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06-19-2012, 07:09 PM   #1
Raleigh
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Saw My New GI

I saw my new GI today, and I think it went pretty well. He was really nice and spent a lot of time with me. He couldn't believe that I had gone 8 years without a diagnosis and some treatment. I had a colonoscopy in May at the Cleveland Clinic, which showed some sort of colitis, but the biopsy was negative. I asked him if he would order a pill cam for me, because they weren't able to view my TI in Cleveland. He thought that a pill cam was a good idea. He also ordered some IBD serology.

I have a couple questions. First, he said that most insurance companies don't like to pay for pill cams used to diagnose Crohn's. He said they prefer EGD/Colonoscopy and stool tests. So he said he could submit it to my insurance under the guise of "obscure GI bleeding", which gets approved quicker than Crohn's. The only problem is that he needs to show that I'm anemic. I was told that I was anemic at the Cleveland Clinic, but my latest labs from my GP says my Hemoglobin was 14.8, which is in the normal range. So I sent him those labs like he asked, but I don't know if they will accept it. I was severely anemic a year ago, but I had an infusion in May 2011. Has anyone else had trouble with insurance paying for pill cams?

Also, like I said earlier, he ordered IBD serology. But I don't know what it is. There are 2 tests marked on the LabCorp order form; C-Reactive Protein and Inflammatory Bowel Disease. I know about the C-Reactive Protein, but I don't know what the other test is. Is this the same as the Prometheus IBD serology? If not, does anyone know what this test is looking for?

Sorry this is so long. Thanks in advance for any insights.

Brian
06-19-2012, 07:40 PM   #2
Clash
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Sorry don't have any info on the IBD blood test. Just wanted to say I was scheduled for a pill cam but the nurse called and said she realized that in order for ins to pay for the pill cam I first needed to have covered the "traditional" tests. I had already had a colonoscopy and upper endoscopy and ct so they requested I had a small bowel follow through first. The GI scheduled it the next day and now I am waiting on the pill cam to be rescheduled. My insurance has been really great in dealing with my son who was diagnosed with CD this year and I can't say that they have denied any testing so far.
06-19-2012, 09:19 PM   #3
Raleigh
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I've had the colonoscopy, EGD, and small bowel follow through, so I guess I should be good to go with the pill cam. Hopefully things will go smoothly.

I found out that the IBD serology is the pANCA; Saccharomyces cerevisiae, IgA; Saccharomyces cerevisiae, IgG. I don't know if he is using the test as a way to diagnose IBD, but I read on this site that it should only be used to differentiate Crohn's from UC.
06-19-2012, 09:28 PM   #4
Clash
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Good to know about the blood test! Hopefully with all the other testing behind you the ins will approve the pill cam quickly! Good luck with your testing!
06-20-2012, 07:35 AM   #5
shazz
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At last it seems like you are getting somewhere!

Long may the progress continue. Xxxxxxxxxxxxx
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DX: September 2011 UC now possible Crohns Feb 2012
Have tried: Pentasa(all forms),Prednisolone,Aza, 6MP, Infliximab,colifoam,metronizadole
Allergic/sensitive to: Penicillin, medical adhesives, tramadol
Am on: Citalopram,warfarin, paracetamol
Ozzie was born on 2/2/12
23/2/12 p.e in both lungs.
Now the gallbladder decides to say hello!!
06-20-2012, 08:17 AM   #6
Keepingfaith
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Alot more GI's aren't doing pillcams as much as one would think. To be diagnosed with Crohn's you HAVE to have the biopsies to prove it. You can have ulcers/inflammation in your small bowel all day but that doesn't mean you have Crohn's! A friend of mine was 'diagnosed' with Crohn's via pill cam & when she was still having issues after doing all of the meds the GI performed another scope & it turned out she had a stubborn bacterial infection-not Crohn's.

I know, getting a diagnosis is frustrating but I would much rather know in my heart I actually have Crohn's then to jump all in with these medications. They are no joke!

Take care!
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Current medication:
Entyvio
Imuran
Entyvio
Prilosec
Protonix
Seasonique
Noritriptyline
Steroid suppositories
Canasa suppositories

Diet: Feeding via J-tube

DX: Crohn's Disease, Juvenile Rheumatoid Arthritis, Endometriosis, Gastroparesis

Previous Medications:
Remicade- Drug Induced Lupus, Humira, Prednisone,
Entocort, 6MP, Methorexate, Amitriptyline, Asacol, Flagyl, Apriso, Cimzia, Cipro, Sulfasalazine etc. You name it, I've tried it.
06-20-2012, 08:31 AM   #7
nikimazur
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I was diagnosed with Crohns, even without biopsies to back it up. We have eliminated every other possible cause. It took six months from my diagnosis to my latest colonoscopy which I did have biopsies to prove it. My symptoms just proceeded the actual inflammation on the microscopic level. It also depends on the doc doing the diagnosing, and what other tests you have had done to rule out other possible causes.
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Original Dx: April 2011


Crohn's, Traumatic Brain Injury, Autoimmune Hepatitis (May 2014)


Current meds:Bactrim DS, Azathioprine, Entyvio, levbid
Past meds: Pentasa, Lialda, Prednisone, Entocort, Asacol HD, Prilosec, Lomotil, Lotronex, Nexium, Myfortic, Humira




http://lifeinthetimeofuncertainty.blogspot.com
06-20-2012, 01:27 PM   #8
Keepingfaith
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Then again, you are only on Asacol HD & not something like an immunomodulator or Biologic. The risks with Asacol are much less than something like biologics or immunomodulators.

Your GI atleast gave you asacol & didn't start you out on something stronger, like my friend was. Which was what my point was. I wasn't intending on offending your GI's diagnosing techniques, I was just simply stating the risks.

Take care!
06-20-2012, 01:44 PM   #9
skippy111
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in 1991, the two tests used to diagnose my crohn's disease were a colonoscopy and an upper gi, (and blood tests)

in april of this year, a colonoscopy was not able to be done due to a stricture so a CT Scan with the Iodine contrast was done of the abdomen/pelvis which showed the rectal stenosis and major inflamation in the intestines and colon.

AN upper GI was done the day prior to my surgery so the surgeon could have fresh films to go by.

I am leery of the pill cam because I have heard of it getting stuck and also my Crohn's disease is on my lower right side so the pill cam would be an unneccessary test for me.
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Check to see if any of the meds you are taking can intereact with another, just go to the Drug interaction section, it is free! http://www.drugs.com/

Crohn's /Anemia DX in 1991
Aspbergers/Depression/ADHD DX 2001

Past meds for crohn's
Prednisone/Azulfadine

Recent Meds While in Hosp for Crohn's/Depression
Flagyl/Cypro,Zofran Protonix, Prednisone, Lovenox
Celexa,Kolonopin, Ritalin
Current meds:
Prednisone,Celexa,Adderall,Kolonopin,Percocet
06-20-2012, 04:39 PM   #10
Raleigh
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I understand that biopsies are the only way to definitively diagnose Crohn's, but like nikimazur said, symptoms can precede the actual inflammation. I think that with the advances in technology, it is important to use every diagnostic aid available. For me, everything else has been adequately ruled out. So in conjunction with the inflammation on my colonoscopy, if the pill cam shows something as well, that would be more than enough for me. One of his patients has small bowel Crohn's, unreachable for biopsy, which he diagnosed via pill cam.

I have spent 8 straight years suffering without treatment. This disease has taken away almost a third of my life. Everything I wanted to accomplish, and where I wanted to be at 27 was taken away because I've never had treatment. So if the evidence is there, even without biopsy, I would gladly move forward with treatment, risks and all. I just want some semblance of what my life used to be.

Brian
06-20-2012, 07:21 PM   #11
Keepingfaith
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Deffinately know where you are coming from. I didn't get DX until last year & I hae been seeing a GI since I was 2. THAT is a lot of years undiagnosed. None of my scopes showed anything nor did my pill cam(Had 1st scope at 5 years old). Turns out the steroid shots my GP was giving me threw off all the tests. If only doctors looked through patients profiles thoroughly. I've also had NEVER had a 'remission' with this disease, despite all of the medications. It's a tough disease that is tough to diagnose.
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