Is it possible to have Crohn's Disease and have normal blood work?

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bdpal575
Regular Member


Date Joined Jun 2011
Total Posts : 25
   Posted 6/17/2011 6:47 AM (GMT -6)   
(I'm new to this site, so please bare with me, hopefully I'm doing this right) :)
For the past 6 months I have experienced many symptoms that have drastically effected my day to day life and would seemingly lead to a diagnosis of Crohn's disease. Constant nausea, weight loss, abdominal pain, constipation, constant fever, and blood in stool (I have many more symptoms, but I will just leave it to my major ones). In February I had an endoscopy done which showed Gastritis and that was treated with medication. My symptoms never went away though, so in April my GI decided to do another endoscopy and a colonoscopy. The biopsy results showed inflamation throughout my GI system, Ileitis, and Colitis. She was sure it was Crohn's disease...however when she ordered bloodwork it all came back normal, (the only thing abnormal was once my white blood cell count was high) so this caused her to completely cross it off the list of possibilities even though everything else points to Chron's. I have read that many people with Crohn's Disease often have normal bloodwork, and I was just wondering if a diagnosis of Crohn's is possible with normal bloodwork, but actual physical evidence to prove a diagnosis. How was anyone else's diagnosis made or based off of? Is my doctor possibly wrong in completely ruling out Crohn's? After all of the extensive research I've done, at least to me, Crohns seems like a serious possibility.
Additional details: 17yrs old, history of GI problems, surgeries I've had: Nissan Fundoplycation, Pyloroplasty, and Gallbladder removal.
Thank you for any help you can offer! :)

big betty
Regular Member


Date Joined Nov 2010
Total Posts : 461
   Posted 6/17/2011 7:51 AM (GMT -6)   
Hi bdpal, Yes, you can have crohns without elevated inflammation levels in your blood work. My numbers were in the normal range when I was dx and still are. I hope your doctor gets it figured out so you can get on the right meds, and that you'll be feeling better soon.

CollegeStudent
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Date Joined May 2011
Total Posts : 331
   Posted 6/17/2011 8:04 AM (GMT -6)   
Yep, I agree with big betty. Even my white count came out normal when I was hospitalized last time.
Are you taking cholestyramine since you had your gallbladder removed?
21 male, NYC
-Pancolitis in 2008 Jan
Recent hos. discharge 5/23/11
-Began LDN 6/7/11
-Began Humira 6/14/11 to reach full remission
-60min cardio or more everday
-Pentasa 2g, 20mg Pred(tapering from 60mg), Canasa(3x a week), Questran
-No HFSC, sugar, red meat, chicken, shrimps, non cooked veges
-White rice+meat/fish+avocado+blueberry+homemade yogurt+steamed vege+OJ+Olive Oil+cooked sesame seeds

sooper
Veteran Member


Date Joined May 2003
Total Posts : 815
   Posted 6/17/2011 8:34 AM (GMT -6)   
You certainly can!
I'm becoming less defined, as days go by. Fading away, wellyou might say im losing the focus. Kinda drifting into the abstract in terms of how I see myself.

joy47
Regular Member


Date Joined Feb 2010
Total Posts : 70
   Posted 6/17/2011 8:45 AM (GMT -6)   
I was 16 when I was diagnosed with crohns all thru my small intestine. I had upper and lower GI s like crazy. They (doctor) still couldn't figure what I had. I went from a 155lb. kid to a 105lb kid. They ended up doing an exploratory surgery removed 3 foot of my small and a small bit of my large. That's been 30 years ago. Since then when Ive had a lower GI. I can see the monitor of my intestine. You could see normal bowel ,"then what looked like a string "I was told that was diseased. So I'm a little confused myself ,cause you can really tell the difference. The only thing I can figure is it was 1 and 1/2 years before the first surgery. Hope you find out it can drive you crazy not knowing. Good-luck to you!

bdpal575
Regular Member


Date Joined Jun 2011
Total Posts : 25
   Posted 6/17/2011 2:57 PM (GMT -6)   
CollegeStudent said...
Yep, I agree with big betty. Even my white count came out normal when I was hospitalized last time.
Are you taking cholestyramine since you had your gallbladder removed?


I have never been put on any medications for the gallbladder removal, what does it do?

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14994
   Posted 6/17/2011 3:20 PM (GMT -6)   
This is the first time in years that my sed rate as gone up, but I have many times in the past felt so sick and all my bloods came back normal. Generally I think when I get the more normal bloods its becuz it was some side issue associated with my Crohns more than the Crohns itself.

Hugs!
Gail*Nanners* Co-Moderator for Crohns Disease
Crohn's Disease for over 35 years. Currently on Asacol, Protonix, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!

bdpal575
Regular Member


Date Joined Jun 2011
Total Posts : 25
   Posted 6/17/2011 8:33 PM (GMT -6)   
joy47 said...
I was 16 when I was diagnosed with crohns all thru my small intestine. I had upper and lower GI s like crazy. They (doctor) still couldn't figure what I had. I went from a 155lb. kid to a 105lb kid. They ended up doing an exploratory surgery removed 3 foot of my small and a small bit of my large. That's been 30 years ago. Since then when Ive had a lower GI. I can see the monitor of my intestine. You could see normal bowel ,"then what looked like a string "I was told that was diseased. So I'm a little confused myself ,cause you can really tell the difference. The only thing I can figure is it was 1 and 1/2 years before the first surgery. Hope you find out it can drive you crazy not knowing. Good-luck to you!


Your stuation when you were 16 sounds SO similar to mine. I too have lost 50lbs and doctors can't seem to figure out why I have all of these "unexplained", as they say, symptoms, even though there is actual physical proof that they have found. some have even wrote it off as an eating disorder because of the significant weight loss, but that is definetly NOT the case, I never tried to loose the weight, I just constantly feel sick and my abdominal has so much pain. How did they figure out you had Crohn's throughout your small intestine? I know that is a tricky area to get to. Me and my family are actually considering taking a trip to a Mayo Clinic to see if they can figure me out because living like this and not knowing what's wrong is not going to work much longer. Thanks for your help!

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14994
   Posted 6/18/2011 1:08 PM (GMT -6)   
Bloods test to diagnose Crohns are notoriously unreliable. I would ask for a pill capsule. Its see areas in the small bowel that the scopes can't reach. Many have had difficulty getting a diagnosis and then did this test and were finally able to get a diagnosis. Hope that helps some. Hugs!
Gail*Nanners* Co-Moderator for Crohns Disease
Crohn's Disease for over 35 years. Currently on Asacol, Protonix, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!

kazbern
Veteran Member


Date Joined May 2010
Total Posts : 7475
   Posted 6/18/2011 6:04 PM (GMT -6)   
Biopsy of the inflamed tissue is really the gold standard of diagnosis. I'm sure she took samples of the areas of the colon that were inflamed, and the pathology on those samples should give you a pretty good idea of what's going on.

That being said, my biopsies were never definitive. I presented with bloody stool, lots of mucous, some pain and discomfort. It took really 3 colonoscopies and changing my meds around to finally get to IBD (Crohn's). My blood work has occasionally shown inflammation (CRP=4), chronic anemia forever, low vitamin D. None of my DRs have ever relied on my bloodwork for a diagnosis. It's the bloody stool, the mucous in the stool, the inflammation in the colon, weight loss.

Push back on your DRs dismissal of Crohn's and/or get a 2nd opinion.
*******************
48 yrs old, IBD diagnosis in spring '01. Proctitis, gastritis, ileitis.
Currently taking Pentasa (3g/day), Sulfazine (1.5 g/day), Prevacid, folic acid, vit. D (2K iu), flax seed oil (2 tsp/day), mesalamine enema as needed.

bdpal575
Regular Member


Date Joined Jun 2011
Total Posts : 25
   Posted 6/19/2011 6:15 AM (GMT -6)   
kazbern said...
Biopsy of the inflamed tissue is really the gold standard of diagnosis. I'm sure she took samples of the areas of the colon that were inflamed, and the pathology on those samples should give you a pretty good idea of what's going on.

That being said, my biopsies were never definitive. I presented with bloody stool, lots of mucous, some pain and discomfort. It took really 3 colonoscopies and changing my meds around to finally get to IBD (Crohn's). My blood work has occasionally shown inflammation (CRP=4), chronic anemia forever, low vitamin D. None of my DRs have ever relied on my bloodwork for a diagnosis. It's the bloody stool, the mucous in the stool, the inflammation in the colon, weight loss.

Push back on your DRs dismissal of Crohn's and/or get a 2nd opinion.


She did take biopsies and that is why she was really thinking Crohn's. After se received the biopsy results she sent me for what she called a specialized blood test that would determine if it was Crohn's or not and after that test came back negative Crohn's was off the table for her. I just don't understand tris though. I have done SO much research and everything I have round says that there is no one blood test that can campletely rule out a diagnosis of Crohn's, so why she has completely stopped considering it I'm not sure...a second opinion is definitely in my future though, 6 months and no answer is not working out, especially since my pain has been increasing a lot lately. Thank you all so much for taking the time to help! :)

bloated
Regular Member


Date Joined Jun 2003
Total Posts : 411
   Posted 6/19/2011 9:21 AM (GMT -6)   
Yes, you definitely can have crohns without bad bloodwork! My bloodwork was perfect for 15 yrs. Only recently some vitamin levels showe a little low but still everything else is always fine. It certainly does make it harder to get diagnosed though. I spent 5 yrs going to all types of specialists and had my gallbladder out before a gastro finally allowed me a colonoscopy. And even then with the bloodwork all good he said he was 99 percent sure he wouldn't find anything. When I woke up though he was handing me a script for entocort and telling me I had crohns. Keep pushing and find a doc who will look at everything!

sudsmom
Regular Member


Date Joined Nov 2010
Total Posts : 167
   Posted 6/19/2011 9:57 AM (GMT -6)   
I agree with everyone else, my sed rate/white cell count can be very close to normal, but then when I recently had surgery, they found inflammed small intestine. I can present with no other symptom than pain (not much diarrhea or constipation or frank blood) and they will see inflammation on a colonoscopy.

It is true that a biopsy is the gold standard, but even then I think they can miss the diagnosis on some of us :)

Don't give up, and I agree a second opinion should be in your future :)

Sudsmom
CD since 1981, numerous surgeries including fistulaectomy, resections, adhesion removal.
Current medications: asacol, nexium, pain medication.
Successful fistula, adhesion, stricture removal (2 ft small bowel) on April 12th!

bdpal575
Regular Member


Date Joined Jun 2011
Total Posts : 25
   Posted 6/19/2011 8:14 PM (GMT -6)   
Thanks everyone for your helpful information! :)

Calypso185
Regular Member


Date Joined Jun 2011
Total Posts : 40
   Posted 6/19/2011 9:27 PM (GMT -6)   
I also had normal bloodwork for Crohn's. My colonoscopy was also normal. My Upper GI and Small Bowel Follow Through were not- showed the inflammation in my small intestine. My GI doctor said with my symptoms and what was shown on the UGI/SBFT that his diagnosis is Crohn's. He also stated to me that he was sending me for the Crohn's bloodwork because a positive result would be nice but a negative one would NOT change his diagnosis since (I think this is the correct percentage, either way it's LOW) only 25-30% of people WITH Crohn's actually have a positive test result. I feel your frustration, I would seek a second opinion.
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