Crohn's vs Microscopic Colitis

SN8888 · Post by **SN8888** » Wed Dec 21, 2016 12:02 pm

For many years, I've been reading about Crohn's and IBS trying to figure out my own problems (I haven't seen my GI doc in a while, but yes, I know I need to go back). On this site, I'm seeing a lot of familiar stories and symptoms, but I'm wondering if any of the following are big red flags for MC vs Crohn's:

ASCA positive
Low white blood cells (specifically neutrophils, other types are ok)
raised ALT and AST (100-150 ish)
diarrhea that wakes you from deep sleep
fever
rapid weight loss
B12 and D vitamin deficiencies
joint pain
hard to tell if there's bleeding, since I often take Pepto when a flare-up begins (always comes out black)
(no calprotectin testing)

I have obvious sensitivities to wheat, dairy, oats, soy, artificial sweeteners, but these only cause a day or two of suffering, not the more difficult symptoms (above).
Taking saccharomyces boulardii along with a low-starch diet keeps me from having a debilitating flare up. Every time I've tried to quit s. boulardii, I have a bad flare beginning about a week later.

I need to go back and get a colonoscopy (many years ago I had one that I was told didn't show too much, but I'm not sure what they even looked for).

Thanks

SN

Gabes-Apg · Post by **Gabes-Apg** » Wed Dec 21, 2016 12:20 pm

Welcome to our group

we have some members that have both Crohns and MC.

the suggestions we offer here are beneficial to all IBD's, that is, remove major triggers (remove inflammation levels) and follow gut healing eating plan, supplement plan, lifestyle.

the only way to confirm things like MC is biopsies taken during colonscopy and reviewed by pathologist. Crohns is visiable to the eye during scope (or pill camera) process

hope this helps

Post by **tex** » Wed Dec 21, 2016 4:50 pm

Hi SN,

Welcome to our Internet family. Your symptoms (and your food sensitivities) are more consistent with MC than with Crohn's disease. For example, neutrophils are rarely a factor with MC. They are definitely a factor with Crohn's disease.

As Gabes pointed out, while analysis of colonic biopsies under a microscope is the only way to get an accurate and reliable diagnosis of MC, a quick and dirty (non-invasive) way to distinguish between MC and Crohn's disease is to use a calprotectin test. Rarely are calprotectin levels significantly elevated (over about 50) in MC patients. If the result is over 100, that's a relatively reliable indication of Crohn's disease.

Again, welcome aboard and please feel free to ask anything.

Tex

SN8888 · Post by **SN8888** » Thu Dec 22, 2016 10:15 am

Thanks for your reply. Most of my symptoms do seems consistent with what I see here and I see that others starting having GI problems after a bout of mono (E-B virus) just like I did.

The only things that seemed more consistent with Crohn's were the neutropenia and ASCA results and I wasn't sure how often MC caused joint pain and fever, etc, but it sounds like that happens too. The neutropenia is relatively mild and I've speculated that it might be due to a depletion of neutrophils (due to infiltration in the gut) rather than an auto-immune destruction of them, but I am out of my field with immunology and inflammation.

I need to go to a new GI doc prepared to discuss all of this, but I want to wait until I'm really feeling sick before I see a GI doc again. I've had them tell me I don't look sick, so there's probably nothing significant to worry about...

brandy · Post by **brandy** » Thu Dec 22, 2016 10:21 am

I think typically none of us "look sick" for the most part. I've long suspected I wasn't taken seriously as I've never "looked sick." We are typically not overweight so just walking in a doctor's door we look healthier than most of the rest of the American population who are morbidly obese that the doctors see in a typical day.

Gabes-Apg · Post by **Gabes-Apg** » Thu Dec 22, 2016 11:28 am

but I want to wait until I'm really feeling sick before I see a GI doc again.

as Brandy said most of us dont look sick. and for things like MC the symptoms and inflammation we are experiencing dont show up in mainstream blood tests.

And even with an accurate diagnosis of MC, majority of the GI fraternity are not pro-active in being able to resolve MC for the patient.
if you want to feel better and optimise wellness starting the eating plan and supplement plan that we recommend will help no matter what the confirmed diagnosis is.
a link to our guidelines for recovery - http://www.perskyfarms.com/phpBB2/viewforum.php?f=79

Post by **tex** » Thu Dec 22, 2016 3:24 pm

I certainly agree with what Brandy and Gabes posted. The fact that we don't look sick" is presumably why so many physicians don't take the disease very seriously. But yes, arthritic-like pain and stiffness is as common with MC as it it with the other IBDs. Fever is not common, but not particularly rare, either. Positive ASCA test results are quite common with MC also, but we usually are able to "escape" that sensitivity after our gut heals.

Tex