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Crohn's Disease Forum » Parents of Kids with IBD » How often for Fecal Cal?


05-29-2013, 08:08 PM   #1
Mehita
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How often for Fecal Cal?

DS had a (horrible) fecal cal in early May, doing pred and Aza now. When should we do another fecal cal? How quickly can it change?
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Mom of DS, age 17, dx Crohn's and Celiac Oct 2008
- Remicade, started Nov 2013, added Solumedrol June 2015
- added Methotrexate/Folate March 2016
- Multivitamins, Probiotics, Vit D
- Small bowel resection, Jan 2013
05-29-2013, 08:25 PM   #2
Clash
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I think I would wait til he was completely tapered off the pred, how much longer will that be? Or if symptoms arose before then I would ask for it.
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C age 19
dx March 2012 CD

CURRENT MEDS: MTX injections, Stelara


Dx May 2014: JSpA
8/2014 ileocecectomy
9/2017 G tube

PAST MEDS: remicade, oral mtx, humira
05-29-2013, 08:32 PM   #3
Mehita
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Taper should finish up mid-June.
05-29-2013, 08:38 PM   #4
Clash
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Then I would probably wait til the taper was finished. I think I posted this on another recent thread(maybe yours?) but C is having one every 3 months last two were 1700, 300 and next is up next week. I think the GI would've opted for every 6 months but agreed to every 3 since he had to be hospitalized in Feb and because it made me more comfortable(you know the whole this crazy lady will be calling every week so let's just give her the test! Ha!)

Does your son's GI have a model he follows or has he left it up for discussion?
05-29-2013, 08:39 PM   #5
my little penguin
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We are doing it every three months after a high number than back to every six.
DS is having issues so another fecal cal this week for him.
05-29-2013, 08:43 PM   #6
Clash
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Our FC test is next week, MLP how long does it take for you to get results back?
05-29-2013, 08:50 PM   #7
my little penguin
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About a week drop off is in the am
Lucky DH
Hopefully he asks for a new cup since this one wasn't planned but we like to keep spares at home just in case.
Gi likes to spring the bring in a stool sample ASAP on us .
05-29-2013, 08:55 PM   #8
Jmrogers4
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Spare stool cups under the sink next to the toilet paper? Must be an IBD home We will be having our 2nd one 6th months after the first which was normal, if this one is normal also it will be once a year unless otherwise needed
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Mom to Jack (18) dx Crohn's 2/2010
Vitamin D -2000mg
Remicade - started 1/9/14; 7.5ml/kg every 6 weeks
Centrum for Him teen multivitamin
Past meds: Imuran/Azathioprine; allopurinol; methotrexate; LDN; Prednisone; Apriso; Pentasa; EEN

Husband dx Crohn's 3/1993
currently none due to liver issues
05-29-2013, 08:57 PM   #9
Mehita
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Thanks for the info. The old GI never did fecal cal, but this new one does. We just haven't had a follow up appt with him since the flare in early May so I'm not sure what kind of schedule he follows yet. I'm just lining up my ducks... and I found an extra sample cup in the cabinet and had an "Oh, yeah" moment. Definitely an IBD house!

I submitted DS's sample on a Friday and we had results the following Wednesday.
05-29-2013, 08:57 PM   #10
my little penguin
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We were told max time between fecal cal should be 6 months.
But for DS all other blood markers are not very useful
05-29-2013, 09:06 PM   #11
Clash
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Transit time for us was similar, I think the thing that has taken the longest is the antibodies test for Remicade.

I've said that GI would probably spread tests out further than even 6 months if C remained asymptomatic and number normalized but that is just my opinion, he has never said one way or another, kwim!

Mehita, yep way to think on the ball! Hope everything continues to go well for your DS and the next FC comes back looking great! Yours too, MLP!
05-29-2013, 09:07 PM   #12
Farmwife
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Every 3 months for Grace.
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I'm mom to............... Little Farm Girl 8 yr old
Ibd (microscopic)
(12/28/12),
dx Juvenile Arthritis
(12/13/13)
dx Erthema Nodosum
(8/13/14)
Bladder and Bowel Dysfunction
(10/14/13)
Ehlers-Danlos Syndrome dx (1/26/17)
Remicade started on (9/8/14)Every 4 wks
Azathroprine started on 10/9/15
EN/EEN- since (1/12/13)
Past Meds- LDN, Humira, Pred, MTX, Sulfasalazine
05-29-2013, 09:15 PM   #13
Mehita
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Can the Remicade antibodies test be done any time, similar to TPMT? Sort of a pre-test?
05-29-2013, 09:16 PM   #14
Clash
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The antibodies test would need to be done after the Remicade has been started and then a certain amount of weeks after an infusion, can't remember the week but MLP might can help there.
05-29-2013, 09:30 PM   #15
my little penguin
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4 weeks after infusion is ideal since that was when all the studies were done .
Typically you wait a bit until after you are through the loading dose since levels fluctuate a but during that period
05-30-2013, 02:58 AM   #16
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We are doing calprotectin every 3 months since it's the only test that ever shows anything for my son. Handing one in today actually since he has been on 6mp for just over 3 months.
05-30-2013, 07:59 AM   #17
Johnnysmom
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When my son had a high fecal cal in August the GI wasn't going to do another for 6 months. When I said I wanted one in 3 months they said fine but made me pay for it out of pocket ($600) and said it wouldn't show much difference because the time frame was too short. (Went from 586 to 430 in 3 months). Now Johnny is sub therapeutic with his meds so GI ordered another fecal cal for 3 months from last one. So apparently 3 months really isn't too short of a time frame. It will usually just indicate the trend though. We knew after 3 months Johnny's was going down but that was really all it told us.
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05-30-2013, 08:44 AM   #18
Tesscorm
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I'm still a bit vague on the Prometheus test but Stephen's GI wants to test remicade level (and I think that includes antibodies??). He wants the test done the same day (before infusion) day or, at most, the day before his next infusion date. This is scheduled for the first 'regular' infusion, ie his three loading doses are done and his first '8 week interval' infusion is June 7 (test being done June 6).
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Diagnosed May 2011

Treatment:
May-July 2011 - 6 wks Exclusive EN via NG tube - 2000 ml/night, 1 wk IV Flagyl
July 2011-July 2013 - Supplemental EN via NG, 1000 ml/night, 5 nites/wk, Nexium, 40 mg
Feb. 2013-present - Remicade, 5 mg/kg every 6 wks
Supplements: 1-2 Boost shakes, D3 - 2000 IUs, Krill Oil
06-11-2013, 12:43 AM   #19
Mehita
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I asked about another fecal cal today at our appt and the GI said he usually only does them when kids are having clinical symptoms. He said we know is level was 1332 last month and if we were to test him again now and it comes back at say 300, even 500, it's not telling us anything we're not already seeing and observing in clinic. Since DS is doing well, feeling well, pooping well, and growing well - what's the point?

Had we come in today after being on pred for a month and DS was still feeling miserable, then he'd consider another fecal cal because then it would provide some relevant info.

I see his point, but it sounds like a lot of your GI's run fecal cal regularly. Should I push for every 6 months?
06-11-2013, 12:49 AM   #20
CarolinAlaska
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We do every 3 months, because it can show if she is having inflammation. Right now we have one pending because she had a mildly elevated sed rate, and it will help us know if it is from her Crohn's...
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06-11-2013, 04:40 AM   #21
dodie74
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My son hadnt had one done since he was diagnosed and that was 3 years ago. All his bloods have been good up until the last one which showed the esr marker slightly up but was put sown to him having a sore throat so consultant not worried but has asked us to do a calprotectin test which we have done and handed into our surgery yesterday. x
06-11-2013, 08:42 AM   #22
Clash
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C just did his today, it was supposed to be last week but he is visiting his Dad and things got twisted up. Hoping for good results!
06-12-2013, 05:54 AM   #23
DustyKat
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I asked about another fecal cal today at our appt and the GI said he usually only does them when kids are having clinical symptoms. He said we know is level was 1332 last month and if we were to test him again now and it comes back at say 300, even 500, it's not telling us anything we're not already seeing and observing in clinic. Since DS is doing well, feeling well, pooping well, and growing well - what's the point?

Had we come in today after being on pred for a month and DS was still feeling miserable, then he'd consider another fecal cal because then it would provide some relevant info.

I see his point, but it sounds like a lot of your GI's run fecal cal regularly. Should I push for every 6 months?
I too can see what he is saying but by the same token that could be said of any test.

I have had two very different experiences with my kids and so being one bitten twice shy I always like to have as much information as possible in front of me and whilst ever that information marries up then I am happy, whether it be for better or worse.

Whilst I agree that it is vitally important to physically observe the child in all aspects, that information can only glean so much and until you compare that with clinical information then you are only getting half the story.

Unfortunately it is not uncommon that the outside story does not match the inside one. So yes, I would push for regular testing so you always have the complete picture.

Dusty. xxx
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