Ruling out Crohn's with a blood test?

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dt19&99
Regular Member


Date Joined Apr 2009
Total Posts : 174
   Posted 4/27/2009 9:41 PM (GMT -7)   
My moms friends son has been experiencing quite a few crohns like symptons and they said their doctor took some blood work and said it wasn't crohns. That doesn't seem right to me because I would think if you could rule it out with blood work then you ought to be able to diagnose it with blood work...
 
Meant to ask my GI last week but forgot (I swear I need to write out lists before I go there)

PV
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Date Joined May 2006
Total Posts : 1177
   Posted 4/27/2009 9:53 PM (GMT -7)   
I know there's a prometheus lab test that can tell you if you're prone towards crohns and/or ulcerative colitis - but is far far far from being foolproof or reliable. If they suspect Crohn's, the test can add weight to that diagnosis, but the test by itself is not diagnostically relevant. As far as I know, only a colonoscopy/endoscopy and biopsy can give you conclusive diagnosis at this time.

It sounds like your mom's friend needs to find her son a better doctor.
Husband with Crohn's
Diagnosed March 2003 Ulcerative Proctitis
Diagnosed March 2008 Crohn's & C-diff, hospitalized 45 days
Canasa, Lialda, Remicade, VSL#3, Florastor
In Remission since June 2008
Stopped vancomycin for c-diff Jan 1 2009
C-diff free, and in crohn's remission, knock on wood


MikeB
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Date Joined Mar 2006
Total Posts : 1169
   Posted 4/28/2009 5:17 AM (GMT -7)   
A family physician or internist is simply not trained or equipped to make a definitive diagnosis of Crohns (or not). That's why they refer patients to a gastroenterologist. And no there is no conclusive blood test that can make the diagnosis either way by itself. I suspect the doctor did a sedimentation rate and foind it normal and concluded that, well, Crohns is an inflammatory bowel disease, no sed rate means no inflammation, hence no Crohns. Not true. See a GI specialist asap.

orngie
Regular Member


Date Joined Feb 2009
Total Posts : 161
   Posted 4/28/2009 7:15 AM (GMT -7)   
I agree with the poster who said they probably just checked her sed rate. When my GI noticed that mine was only slightly elevated shortly after a hospitalization he said we just wouldn't be able to rely on my sed rate as an indicator of my inflammation. Even the promethius ibd serology blood test is not 100% accurate.

Your mom's friend's son needs to see a specialist. He may not have Crohn's, but the best way to find out for sure is to see someone with expertise in the area.

Kittikatt
Regular Member


Date Joined Jul 2004
Total Posts : 422
   Posted 4/28/2009 1:48 PM (GMT -7)   
No, Crohn's can't JUST be diagnosed with a blood test. Everyone is diagnosed different and some people have so many different symptoms, it is often hard to diagnose between Crohn's, UC and other gastrointestinal problems.

After an Upper GI with Small Bowel Follow Through and an Abdominal & Pelvic CT scan showed inflamation in my small and large intestines, my GI scheduled me for an Upper Endoscopy, Colonoscopy and bloodwork for IBD that was sent to the Prometheus Labs.

Based on the inflammation shown in the first 2 tests; the many ulcers found in my large intestine during the Colonoscopy (Upper Endoscopy was clean); the 99% IBD markers from the blood test that are only seen in Crohn's patients and based on my "extra-intestinal" complications (mouth ulcers, leg lesions, swollen ankles, fatigue, etc.) the diagnosis was unquestionably Crohn's Disease for me.
Diagnosed in October, 2004 at age 32 (misdiagnosed with IBS in 2002)
37/F/SC
Current Rx's: Colazal (generic), Omeprazole, Ferrous Sulfate, Librax, One-A-Day multivitamin, Probiotic, Omega-3 Fish Oil, Vitamin D, Cranberry pills
Secondary conditions: swelling ankles, extreme fatigue, mouth ulcers, joint pain
Previous/occasional Rx's: Prednisone, Flagyl, Levaquin, Xifaxan, Carafate
4/7/09: Gall bladder removal laproscopic surgery (gall stones)


onedaymore
Regular Member


Date Joined Apr 2009
Total Posts : 111
   Posted 4/28/2009 3:35 PM (GMT -7)   
MikeB said...
A family physician or internist is simply not trained or equipped to make a definitive diagnosis of Crohns (or not). That's why they refer patients to a gastroenterologist.


Funny story . . . I saw gastroenterologist after gastroenterologist for two years, they all scratched their heads (my symptoms are not typical) . . . it was an internist who was the one who suspected it was Crohn's and sent me for all the tests. So that's not necessarily true -- my internist is very good at figuring things out.

Like those who have said before me, no one test can conclusively say whether a person has Crohn's or not. It usually is a combination of several tests that gives a diagnosis.
Diagnosed with Crohn's in 2008 at the age of 22.
Currently taking: Azathioprine, tramadol, welchol, promethazine
Surgeries: Cholecystectomy (2007)


duplessis3
New Member


Date Joined Apr 2009
Total Posts : 17
   Posted 4/28/2009 7:02 PM (GMT -7)   
This interests me, because my neice has very very severe crohns. When I got diagnosised (based on symptoms, the way the really bad onset happened, and a colonoscopy and endoscopy that revealed that my small bowel is bleeding) my sister insisted to my mother that I couldn't have it because it takes a "very expensive chromosonal test".
Finally diagnosised with crohns. Psoriasis, rosecea, sebborhea, contact dermatitis, food allergies.

One husband, two sons, one parakeet, four cats, eight hens.

Proud owner of urban flock of hens!


dt19&99
Regular Member


Date Joined Apr 2009
Total Posts : 174
   Posted 4/28/2009 9:01 PM (GMT -7)   
onedaymore said...

Funny story . . . I saw gastroenterologist after gastroenterologist for two years, they all scratched their heads (my symptoms are not typical) . . . it was an internist who was the one who suspected it was Crohn's and sent me for all the tests. So that's not necessarily true -- my internist is very good at figuring things out.

Like those who have said before me, no one test can conclusively say whether a person has Crohn's or not. It usually is a combination of several tests that gives a diagnosis.

Yes, there are exceptions to the rule... Your internist being one... I'd suggest my GI (and he has a physicians assistant whom I see more than the doc himself; but I'm quite happy with the both of them) to my mom's friend but I guess it all depends on their insurance.  I'm gonna go to my parents house tomorrow so I'll give my mother the info I've learned here.
 
This website has been great, I wish I would have looked for it 7 years ago when I was first diagnosed; God knows when I was 16 and thought I was the only person in the world with the disease the support and knowledge of the members here would have helped a lot.

Kittikatt
Regular Member


Date Joined Jul 2004
Total Posts : 422
   Posted 4/29/2009 4:46 AM (GMT -7)   

The comment about the INTERNIST reminds me...

I went to my GI in December, 2007 and complained of shortness of breath, fatigue and heart flutters.  He totally skimmed over that and didn't even comment on those things...just went on asking about intestinal stuff.  Ok.......

So in 2008, I went to see my general practitioner complaining of the same things.  He sent me to a CARDIOLOGIST.

So I go through an Echocardiogram, EKG, Stress Test and 2-day heart monitor.  But before I left the office on that final visit, the Cardiologist came in to talk to me about the results of the tests which were all good.  Turns out, he was an Internist and then decided to specialize in Cardiology.  Anyway, he looked at the symptoms I came in complaining about; called down the street to my GI's office and asked them to fax over my most recent bloodwork.  When the Cardiologist got the fax he said, "Did you know your Iron levels are low?  Low Iron can cause shortness of breath, tiredness and heart palpitations." 

SHUT UP!  Are you serious?!  You mean to tell me my GI & GP didn't pick up on this so it took me spending over $1,000 to go through all these heart tests to have a younger doctor/internist/cardiologist realize I simply needed some freakin' Iron supplements?! Good grief.  Hail to the Internist turned Cardiologist! smilewinkgrin

And then this year before my gall bladder surgery I was talking with my surgeon's NP.  She was JUST out of Nurse Practitioner school...maybe all of 25 years old, if that.  I'd told her I was having those symptoms and she quickly said, "Oh - is your Iron low?"  She knew immediately!  I'm starting to think some of the newbies docs might know a bit more than the oldies...on SOME things. tongue


Diagnosed in October, 2004 at age 32 (misdiagnosed with IBS in 2002)
37/F/SC
Current Rx's: Colazal (generic), Omeprazole, Ferrous Sulfate, Librax, One-A-Day multivitamin, Probiotic, Omega-3 Fish Oil, Vitamin D, Cranberry pills
Secondary conditions: swelling ankles, extreme fatigue, mouth ulcers, joint pain
Previous/occasional Rx's: Prednisone, Flagyl, Levaquin, Xifaxan, Carafate
4/7/09: Gall bladder removal laproscopic surgery (gall stones)


MikeB
Veteran Member


Date Joined Mar 2006
Total Posts : 1169
   Posted 4/29/2009 7:28 AM (GMT -7)   
Yep there are always exceptions, but remember that cardiologists and gastroenterologists all complete a full three-year residency in internal medicine before going their fellowships in their chosen subspecialties. What's interesting is that the more doctors have to specialize (and I do not blame them, since there is so much technology and knowledge in medicine now) Still, all things being equal, I want a GI doing my colonoscopy, a cardiologist doing my heart cahterization and a general surgeon taking out my gall bladder.

dt19&99
Regular Member


Date Joined Apr 2009
Total Posts : 174
   Posted 4/29/2009 8:34 AM (GMT -7)   
Ha, I don't want any of them doing any of those things...
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