Living With Crohns Disease

I haven’t written anything about these yet. I can’t bring myself to, somehow. I’m sure you understand…

When you have blood drawn, there are a number of tests that can be performed to analyze it for different properties, amounts of certain chemicals, types of cells, etc. Your blood carries within it lots of information about what’s going on in your body.

A blood test for Crohn’s disease especially is used as a preliminary procedure that will give your doctor some insight as to where to go next. You may need to learn how you can normalize levels of certain chemicals found in your blood, whether it be by eating more or less of some foods, or engaging in healthy activities and ceasing unhealthy ones. Anything from how to lower triglycerides, to increasing iron levels and red blood cell count, may be among the problems found in your blood based on your height, weight, age, and physical condition.

During any procedure in which the body is physically examined, a biopsy may be taken by the doctor. A biopsy is a sample of tissue that is removed from the body of the subject.

This procedure can be performed in a number of different ways depending on the type of tissue, but in Crohn’s patients it is most often done during colonoscopy or a surgical procedure where an abnormality such as a polyp, fistula, lesion or diverticulitis exists.

Cell samples taken with a biopsy are analyzed in a lab and may be searched for the presence of disease, infection, bacteria, or cancer. The biopsy may be taken by extracting the cells with a needle or cutting them with a scalpel, razor or surgical blade.

A minimally invasive procedure called a CT Scan is most often used in patients living with crohns disease in order to look into the abdomen. CT (computed tomography) is a newer radiological technology that is used for three-dimensional imaging of many areas of the body, but for Crohn’s patients specifically it is most often performed on the abdomen and pelvis.

Unlike an MRI (magnetic resonance imaging), which uses magnetic fields to obtain an image and does no harm to the subject, CT conveys relatively high doses of radiation. These doses are not above safe levels, but care must nonetheless be taken as cancer occurrence is thought to be linked with radiation exposure.

CT and MRI images may be taken with or without contrast. When contrast is used, CT scans most often utilize a barium contrast that is taken by mouth to illuminate the digestive tract, along with an intravenous injection of iodine, which aids the machine in achieving high image quality. An MRI scan will use oral contrast and/or intravenous dye as well, but agents such as manganese, ferric chloride, ferric ammonium citrate, and gadolinium are more conducive to MRI tests involving the abdomen.

Some people may have a sensitivity to any of these contrast agents and some have minor side effects, but all are generally safe for use in the average patient.

While MRI tends to be superior to CT in function, the fact is that CT is cheaper, tests can be performed faster, and it works in a wider field than MRI. Some patients who experience claustrophobia in the tight confines of an MRI machine do better in the wider ring used by most CT scans. Because MRI is a magnetic technology, image quality is benefitted from a more tightly enclosed space with the mechanical instruments closer to the patient’s body.

Both types of scans use multiple fields in different ways to bounce energy off the tissues of the body. They record thin slices of an image based on the return values of these fields and construct a two-dimensional, or more commonly, a three-dimensional image based on those values.

The costs of each test will obviously change over time, but an MRI may be anywhere from 20-60% more expensive than a CT scan.

If your doctor wants to get a closer look at what’s going on in your large intestine, you may be prescribed a procedure called a barium enema. This is a radiological test that will most likely be performed in your local radiology lab.

If you’ve been scheduled for this test, I’d like to tell you that it isn’t that bad. But it is. No, seriously. It’s horrible. I had to have one once, and I thank my dear Lord every day that goes by where I don’t have to have another one.

I don’t want to scare you out of it, but let me be honest with you. The test doesn’t hurt at all, it’s just very uncomfortable. Let me think of how I can describe it.

Imagine the most intense feeling of having to go Number 2 that you’ve ever felt before; a time when your guts literally felt as if they were about to burst. Multiply that by three, and you’ve got yourself the lovely sensation you get while you’re undergoing a barium enema.

Sounds pretty bad, huh? Well, the truth is it only lasts for a few moments, and while it’s happening you’ll probably be more worried about the feeling that you’ll crap all over the place than anything else. You’re going to be perfectly fine though; these people perform this test all the time and they’re used to it. They know it sucks for you and it isn’t going to be pleasant for anybody, but it doesn’t take very long to complete.

This is how they do it. First, they’ll insert a tube into your rectum (I know, descriptive), followed by a balloon. Neither of these two implements hurts going in, but the balloon feels really weird. Like, I don’t know how to explain it - it’s kind of a feeling that makes you shudder.

You’ll be lying down on your side when they put these things into you, then they’ll stand you up with a pivoting exam table they use for x-rays, so you won’t have to stand up on your own or anything. The table literally lifts up like a big Frankenstein machine and takes you from a prone position into a standing position, very slowly.

So the first tube injects contrast, which is made up mostly of barium, a radioactive element that makes your insides glow so they show up on the x-ray. The second tube with the balloon will inflate to keep all this wonderful white junk from escaping out of your you-know-where. Some of it probably will, but if it does don’t worry about it. I’m telling you, it’s a common thing during these tests for that to happen.

The reason the test is so uncomfortable is because that first tube can also be used to push air into your bowel. They need to properly inflate your large intestine so they can get a good look at what’s happening in there. So the air blows it up, and the barium coats the lining and highlights your colon for the x-ray machine.

You may be asked to swivel a little bit from side to side so they can take pictures of your stomach from different angles, and the doctor may also use a rubber instrument to press on your stomach so your insides move around and they can get the different views. Other than that you’re just going to be squeezing your sphincter as tight as you can and standing there, gritting your teeth.

In between when the doctor takes each series of pictures, they’ll be able to pull out some of the barium and air to give you a little relief. Those moments aren’t bad at all, they’ll give you a rest for the next go.

The one cool part about the test is that, since the doctor will be standing next to you taking the pictures, you’ll probably get to see yourself on the screen! I don’t know about you, but I think it’s pretty awesome being able to check out your guts on camera.

So my final word to you, friend, is don’t worry. Sure, it’s going to suck and be uncomfortable for a minute or two, but the test will help your doctor and/or surgeon get a much better picture of how you’re doing down there. And it really doesn’t hurt, so you don’t have to worry about pain. If you have any questions about the barium enema or other procedures, just drop me a line.

Various types of X-Ray and radiological procedures are often used to diagnose Crohn’s disease, or to assess the condition of a Crohn’s patient’s disease.

Each radiological examination carries with it certain risk factors, such as exposure to radiation.

Below is a chart showing the average radiation level introduced into the body with each procedure commonly used in Crohn’s patients. Amounts vary due to the use of several kinds of radioactive contrast.

Having your first colonoscopy is like breaking up with your first love - years later you’re glad you went through with it, but at the time it really, really sucked.

The worst part of a colonoscopy is usually the preparation. You’re made to ingest a chemical which, for lack of a less disgusting term, makes you crap your guts out.

You basically spend the day before the procedure taking pills every few minutes and drinking copious amounts of water until you start going to the bathroom almost constantly. The idea is to clean your bowels out completely so that the doctor can get the clearest view possible when he looks inside you.

To make matters worse, they also tell you to refrain from eating or drinking anything but clear liquids after midnight that night.

You go in for the procedure and they’ll hook you up to an IV, and then wheel you into the procedure room where all the magic happens. They send some happy juice down the tube and you’re out like a light.

Once they take you down, I’m telling you, the next three to four hours of your life are going to be just fine. You wake up feeling good and you get to eat again! If all goes well and they get the dose for your knockout drops right, you shouldn’t feel a thing during the actual procedure.

The sigmoid is the last length of colon along the tract, and is named after the ‘S’-shaped curve it forms. A sigmoidoscopy is like a less extensive colonoscopy where the doctor uses a fiber-optic camera to look inside you from the bottom end and see what’s happening.

I’ve never had this procedure performed on me, but I’m told it is fairly uncomfortable because they don’t put you under before you have it done. Air is inserted to inflate the colon and you’re told to lie in a somewhat compromising and awkward position, then the camera is inserted. Not a fun procedure, but it’s at least better than prepping for a colonoscopy.

The normal colonoscopy involves inserting a camera into the rectum to look at the patient’s colon. During a virtual colonoscopy a CT machine takes images of the abdomen so that a physical camera does not need to be present inside the patient.

Preparation for the virtual colonoscopy is usually the same as the methods used for the conventional procedure. Read about them here.

A thin tube is inserted into the patient’s rectum to introduce air that expands the colon and stretches the lining so that any damage or abnormalities can be more readily viewed. Whereas a traditional colonoscopy can take up to an hour to complete, a virtual colonoscopy takes only 10 to 15 minutes.

Virtual colonoscopy may be a favorable option for those living with crohns disease for the same obvious reasons it would be for anyone else, but also due to the fact that even a brief period of time in which the digestive system is put under any kind of stress or abnormal conditions becomes that much more detrimental when nutrition is of utmost importance, as it is in the Crohns patient.