Potential PSC diagnosis (ERCP, MRCP, CROHNS)

[Joels41]

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I am a 25 yr old male with crohn's disease. I apparently have had high ALP levels (130-150) for the past 3 years. They do not appear to be increasing. I had an MRCP done and i was told it indicated some inflation by my gastro doctor. She basically told me i had PSC. I had an ERCP completed and the doctors performing the procedure said that based on the MRCP they cannot make a diagnosis and the ERCP was to rule out psc. Based on the ERCP results they still cannot come to a conclusion. They did note some area of inflamation in my bile duct but cannot at this point call is PSC. They said it MAY be early indications of psc but if i didn't have crohn's a PSC potential wouldn't be on the radar. I have had crohn's for 12 years and have had some arthiritic symptoms and have had a fistulae that was treated with cipro for year and has since been not treated for the past 2-3 years. I have no symptoms or pain. I am wondering what this could be if it is not PSC. COuld it be related to the fistulae or be a random swelling for no reason or what. Any info would be helpful

[sfbaygirl]

We mainly deal with hepatitis here. I am chirping in here because I  had an ERCP and inflamed bile ducts. They were able to put a stent in my bile duct so it could drain. Easy and I have no problems with it now. Not sure what PSC is? Perhaps you should check out the gastro forum.

[compulsive]

Hi Joel,

  My ALP levels are also high, but I have HEPATITIS C and a stricture from surgery.  All I can really offer you is some sympathy.

  It's REALLY stressful when they start talking about Cholestasis, strictures, inflamation, and Primary sclerosing cholangitis (PSC).

  Especially when you already have enough on your plate.

  I spent an awful lot of time doing internet searches while they were testing me.  I was VERY stressed.  Not alot of reassurance out there either, it's all very technical and hard to understand - and what I DID understand REALLY frightened me.

  I am very glad for you that they have not made a definitive diagnosis of PSC.  It could be an inflamation from some unknown source - it does happen.  If I were you I would get a second opinion on this.  Your doctor should be ok with this.  Make sure your second opinion doctor has all the test results.

I am sorry to here about the crohn's disease, but it is good that you have no symptoms or pain.

   I don't have anything very useful to say about what else it could be (because in my case it turned out that the high ALP levels are caused by a combination of Hepatitis C and a stricture from surgery), I just wanted to let you know that I know how tough it can be to go through all those tests and not get answers.

  It takes a long time for them to say yeah or nay on a PSC diagnosis, and it's stressful waiting.  Hang in there!

[wyntre9]

Hi Joel.

I don't know anyting about Crohn's, or abut much else, for that matter.  

I just wanted to wish you good luck.

Wyntre