CT Scan vs. MRI vs. Nothing at all

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WriterMum
Regular Member


Date Joined Apr 2009
Total Posts : 166
   Posted 11/17/2009 11:46 AM (GMT -7)   
I was in emergency again yesterday after 4 days of miserable abdominal pain while on a quick trip to Grand Cayman. Grrrh!! I got back late Sunday night, and tried my GI on Monday morning. His secretary said to go to Emergency, "he is too busy to see you today". After several hours the young senior resident on duty said that he could pretty much say that it was just the Crohn's flaring up somewhere, but he didn't want to do a CT scan due to the radiation and cancer 20 years from now. He sent a note to the GI team which my GI belongs to on the 16th floor of the hospital to see me this week.

I am really frustrated about never having had a CT scan or MRI to look at the whole system. I have had scopes from both ends, and barium x-rays of the upper intestinal tract. Isn't it about time that I get a better picture?

What has anyone here found from their experience with tests? Should I not worry about it, and just go on another round of Prednisone? I just feel that it is time to get a CT scan or MRI. Which one and why IYHO?!! Thanks.
44 years old. Diagnosed with moderate to severe Crohn's in April 2005. Hiatus hernia diagnosed in 2008. Had Crohn's under control until March this year when I had a major flare up and ended up in hospital. Diagnosis is now CD and IBS. Getting it under control again.
Currently taking: Salofalk 2000 mg, Calcium and Vitamin D, Matamucil, Yogurt for probiotics, Salofalk suppositories as needed.


lamb61
Veteran Member


Date Joined Jan 2005
Total Posts : 1718
   Posted 11/17/2009 12:41 PM (GMT -7)   
Sorry you're having it rough right now. I've had CT scans in the past and they aren't hard at all. You have to fast ahead of time, then drink contrast over an hour or so at the hosp. prior to the test. You will also have an IV for contrast -- makes some people feel like they are peeing themselves. Overall it's quick and relatively painless as tests go.

Good luck!
 


CrohnieToo
Veteran Member


Date Joined May 2003
Total Posts : 9448
   Posted 11/17/2009 3:05 PM (GMT -7)   
When I asked about the MR Enterography at Mayo Clinic I was told that as of yet the CTE is superior to the MRE except for the rectal region. This was in 2008. They also said tho that they keep working on refining and improving the MR equipment and sensitivity as a sensitive enough MRE would be much preferable to the radiation exposure of CTE and SBFT imaging procedures.

Do you have small intestine Crohn's? Have you considered talking to your gastro about the Pill Camera Endoscopy? That REALLY gives a good view and 1000s of pictures of the interior of the small intestine.
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.


Tom1
Regular Member


Date Joined Mar 2007
Total Posts : 228
   Posted 11/17/2009 3:16 PM (GMT -7)   
I wonder how many doctors realize just how little their office staff understands about "people skills".  If you plan to stay with this doctor I would let him know about the incident.  If he alibies for it, find another doctor.

WriterMum
Regular Member


Date Joined Apr 2009
Total Posts : 166
   Posted 11/17/2009 6:07 PM (GMT -7)   
I have Crohn's at the ileum AND in the last few inches of my rectum, so it sounds like the CT scan may be the way to go, since the sigmoidoscopy clearly showed my issues with the rectum. I don't think I'd persuade my GI to do the pill cam unless I go into a major flare again.
44 years old. Diagnosed with moderate to severe Crohn's in April 2005. Hiatus hernia diagnosed in 2008. Had Crohn's under control until March this year when I had a major flare up and ended up in hospital. Diagnosis is now CD and IBS. Getting it under control again.
Currently taking: Salofalk 2000 mg, Calcium and Vitamin D, Matamucil, Yogurt for probiotics, Salofalk suppositories as needed.


Becky77
Veteran Member


Date Joined Dec 2005
Total Posts : 1768
   Posted 11/17/2009 6:37 PM (GMT -7)   
Here's my opinion...and keep in mind I'm an xray tech and in school learning MRI right now, so I do know a lot about each of the tests from a patient and professional standpoint. Mind you I do prefer to have tests done so that I know what's going on in there...however- the big question I ALWAYS ask my GI, ER doctor, or anyone who debates testing or anything is how it would affect my treatment. If knowing the crohn's is active or things have changed on a test would change what medicines I would take, or would alter what my doctor would do, please, by all means, do testing. That is to say if they don't have a plan of treatment without tests, please do them and come up with an appropriate plan of care. If however, the doctor has a reasonable treatment that I'm willing to try, I try that first, and if that doesn't help, then I insist on tests to see if we're missing anything.

I also WILL NOT have a pill cam...not now, not ever, because I've had obstructions and strictures too much in the past, and the risk of the pill cam getting stuck and requiring surgery is too high for me or my GI to take.
Becky

31 yr old female-dx with Crohn's in '97 after emergency resection and appendectomy, 2nd resection '05, Bilateral pulmonary emboli 10/09
Currently on Humira, Omeprazole, Effexor, Seroquel, Calcium, Vit D, sublingual B12, Coumadin


CrohnieToo
Veteran Member


Date Joined May 2003
Total Posts : 9448
   Posted 11/19/2009 10:21 AM (GMT -7)   
Goodness gracious, bar77, don't you or your gastro know about the Agile Patency Capsule?? I very much wanted to do a PCE to get a good look at my small intestine - BUT - I have a known high-grade partial obstruction at my old anastomosis. I insisted on the APC so that we could HOPEFULLY do the PCE but I wouldn't do the PCE w/o the APC.

The APC is the same size as the PCE but it is guaranteed to dissolve w/in 2-3 days or is it 3-4 days? I've forgotten now. You swallow the APC one day and 26 hours later go in for an abdominal xray to see if it has passed or is stuck. *sigh* Mine stuck. So no PCE for me. *sigh*
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.


Becky77
Veteran Member


Date Joined Dec 2005
Total Posts : 1768
   Posted 11/19/2009 8:50 PM (GMT -7)   
PCE's aren't xrays, so no, I didn't know about the APC....now that I know, I'll talk to my GI about it. Thanks for informing me!! It may still be an issue, since my GI is out of network and having a PCE would be done at an out of network hospital....I already have to find a GI in network that is willing to work with the GI I already have and won't leave to do conolonscopies...they have become far too expensive to do in her encoscopy center ($800 copay for her to do them vs $400 at the hospital closer to home)
Becky

31 yr old female-dx with Crohn's in '97 after emergency resection and appendectomy, 2nd resection '05, Bilateral pulmonary emboli 10/09
Currently on Humira, Omeprazole, Effexor, Seroquel, Calcium, Vit D, sublingual B12, Coumadin

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