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how can we and MD find out of crohn or uc

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Ulcerative Colitis
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Posted 12/8/2014 3:40 PM (GMT -5)
Hi.
diagnosed in 2001. Most MDs believe it's uc while two believed it's crohns. Failed Asa failed remicade and simponi.cannot take immuran or 6mp because of pancreas problems. Now left with entyvio or methotrexate or surgery. Disease has been historically in colon. Exterm for this weird pancreas thing which nobody knows if it's medicine related (in my case 5asa because have not been on immuran or 6mp ) or autoimmunE because if inflammation. If I fail entyvio surgery will be brought to table but what if it's crohn. anyone been in this situation?what did you do?
Posted 12/8/2014 3:52 PM (GMT -5)
When facing surgery, I think the best thing to do is to really figure out whether it is Crohn's or UC, since the answer will change your surgical options. There are IBD blood tests available, which can help doctors figure out which one you have (but they are not completely accurate sometimes), there are tests to take images of your intestines to see where inflammation is, and then you can get a biopsy during a colonoscopy of the deeper layers of tissue to see if they are inflamed or not.

In UC, the inflammation is just on the top layer. In Crohn's, the inflammation will be throughout all layer of tissue.

I think that might be the best way to be sure, but I am personally inexperienced in this area, so i'm not sure.
Posted 12/8/2014 3:57 PM (GMT -5)
I agree, the answer to your question is from the biopsies taken during your scope(s). You can also try the Prometheus blood test, but I don't know if I would rely on that for this critical decision.

The risks as far as I understand it are these - if you do have Crohn's, and you have a colectomy, you are not cured of your disease and you should either continue to take meds or at least commit to maintaining your close relationship with your GI.

And if you do have Crohn's you should not opt for a j-pouch (I think that's what it is called when the TI is attached to the rectum) as this will no doubt lead to disease in the future.

You can visit the ostomy forum and talk to the kind folks over there. Some are Crohnies.

Welcome to the forum, and sorry for you difficult to treat disease. I hope you feel better soon.
Posted 12/8/2014 5:51 PM (GMT -5)
I think you should get the biopsy reports and see about having them looked at by another pathologist/MD. How many scopes have you had that you "the majority" say UC and 2 say Crohn's?
Posted 12/8/2014 7:03 PM (GMT -5)
thanks for responses. I would say I had close to 15 colonoscopies in last 13 and a half year. maybe more than 15 but somethung around that number. I've had about 7 GIs...
will also ask in ostomy forum.
Posted 12/8/2014 7:31 PM (GMT -5)
Kari7,
Its not very difficult to differentiate between UC and Crohn's if you have a good doctor.
Let me narrate the major differences:
(1) Rectum involvement: In UC, rectum is involved..In Crohn's rectum is NOT involved.
How do we know if it is involved...1. If you had fresh bright red blood in stool and your colonoscopy shows
rectal inflammed mucosa...your rectum is involved..SO..it goes in favor of U.C.
(2) If the Biopsy shows CONTINUOUS redness,ulcer and swelling throughout the COLON, then, it goes in favor of UC...but if your biopsy shows areas of NORMAL mucosa followed by inflammed mucosa, it goes in favor of Crohn's
(3)Pain in abdomen is mild or absent in UC but much more in Crohn's.
(4)Small intestine involved (inflammed) goes in favor of Crohn's ...small bowel normal..its UC.
(5)SEROLOGY TESTS: pANCA positive..more likely UC....pASCA positive ,more likely Crohn's.(not 100% true)
(6)Mucus in stool more in UC but very little or none in Crohn's.
It's very important to be able to know if its UC or Crohn's as treatment and future course differs and complications differ . UC can be cured by surgical removal of colon but Crohn's can't be cured bu Surgery.
I hope it helps a bit.
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