Need some information. How is Crohns diagnosed?

Njonnson · Dec 29, 2014

Hello. I am new here and joined because I have been having some problems with my digestive system. I am not sure if I have Crohn's but it is a possibility. My doctor believes it could be IBS , but I failed to tell het that I got canker sores ...about 3 in a 2 month period. I never got canker sores before and never realized that it could be linked to what is going on in my gut. Actually, I only read today that canker sores could be related to crohns and that is what lead me to this forum. I have a few questions I'm hoping a few of you could answer...

I am wondering how you were diagnosed with Crohns? I have done a complete blood count and all was ok. Also a low sensitivity crp that read <5 mg/l ... Which I assume is good? My doctor just said everything looked ok in my blood work. Would that automatically rule out crohns? I also have a colonoscopy in about 3 months (canada is slow in getting people in for a colonoscopy)... But I'm wondering, if I'm not having a flare up, would a colonoscopy still show crohns or do I have to be going through a flare up for a colonoscopy to show it. I'm also wondering what is the main symptom of crohns? I had loose stools that come and go. Some days my stools are normal and other days they're loose and would have to go about 3 to 4 times a day. Which is similar to ibs and other digestive problems. What sets Crohns apart from ibs, ulcerative colitis, bowel cancer etc?

Thank you to anyone who read and replies to this. Much appreciated

ronroush7 · Dec 29, 2014

I had two surgeries that were healing slowly. He determined I had Crohns,

UnXmas · Dec 29, 2014

IBS is diagnosed when there are no positive, objective signs of another digestive condition. Crohn's and ulcerative colitis cause inflammation that can be detected with an endoscopy (and various other tests which can help confirm the diagnosis, assess its severity, etc.).

Symptoms that do not occur with IBS but which can be caused by Crohn's and colitis (though may be caused by many other conditions also) are passing blood, unintentional weight loss, and fevers. The absence of those symptoms doesn't necessarily rule out Crohn's and colitis, but they make them, and other more serious digestive conditions, less likely (so without them, your doctor may be more likely to feel it's safe to keep you waiting a bit longer for tests). Normal blood tests have a similar meaning: they make Crohn's, etc. less likely, but don't exclude them. Blood tests do give your doctor a good idea of the general state of your health.

A colonoscopy will show signs of active Crohn's in the colon by detecting inflammation, but can also show evidence of past inflammation, such as scarring. A colonoscopy doesn't look at the upper digestive system, so other tests would be needed to detect Crohn's located there.

But it's not as simple as being either Crohn's (or colitis) or IBS. Those are just the most common causes of diarrhoea and abdominal pain, so they're the ones doctors look for first and the ones that will come up again and again online. There are endless other causes - but a good number of them can be confirmed or ruled out with endoscopies and other tests (barium studies, etc.), so getting a colonoscopy done will provide your doctor with a lot of information about what you are or aren't dealing with.

Do you have any symptoms besides diarrhoea and the sores?

(As for colon cancer, your age and family history are far more relevant than symptoms like diarrhoea. As far as I know, a colonoscopy is the best test for ruling it out.)

Njonnson · Dec 31, 2014

UnXmas said:
IBS is diagnosed when there are no positive, objective signs of another digestive condition. Crohn's and ulcerative colitis cause inflammation that can be detected with an endoscopy (and various other tests which can help confirm the diagnosis, assess its severity, etc.).

Symptoms that do not occur with IBS but which can be caused by Crohn's and colitis (though may be caused by many other conditions also) are passing blood, unintentional weight loss, and fevers. The absence of those symptoms doesn't necessarily rule out Crohn's and colitis, but they make them, and other more serious digestive conditions, less likely (so without them, your doctor may be more likely to feel it's safe to keep you waiting a bit longer for tests). Normal blood tests have a similar meaning: they make Crohn's, etc. less likely, but don't exclude them. Blood tests do give your doctor a good idea of the general state of your health.

A colonoscopy will show signs of active Crohn's in the colon by detecting inflammation, but can also show evidence of past inflammation, such as scarring. A colonoscopy doesn't look at the upper digestive system, so other tests would be needed to detect Crohn's located there.

But it's not as simple as being either Crohn's (or colitis) or IBS. Those are just the most common causes of diarrhoea and abdominal pain, so they're the ones doctors look for first and the ones that will come up again and again online. There are endless other causes - but a good number of them can be confirmed or ruled out with endoscopies and other tests (barium studies, etc.), so getting a colonoscopy done will provide your doctor with a lot of information about what you are or aren't dealing with.

Do you have any symptoms besides diarrhoea and the sores?

(As for colon cancer, your age and family history are far more relevant than symptoms like diarrhoea. As far as I know, a colonoscopy is the best test for ruling it out.)

Thank you so much for the reply. The only other symptom I have that's been persistent is a right sided upper abdominal pain (right under my bottom right rib cage). It's a sore sunburnt feeling inside. And just full body aches in the morning and feeling of fatigue even after a lot of sleep. I have some mild to moderate abdominal cramping from time to time and gas. I also started getting weird tiny water bubbles under my fingers. Is this psoriasis that is linked with IBD/Crohns? Or is psoriasis different.

As for colon cancer, I'm 31 years old and dont have much family history of cancer. My grandma has pancreatic cancer at 68yrs old and my cousin passed away of breast cancer at a young age of 35. Other than that, no other links to cancer that I know of.

Alley2231 · Dec 31, 2014

I was diagnosed by having a colonoscopy done. I was having some symptoms (diarrhea a few times a day, urgency to go...) for a few months that I didn't think anything about. I actually thought it was a combo of a new med I was on, as well as getting back into a healthy lifestyle.

It wasn't until Christmas Day last year that I went to the bathroom multiple times after dinner and each time I went my stool had blood and mucus in it, that I got very freaked out and knew it wasn't normal. I mentioned something to my primary doctor and he immediately referred me to a GI. Due to the symptoms I had, as well has family history of Crohn's, IBS, colon cancer and cancerous polyps, the GI doctor ordered a colonoscopy immediately. I was diagnosed with Crohn's a few weeks later....a few weeks after that I experienced my first horrible flare and landed myself in the hospital, twice.

Are you seeing an actual GI doctor or a primary? I would suggest seeing a GI doctor, if you're able to. Also, I know you said you're in Canada, but the Crohn's & Colitis Foundation of America (www.ccfa.org) has a lot of great information on their website too.

WAdesert · Jan 2, 2015

Njonnson said:
Hello. I am new here and joined because I have been having some problems with my digestive system. I am not sure if I have Crohn's but it is a possibility. <snip> I have a few questions I'm hoping a few of you could answer...

I am wondering how you were diagnosed with Crohns? I have done a complete blood count and all was ok. Also a low sensitivity crp that read <5 mg/l ... Which I assume is good? My doctor just said everything looked ok in my blood work. Would that automatically rule out crohns? <snip> What sets Crohns apart from ibs, ulcerative colitis, bowel cancer etc?

Thank you to anyone who read and replies to this. Much appreciated

Hi,

Being new here myself, I can't answer many of your questions, but I can tell you how I was diagnosed with Crohn's. I have no typical symptoms of the disease. In the past I've had cramping and vomiting but it is rare and random. I was iron deficient anemic in May for the first time ever but that has resolved on oral iron. All blood work now comes back normal. My CRP and sed rate have always been normal. All CT's scans, MRI, SBFT, colonoscopy, upper endoscopy - normal. The calprotectin was elevated (210), but not extremely high. The pill cam was the first that showed inflammation, then the upper DBE found inflammation and strictures. That's when one of the doctors said I had Crohn's, the other NSAID enteropathy.

So in my case it was because they saw inflammation and strictures that I was diagnosed. You're having a few more of the typical symptoms than I ever did.

I've literally got a call in right now with the GI who did the DBE to see if I can get answers about the kinds of strictures/inflammation he saw. I don't have a lot of hope he'll give me any answers because as a patient I'm not supposed to know there are differences between those with the two potential diagnosis.

DEmberton · Jan 2, 2015

It was a CT scan in my case, though when I saw the senior GI consultant again he said he'd have guessed Crohn's from my blood work and colonoscopy results. I was losing weight and becoming increasingly anemic. IBS by definition means nothing is physically wrong so can't cause blood, anemia or weight loss.

*yvonne* · Jan 4, 2015

I'd just like to say that I am having a dreadful flare just now but my bloods are ok. My flare was spotted via my fecal calprotectin result which was in the 800's. My CRP only raises just before I end up in hospital and it can go from normal to the 100's or 200's very quickly.

I was diagnosed by being admitted to hospital I was having loose stools crampy pain and my GP had booked tests but while I was waiting for the tests I ended up being admitted as I got really ill. I spent 2.5 weeks in hospital and they tested everything but it was my colonoscopy biopsies that diagnosed Crohn's disease.

I wish you luck in finding an answer and hopefully it won't be too long to wait.

momofthree · Jan 4, 2015

Sorry your having troubles and not getting answers. I was finally diagnosed in 1998 after suffering for about 4 years. My doctor would always tell me that nothing was wrong, or that I was lactose intolerant, or that I should see a shrink cause it was all in my head. When I moved to the Toronto area I found a GI that would listen to me, and he took my symptoms seriously. It was a Small Bowel Follow Through (SMBT) that showed the Crohns's. Because my Crohn's is located the the small bowel, a colonoscopy would not detect it. The symptoms that led me there were horrible belly pain, bloody and mucous filled diarrhea, weight loss/no weight gain, and I'd be in the bathroom about 15-20 times a day.
I'm in Canada too, and the wait times for these procedures are so long. Hang in there, and trust your gut. I've had a partial blockage for over a month now, and I'm still waiting to hear when my CT is. (Looks like it'll be my third resection in three years)
Good luck with everything. And don't let the doctors brush you off.