Does anyone know what this means?

I had a CT scan a couple of weeks ago. The gi didn't seem to be too concerned with the results. However, I'm still feeling very fatigued with alternating constipation and diarrhea. A colonoscopy discovered an ulcer in the ileum, and my mom has crohn's in the ileum. She had two feet removed several years ago. Anyway, I've got a copy of the radiologist report. Does anyone know what the statements below mean? Thx!

"There is secondary diffuse wall thickening of the proximal loops of the small bowel felt to be related to poorly distended state. No worrisome areas of wall thickening are seen. There is a density seen within the distal small bower loop on the images #100 thought to be ingested contents."

Why would the thickening not be worrisome? I'm also going for a second opinion next week.

Thx!

Thx so much Silver! That's a good explanation!

Jimmy it could be that they just accept some amount of inflamation, what I would think is wall thickening, with the disease but what they saw is just not so bad. That's my take on it but definately ask your GI

Thx crohnicaly! I'm going to see Dr. Deal in Charlotte, NC on Tuesday. From what I've heard he's one of the top gi's in the nation. Maybe he can get this thing figured out.

Thx again!

Jimmy

Hi, Jimmy,
How did your appointment go?

Hi Mayflower,

I wasn't that great. I was really hoping that he would have some new ideas, but he wanted to do another colonoscopy. I chose not to go through with the procedure. He wouldn't consider doing something new like a capsule endo. He said it was too expensive to do a capsule endo. I've created another post inquiring about the cost of the capsule. I'm going to see what my 1st GI thinks about the capsule. He had mentioned it one time before.

I'll be honest, I'm highly frustrated with the GI's. I'm very happy with my endo and fam prac, but these GI's are evidently too busy. I had parathyroid surgery about a year ago, and my fam prac and endo were great. In fact, my endo has ordered some blood work that probably should have been done by the GI. I've called to try and get earlier appointments with the GI, but there is nothing available. In the mean time, I'm barely able to work a full day, and I don't feel like doing much with my family. This has been going on for 6 months. I'm really frustrated!

Sorry, about the rant! You guys on this board are great! I really appreciate all the support and encouragement!

Jimmy

Jimmy, sorry things didn't go as well as you had hoped. One reason a colonoscopy could be better is they can take biopsies, which is one way to diagnose crohn's. Did they do that before?

You know I think all GI doctors are just very busy and my theory about that is this. There are so many suffering autoimmune disease and these patients are tough to get lasting resolution for. So they get this huge backlog of patients who keep returning sick and needing something. If they would just cure us we could all go away and open up their schedules. lol!! wishful thinking right?

Good luck!

Hi crohnicaly,

Yes, they did do a biopsy with the first colonoscopy. It was neg for crohn's at the time. I had a ct scan that showed some possible thickening in the upper small bowel. That's the reason why I asked about the capsule. I'm just wondering if I have more ulcers that can't be seen with a colonoscopy and endoscopy. I should have noted that above, sorry about that.

That does make sense about the backlog. I guess most of the GI clients do have chronic conditions.

Thx again crohnicaly!

Jimmy

Good luck Jimmy. Keep asking questions and doing what your doing, nobody cares as much as you do so keep after it.

I don't know about the capsules but I'm sure you find an answer here.

I'm sorry things didn't go more smoothly. I hope you get some resolution soon. Being in limbo sucks!!

Did they do multiple or just one biopsy? When I get my scope done there are TONS of biopsies taken.....

Wonder why the capsule would be so expensive? No drugs (right?)....swallow the capsure and.......is it recovered or the data taken off electronically? Never thought about that before...hmm....

Hi pasobuff,

I'm not sure about how many biopsies they took. I want to say that they took more than one. The GI said they checked for crohn's and celiac. I'll be sure to ask him that at the next appt.

Thx for the heads up!

Jimmy

hey jimmy it also sounds to me like you do have some thicking of th e intestines please do not let this get out of hand

Hi Jimmy! I also wish your appt would have gone better, always so disappointing when nothing comes out of a visit you wait and spend money for!

If you haven't done it already...I would suggest doing a search for GIs in your area that specialize in IBDs, I have found they are much more directional than others I have seen. In all I have read on here, and as you know, the fact that your mother has crohn's is a definite flag.

Good luck and keep us posted!

Thx shoobxl and Lisa! Good advice! I'll do some checking on the GIs that might specialize in IBDs. It didn't occur to me that some might specialize in certain areas of the GI tract.

Jimmy

Hi Jimmy,

Agree with above, the CT sounds very reassuring. One small ulcer in the ileum with a normal biopsy also sounds very good, however, given the positive family history, might be worth a little more investigation.

Firstly, I would ask whether the colonoscopist just got into the terminal ileum, or did they go a decent way in and have a good look. If they only just got in, I would get a second colonoscopy from a dedicated IBD gastoenterologist.

If it was a good colonoscopy, with decent views (ie. good prep), then you could consider further imaging - I would suggest MR enteroclysis or enterography - you will get great views of the small bowel, don't get the radiation of a CT, and it is cheaper that a capsule.

A final note, given the alternating diarrhoea and constipation - my first thought is that it sounds more like IBS.

Hope that is helpful.