Ulcerative-Colitis/show/228624
- http://www.consultantlive.com/gastrointestinal-disorders/mimics-inflammatory-bowel-disease
Brief Answer:
Please follow...
Detailed Answer:
Hi back,
I read carefully all your medical reports and I can say as follows:
1. You have done MRI enterography and not a simple MRI. It is more trusted in diagnosis of small bowel disease.
2. What you doctor describe is suspected fistulae bowel to bowel. This can partially explain your poor clinical signs.
3. With regards to initial clinical symptoms , these seems to be typical for IBD .
I read carefull all information on links that you have posted to me and one of them is really important ( the first one ).
It is true that there are some other conditions that mimic the clinic an d a part of signs of Crohn disease in terminal ileum.
Otherwise biopsy of terminal ileum is the best exam that helps us in clinical practice to evaluate the exact diagnosis.
4. This is why I strongly suggest to discuss with your doctor performing an eneteroscopy( longer than colonoscopy whitch reaches ileum) with multiple biopsies to definitely confirm/ rule out Crohn disease.
Hope it was helpful to you!
Dr.Klerida
Please follow...
Detailed Answer:
Hi back,
I read carefully all your medical reports and I can say as follows:
1. You have done MRI enterography and not a simple MRI. It is more trusted in diagnosis of small bowel disease.
2. What you doctor describe is suspected fistulae bowel to bowel. This can partially explain your poor clinical signs.
3. With regards to initial clinical symptoms , these seems to be typical for IBD .
I read carefull all information on links that you have posted to me and one of them is really important ( the first one ).
It is true that there are some other conditions that mimic the clinic an d a part of signs of Crohn disease in terminal ileum.
Otherwise biopsy of terminal ileum is the best exam that helps us in clinical practice to evaluate the exact diagnosis.
4. This is why I strongly suggest to discuss with your doctor performing an eneteroscopy( longer than colonoscopy whitch reaches ileum) with multiple biopsies to definitely confirm/ rule out Crohn disease.
Hope it was helpful to you!
Dr.Klerida
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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