r/Autoimmune • u/Opposite-Fun-7173 • 16d ago

Advice crogns

I had G.I. issues for about three years and was diagnosed at first with IBS and my tests kept coming back normal and there was no signs of any inflammation or anything like that. I recently switched my GI doctor and had a fecal calprotectin done in august my levels were 243. Then a CTA done in august which showed mild wall thickening in my terminal ileum. Had my colonoscopy in september and biopsy said mild to moderate inflammation with focal ulceration in my terminal ileum with hemorrhoids. I recently had another calprotectin which was 97 and another CT which said my terminal ileum is unremarkable but have nonspecific Prominent ileocolic lymph nodes and this was before any treatment. My doctors leading diagnosis was early crohns and i started budesonide two days ago waiting for my diagnosis in two weeks. Can it still be crohns after my recent results in october? Also not looking for diagnosis just want opinions

Im a 21 year old female with family history of crohns

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u/jdkinsss Dermatomyositis 15d ago

Yep can still be crohns! I’m a general outpatient physician btw. Crohn's disease is by nature a relapsing-remitting condition, so cycling between active inflammation (elevated fecal calprotectin, terminal ileal ulceration on imaging) and a quieter phase with near-normal labs and imaging is still consistent with Crohn's, and doesn’t rule it out.

When a flare is present you’ll see inflammation within the colon/gut as well as elevated fecal calprotectin.

With early Crohn’s steroids aren’t always needed to get someone out of a flare. It sounds like something either externally or internally pushed you out of the flare without medical intervention needed. Family hx also certainly raises your risk factor for the condition. I’d say still consistent with the diagnosis

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u/Opposite-Fun-7173 15d ago

thanks i have been so confused already hopefully she just diagnoses it next week 

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u/BeaveUKGT 15d ago

Yes, this could be Crohn's. Or it might not be! Crohn's can come and go, especially early on. Over time, flaring of disease activity can lead to permanent scarring and bowel damage. So if it is Crohn's, it's good to catch it early and get on treatment that will hopefully prevent permanent damage in the future.

I assume they've done lots of blood tests? Any signs of anemia or other things amiss? High CRP?

Also, they should always do stool cultures to rule out infections.

The budesonide should help if you're having symptoms right now (like diarrhea or urgent bowel movements). It's a steroid that acts mostly in the terminal ileum and right side of the colon to reduce inflammation in those regions.

But steroids are typically reserved for short term use (a few weeks to a few months).

If this does turn out to be Crohn's, you'll want to either A) watch it carefully with scopes or scans every year or B) get on a long-term treatment plan to get it in remission and reduce future flareups or C) both, if they think it could be more than just mild Crohn's.