Expert: Odette Yuhas - 6/3/2004

Question
I WAS DIAGNOSED IN 1993 WITH UC THEN IN 1996 WITH IBD AND FINALLY IN 1999 WITH CD (THRU A NEW COLONOSCOPY AND BIOPSY). I HAVE BEEN ON ASACOL SINCE 93. I WAS DIAGNOSED IN 2002 WITH LUPUS MYOSITIS AND BEGAN TREATMENT WITH METHOTREXATE. I HAD TO CHANGE GASTRO-SPECIALISTS A YEAR AGO AND HE CONTINUED CROHNS TREATMENT (ASACOL, 6-MO CHECKUPS AND COLONOSCOPIES EVERY 5 YEARS). A COUPLE OF WEEKS AGO I HAD MY COLONOSCOPY AND HE SAID MY COLON LOOKED CLEAN AND BIOPOSY NOT SHOWING CROHNS. HE SAID THAT METHOTREXATE MAY HAVE HELPED OR ORIGINAL DIAGNOSIS INCORRECT. MY QUESTION IS - IN REMISSION COULD NO CROHNS SHOW UP ON THE TESTS? I HAVE GONE OFF THE ASACOL (NO NEED IF I DON'T HAVE CROHNS)- DR. SAID I COULD STAY ON IT OR DISCONTINUE AT MY DISCRETION. HE ALSO SAID I DIDN'T HAVE TO COME IN TO SEE HIM ON A REGULAR BASIS- JUST IF SOMETHING WOULD HAPPEN. I AM SO CONFUSED--- DO I HAVE CROHNS OR NOT AND AM I CORRECT IN STOPPING THE ASACOL? COULD THE METHOTREXATE HAVE DONE THIS?

Answer
Hi Jane,

I would suggest you go to another doctor and get another opinion.  Crohn's is chronic, it does not go away although we can have fisutli free which means remission but NOT that we are cured.  There is no cure for this disease, just therapy.  Asacol is an antibiotic and may have helped as well as the methotrexate.  But please see another doctor.  Crohn's is diagnosed via a CT scan not a colonoscopy.  The colonoscopy shows whatever fistuli there may be but does not diagnose it.  Your original colonoscopy could have been correct with the UC and IBD.

I wish I could help you more.  It angers me when the doctors do not know what the problem is when it comes to the Lupus and CD...they go hand in hand, almost identical...please ask for the CT scan..please.

Best of luck and let me know,
Odette