Can you have active disease with normal blood work?

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gumby44
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Date Joined Nov 2007
Total Posts : 4095
   Posted 3/8/2008 9:31 AM (GMT -7)   
I have had a rough few months. I have a small stricture in my ileum as seen by a CT, but I also had Salmonella. My stool cultures are now normal, but I still have bloating and cramping, although my poop is fairly normal looking. I'm also very tired, but I often don't sleep well from the abdominal pain. My recent blood work is completely normal...sed rate, anemia, WBC, B-12 etc. My doc attributes the GI symptoms to what he calls "post infectious irritable bowel." I worry though, that it is really my stricture causing the trouble. I don't know if the stricutre is from inflammation or scar tissue.

I am just wondering if you have inflammation going on, will it always show up on blood work? I am currently taking Pentasa, and one more 10 day round of Cipro. (the doc wants to make sure the infection from Salmonella is completely cleared up...I guess stool cultures aren't always accurate) Thanks in advance for any insight.
49 yr. old female, diagnosed with Crohn's in small intestine and terminal ileum Sept-Oct. 2007
currently taking Pentasa 2750 mg- 9pills/day and on and off Prednisone for flares


Nanners
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Date Joined Apr 2005
Total Posts : 14995
   Posted 3/8/2008 9:48 AM (GMT -7)   
Gumby do you take any probiotics? I think with having the salmonella, being on antibiotics and having Crohns, this is really something you should consider. We as Crohnnie's already have alot more bacteria in our bowels and with the salmonella and taking the antib's you really need to level out the playing field bacteria wise in your intestinal tract. I take lactobacillus every day, and since I started them I notice alot less gas, diarrhea and bloating. Hope that helps.
Been living with Crohn's Disease for 32 years.  Currently on Asacol, Prilosec 60 mg, Estrace, Prinivil, Diltiazem, Percoset prn for pain and Calcium.  Resections in 2002 and 2005.  Recently diagnosed with Fibromyalgia and doing tests to see if I have Inflammatory Arthritis or AS.


gumby44
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Date Joined Nov 2007
Total Posts : 4095
   Posted 3/8/2008 10:24 AM (GMT -7)   
Hi Nanners,
I was taking VSL#3 probiotics, but then it seemed like I was getting constipated, so I stopped it. I really don't know if the probiotics were causing the C. I confuse myself continually, trying to figure out what causes what symptoms. Maybe I'll try it again.
49 yr. old female, diagnosed with Crohn's in small intestine and terminal ileum Sept-Oct. 2007
currently taking Pentasa 2750 mg- 9pills/day and on and off Prednisone for flares


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 3/8/2008 11:14 AM (GMT -7)   
I believe you can still have some inflammation that doesn't necessarily show/reflect on your blood work.

:)
My bum is broken....there's a big crack down the middle of it!  LOL  :)


onebloodonelife
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Date Joined Feb 2006
Total Posts : 842
   Posted 3/8/2008 5:19 PM (GMT -7)   
Yes, you can absolutely still have active disease that doesn't show up on blood work. It was actually known to my GI that my blood tests never show anything out of the ordinary, unless I'm in my most serious of flares. This was an issue for him at first, but he did learn to trust me and my descriptions of symptoms, and he then treated me accordingly.
Crohn's Disease for two years and counting (diagnosed March 8th, 2006)
Imuran: 150mg
Humira:finally got approval on 9/21, done with loading doses, starting biweekly schedule on 10/10
Dicyclomine and hyoscamine for intestinal cramping and spasms
www.myspace.com/onebloodonelife
http://studentwebs.winona.edu/catraun4902 <--This link will be changing, but for now it works!


Lady G
Regular Member


Date Joined Sep 2006
Total Posts : 321
   Posted 3/8/2008 6:03 PM (GMT -7)   
I am the same as listed right above, my crohns can flare up and cause me a ton of problems and not a thing will show up in my bloodwork, which sometimes is a real pain because then they won't believe its my crohns, but now I have new docs for it and they are really good and tend to take my word for it now too. So yeah, it happens for sure.
26 year old, married. Diagnosed with Crohns at 17, suspected of having for at least a year or so before that.  Alot of Crohns in my family history.  No surgeries yet. Imuran treatment with Prednisone tapering at moment.  Possible Fistula.


Mark Mac
Regular Member


Date Joined Mar 2008
Total Posts : 41
   Posted 3/8/2008 6:12 PM (GMT -7)   
Have your doctor test for CRP (C-reactive protein). This is a marker of inflammation in the body. If your symptoms are truely just from the Salmonella, I don't imagine that the inflammation will be as high as those that would indicate crohns. that's just my two cents

sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 3/8/2008 6:23 PM (GMT -7)   
I think if I were concerned about inflamation that did not show up in my sed rates I would ask about having the doc do a C-Reactive Protien test it is more sensitive to inflamation and changes much more quickly. If you have inflamation that test would almost surely detect it and then it can be treated. In you shoes if the cprotien showed inflamation I would ask for the dreaded pred but that of cource is between you and your doc.

njmom
Veteran Member


Date Joined Apr 2006
Total Posts : 1884
   Posted 3/8/2008 7:38 PM (GMT -7)   
Both your CRP and sed rate (ESR) can look normal even when your disease is active.

sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 3/9/2008 11:38 AM (GMT -7)   
njmom,
You are right of cource it can happen, Which is one of the reasons it can be so hard to get accurate diagnosis and treatment.
Sj

gumby44
Veteran Member


Date Joined Nov 2007
Total Posts : 4095
   Posted 3/9/2008 12:29 PM (GMT -7)   
Thanks..I'm seeing my doc tomorrow so I'll ask about the CRP. this endless bloating is driving me nuts!
49 yr. old female, diagnosed with Crohn's in small intestine and terminal ileum Sept-Oct. 2007
currently taking Pentasa 2750 mg- 9pills/day and on and off Prednisone for flares


nikki0294
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 3/10/2008 7:41 AM (GMT -7)   

My daughter had salmonella when she was on treatment for leukemia so her immune system was very compromised to say the least.  She was able to get rid of it with culturelle in addition to other antibiotics.  Just thought I would mention that.  Her GI doc suggested it. 

Take care

Chris


Illini
Regular Member


Date Joined Dec 2007
Total Posts : 298
   Posted 3/10/2008 8:32 AM (GMT -7)   
I have Crohn's only in the terminal ileum, but I also have cramping in the large bowel occasionally.  Often if I sense a cramp on the left-hand side or lower abdomen, and touch that spot, and I can feel either gas or a BM in the colon. I developed this after I was hospitalized, took a lot of antibiotics, and went about four days eating only sporadically.
 
I explained my symptoms to a gastro and was told I have spastic colon, a.k.a. IBS. Since I only have Crohn's in the TI, I pretty much write off cramping anywhere else as IBS (I do "palpate" to check for real pain, never felt it though). I don't think it's uncommon to have IBD and IBS in the same person. My GP told me that using a soluble fiber supplement could reduce colon spasms.
 


ZenaWP
Veteran Member


Date Joined Aug 2007
Total Posts : 884
   Posted 3/10/2008 1:14 PM (GMT -7)   
I agree with njmom about the CRP. I am in a lot of pain from arthritis yet my CRP is always in the low normal range.
...rejoice in our sufferings, because we know that suffering produces perseverence; perseverence, character; and character, hope.   Romans 5:3-4


gumby44
Veteran Member


Date Joined Nov 2007
Total Posts : 4095
   Posted 3/10/2008 4:40 PM (GMT -7)   
Nikki what is culturelle?
49 yr. old female, diagnosed with Crohn's in small intestine and terminal ileum Sept-Oct. 2007
currently taking Pentasa 2750 mg- 9pills/day and on and off Prednisone for flares

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