two sigmoidoscopies in a month

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WebDude - 23 Mar 2006 23:45 GMT

Hello, i have had crohns for the peast 20 years.

Recently, ive been feeling pretty sh*tty but my primary Gi doctor didnt
think much of it. So i went to see another GI doctor for his
opinion.....long story short... now each of them wants to perform a
sigmoidoscopy on me in the next month. ANd while i want each of them to
look inside me, is their any increased risk of having two such exams in
such a short period of time?

I have had colonoscopies and sigmoidoscopies before, they are no big
deal. But i just wanted to double check that having two in a month
didnt pose any hidden danger.

Cheers,
WebDude!

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Howard McCollister - 24 Mar 2006 00:00 GMT

> Hello, i have had crohns for the peast 20 years.
>
[quoted text clipped - 8 lines]
> deal. But i just wanted to double check that having two in a month
> didnt pose any hidden danger.

Flexible sigmoidoscopy is a pointless exam for Chrohn's disease. A
colonoscopy *might* be more useful. Best test for tracking Crohn's disease
would be a pillcamSB (if you insurance company will pay for it).

HMc

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WebDude - 25 Mar 2006 08:12 GMT

Ive already had a small bowel followthru, from which they saw a
narrowing of my sigmoid. which is why they want to take a look.

i'll mention the pillCam. no one has ever offered it to me before.
though i saw it on tv.

cheers

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Howard McCollister - 25 Mar 2006 13:06 GMT

> Ive already had a small bowel followthru, from which they saw a
> narrowing of my sigmoid. which is why they want to take a look.
>
> i'll mention the pillCam. no one has ever offered it to me before.
> though i saw it on tv.

A flexible sigmoidoscopy obviously only looks at the sigmoid - it won't tell
you if you have other areas in the colon that are active and causing pain.

A small bowel follow through may show strictures or other obvious anatomic
abnormalities, but you can still have significant active Crohn's disease in
the small bowel that is causing symptoms but is not demonstrated with that
rather blunt diagnostic tool. PillCam SB is very accurate for evaluating the
small bowel mucosa for such things. It's one of the rather narrow line of
indications that are recognized for the PillCam by most insurance companies.
If colonoscopy is negative and small bowel follow through is unhelpful, then
it's time for PillCam.

HMc

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WebDude - 26 Mar 2006 15:39 GMT

btw. Im also having a CT scan done.. which can display a three
dimension view of my abdoman from what i understand. so that'll be good

:-)

Um, The PillCam, im having second thoughts about mentioning that to my
doctors cause it looks kinda large.. ive had food smaller then that get
stuck in my intestines back when my colon wasnt narrowed (as it is now)

:-|

Cheers,
WB

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Howard McCollister - 26 Mar 2006 17:16 GMT

> btw. Im also having a CT scan done.. which can display a three
> dimension view of my abdoman from what i understand. so that'll be good
[quoted text clipped - 4 lines]
> stuck in my intestines back when my colon wasnt narrowed (as it is now)
> :-|

So, is this Crohn's disease of the colon? Small intestine? Both? You have a
history of Crohn's disease of the colon and he wants to do a sigmoidoscopy
instead of colonoscopy? He saw a stricture in your sigmoid from a small
bowel followthrough? This stuff isn't adding up for me. Either I'm not
grasping your explanation, or this is a very muddled workup he's got going
for you.

Flexible sigmoidoscopy for Crohn's disease is a very unusual approach if one
is trying to find out about colonic involvement since it can involve more
than one segment (skip areas). What's he doing to look at the other 2/3 of
your colon? CT scan, small bowel followthrough, Pillcam, flexible
sigmoidoscopy are all useless for that.

If you're talking about the possibility of your current symptoms being due
to acute disease in the small intestine then CT scan, with or without 3-D
and saggital reconstruction, will provide less information than a small
bowel follow-through unless he's looking to rule out an abscess from
perforation. If he's just tumbling to that possibility now, he either has a
very low level of suspicion that that's the case or you should consider
getting another opinion.

HMc

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