There are several Prometheus tests for IBD available. The initial test, prior to the new Lactoferrin, etc. test, definitely indicated positive for Crohn's. But I felt the test was a waste since we KNEW I had Crohn's. I'd had a resection in 1978 at Mayo Clinic for Crohn's. (Then was blessed w/a 20 year remission!).
However, I am a believer in the use of the Prometheus ProPredict Metabolite test to monitor therapeutic level for the Imuran I am taking and possible hepatotoxicity. I know we do the regular hepatic function panel and CBCs w/differentials and platelets but I still prefer we also run the Prometheus ProPredict when I've had a weight change or increase in symptoms, etc.
As for the Pill Camera Endoscopy: I haven't had one yet, my gastro and I are discussing it. I refused one until Givens came out w/the dissolvable pill and my gastro was able to convince the local hospital (the hospital I DISLIKE) that does the PCE to get one in for me. (Odds are too good of the PC getting stuck as we know I have a partial obstruction at the resection anastomosis).
Since I tend to constipation rather than diarrhea my gastro asked that I chart my BMs the last two weeks and I was to go in and see her this past Monday when we would further discuss and decide on the whether to do the PCE and most likely would have swallowed the dissolvable pill then. Unfortunately I was packed off for a cardiac stress test instead. I'm rescheduled to see my gastro about
the PCE in two weeks.
I will have to do a bowel prep for the PCE. I am NOT even going to consider doing one for the dissolable pill. It is NOT necessary and no way are she or her NP going to convince me otherwise!!
So: if an obstruction or partial obstruction is suspected, prior to trying the PCE itself, Givens has produced a pill the exact same size as the PCE that has a VERY small rod in it that is detectable by xray or a hand held wand they developed. The patient swallows this pill. The pill is guaranteed to dissolve w/in 3-4 days so if there is an obstruction that it can't pass thru it doesn't create an emergency. It will eventually dissolve w/in that time period w/ocreating injury.
I've read of those who have some difficulty getting a pill that large down being given a gel or slippery type substance on the pill to help it slide down the throat and esophagus.
They then can do an xray to determine whether the dissolvable pill has been passed (remember the tiny rod in it). If the dissolvable pill passed then the PCE will and you are a candidate to have the PCE.
Prior to the adminstering of the PCE I will have to do a prep. (D*mn!). The PCE takes 1,000s of pictures as it passes thru the intestines. Of those 1,000s of pictures the 'puter software singles arranges them in frames of 4 pics per frame. The doctor then goes thru those frames which takes about
2 hours and picks out any suspicious pictures which can then be reproduced and printed out for the doctor and patient. (I'd rather sit thru the 2 hours w/the doctor and see for myself).
My understanding is that there is proprietary software (mucho expensive) that not all places utilizing the PCE purchase, that will put those pictures positive for lesions on CD/DVD but that this local hospital only provides printouts of those pictures as they didn't invest in the mentioned software. Grrrrrr!
If one doesn't SEE the PCE pass from the body then an xray can be done to see if it has passed or is still lodged in the intestines somewhere. And THAT, of course, does eventually produce a problem if it doesn't pass. Doing the dissolvable pill successfully first should negate that problem.
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Post Edited (CrohnieToo) : 1/30/2008 11:19:15 AM (GMT-7)