Colonoscopy found no Crohns - How is this possible?

Hey guys,

Today I had a Colonoscopy of my large bowel and also reaching into my small bowel. Surprisingly.. the GI said I have no signs of inflammation or Crohns at all. Waiting for the biopsy results, but how can this be possible?

If you are in remission - would your Colonoscopy be this clean?

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To give a backstory I perforated my small bowel in a kickboxing injury requiring surgery in Jan 2015. It wasn't until June 2015 I got a CT scan by chance and discovered inflammation. I'll include the previous tests I had done last year in the US. They were all consistent with Crohns. Am i cured? :yfaint:


- CT Scan (June) - (https://gyazo.com/3a22d5d1fd7d895a423acf1b5b6941c3)
- Colonoscopy (https://gyazo.com/43f34b0614ed01fb7118c342435d7c6d)
- Promethius Blood Test (https://gyazo.com/98625505b2be90db7aa3972d741d6e7c)
- CT Enterography (November) - https://gyazo.com/08f31218bcba8fed65404be02083c35a

You had surgery in January of 2015 and showed up with inflammation in June of 2015? hmmm. Six months would be a long time to be experiencing inflammation from the surgery but I wouldn't completely write it off. If its possible that you were experiencing complications from the surgery, then its safe to assume the following tests could show false positives.

I don't want to doubt the original diagnosis... but I doubt the original diagnosis.

Having said all of that, showing no signs of disease doesn't mean there is no disease. My most recent colonoscopy showed the same thing but I know I have the disease. It is pretty amazing though that you were able to fully enter remission so quickly without any meds. Had you drastically changed your diet since?

Yes it is possible. I just had a clean scope with no sign of inflammation.....which equals remission still for me!

I'd wait for the biopsies to come in and go from there as far as second guessing the dx. Six months after my son's small bowel resection he had a colonoscopy and the GI was delighted saying his bowels were pristine. He would never think that CD had been present except for the fact of an anastomosis site. Biopsies told a completely different story with active CD inflammation at the cellular level.

This inflammation progressed in another 6 months to be seen throughout the bowels visually, necessitating a change in med schedule and such.

If after biopsies things are clear and you're concerned about the original dx a discussion with your GI about these concerns or possibly you could send your med records for a record review at a prominent IBD center or even another GI opinion.

Hope you find answers soon!

Thanks for all your replies.

Interesting that the scopes can look so clean if you're in remission - I guess I'll have to wait for the biopsy to get a definitive answer.

It's just weird that I can go from having inflammation and patchy colitis in a colonoscopy 6 months ago to having nothing. I'm kind of glad I didn't rush into hard drug treatment plan now.

@Gianni - I haven't changed my diet, but I have always eaten pretty healthy.
I did have a short course of steroid medication (budesonide) for 3 months after the CT Scan last year (Nov 2015 to Feb 2016). But i was tapered off it when I got back to the UK as I've never had any symptoms. They stopped Pentasa too - I was taking that for around 5 months.

Steroids could explain some of it.

Out of curiosity does IBD run in your family at all? I find it really interesting that they discovered rather advanced crohn's 6 months after a non related bowl incident and surgery.

Gianni said:

Steroids could explain some of it.

Out of curiosity does IBD run in your family at all? I find it really interesting that they discovered rather advanced crohn's 6 months after a non related bowl incident and surgery.

Click to expand...

No we don't have any IBD in the family.

I remember when the kickboxing injury happened last year all the Doctors told me how rare it was to perforate your bowel from a stomach trauma. They did comment saying it looked really inflamed during surgery, but no mention was ever given to IBD.

And the specialists I've seen since have either said Crohn's may have weakened my stomach to cause the injury in the first place or that it's just a post-surgical phenomenon and not crohns.

Just a mystery really :shifty:

Asymptomatic CD isn't unheard of and it is fairly difficult to perforate the bowel in the way that you did, so a weakened bowel due to existing chronic inflammation seems reasonable.

During the scope did the biopsies show granulomas? That would be telling toward CD.

If your biopsies come back clear and you fell your aren't getting definitive answers maybe you could set up regular testing to monitor for a time. If inflammatory markers like CRP are indicative for your past inflammation then they could be useful or possibly fecal calprotectin stool tests.

Clash said:

Asymptomatic CD isn't unheard of and it is fairly difficult to perforate the bowel in the way that you did, so a weakened bowel due to existing chronic inflammation seems reasonable.

During the scope did the biopsies show granulomas? That would be telling toward CD.

If your biopsies come back clear and you fell your aren't getting definitive answers maybe you could set up regular testing to monitor for a time. If inflammatory markers like CRP are indicative for your past inflammation then they could be useful or possibly fecal calprotectin stool tests.

Click to expand...

Yeah my first Colonoscopy last year showed patchy colitis during the colonoscopy and granulomas after the biopsy.

P.s. Just went for a faecal calprotectin today after your suggestion Hopefully since I just had my colonoscopy 2 days ago it wont affect the results..