Chron's Disease or Not?

Does a mildly elevated ASCA mean I have Chron's disease? I recently had some blood tests run, and while my sed rate and CRP were normal, my ASCA was 35 (25 is normal). I also had an upper and lower scope that showed mild inflammation. The biopsy showed ileitis but not Chron's ileitis. My first GI said that he suspected Chron's disease. I got a second opinion, who does not think I have Chron's disease. My main symptoms are loose bowels and bloating. No blood in stool or fever, and all my vitamins and WBC and RBC are normal. Most of my loose bowels symptoms started after I had my gallbladder out, and have not worsened over the past two years. Should I seek a third opinion? I am wanting to get pregnant, and wondering how important an accurate diagnosis is.

[Ratnakar Kini, MD]

Hi Diana31,
ASCA is not a confirmatory test for Crohn's disease. It is not specific for Crohn's disease as it is positive in a few other conditions like celiac disease and collagenous colitis.

Moreover if Crohn's is active , your CRP level should be high.

In case of doubt you can have a barium meal series or capsule endoscopy to look for lesions in the small intestine. You can also a work up done for Celiac disease.

There is a possiblity of the symptoms being due to post cholecystectomy syndrome which occurs after the gall bladder is removed.
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The information provided is for patients’ education only and is not a medical advice. Always consult your personal physician for complete evaluation of your health problem.

- Ratnakar Kini M.D.