Discussions By Condition: Gastrointestinal conditions

Crohn's and potential PSC diagnosis

Posted In: Gastrointestinal conditions 5 Replies
  • Posted By: Joels410
  • January 20, 2007
  • 01:47 AM

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. I had an ERCP completed and the doctors performing the procedure said that based on the MRCP and ERCP they 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.

Reply Flag this Discussion

5 Replies:

  • No, fistula do not produce elevation of liver enzimes and alkaline phosphatase. It is very likely that your doctors are right and that you may be in an early stage of PSC which might develop in the future.Yours very trulymedicald@hushmail.com
    Anonymous 42,789 Replies Flag this Response
  • It has been 2 years now and the Docotors have monitored my ALP levels about 4-5 times per years. MY levels have decreased and have been normal 100-120 with the last 3 tests at 101, 100 and 95. My doc's are saying that they do not believe i have PSC and that the liver can do funny things with crohn's due to inflammation. They indicated that PSC would show elevated ALP's and they would not return to normal like this. Wondering if anyone has thoughts, ideas or anything regarding what the doc's are saying.any ideas or perspective would be much appreciatedThanks,Joels410
    Joels410 3 Replies
    • November 13, 2008
    • 02:55 AM
    • 0
    Flag this Response
  • Well, In my case, post-colectomy(for UC) Crohn's and PSC, my labs can look normal sometimes and other times be hideously elevated. Most of the time my ALT, AST, ALP and GGT not to mention INR are all elevated and out of whack. If it's only one marker that's elevated, I think your docs are right to be very cautious in calling it PSC. It MAY be the early stage of PSC, then again it may be a stress induced elevation due to the stress Crohn's puts on the body. I would just monitor things like you have been and just be alert to any of the symptoms of PSC.Just my $.02.
    Eahlmunde 4 Replies
    • January 21, 2009
    • 08:29 PM
    • 0
    Flag this Response
  • Thanks for your input.I do feel as though is am having symptoms but my docs are telling me i am not. they are saying that with my blood tests there is no way i would be having symptoms. I feel as though i am having intermittent RUQ pain, light stools and some itching but not enough for me to certainly know.They seem to come and go. What symtoms would i see with PSC???Would they be this clear or would they be more mild???Also i am PANCA negetive. ALP has been the only evevated level and billi and GGT have been normal.Also i have had high ALP's dating back years. when i was 18 my ALP was 136 and i was not growing back then as i am the same height now so i dont believe it woudl be bone ALP.Any additional input would help.thanks,Joel
    Joels410 3 Replies
    • January 22, 2009
    • 11:13 PM
    • 0
    Flag this Response
  • PSC can have numerous symptoms including the ones you list. However, those very same symptoms are also present with Billiary Colic, Gallstones, Liver Stones and many other illnesses. You say that your billi was normal, which would seem to preclude the itching being caused by billi. Believe me, the itching is almost unbearable because its under the skin. In your case, I think it's a safe bet that its the Crohn's stressing your body ... until the labs start to elevate and a MRCP/ERCP shows definative pathology. You were asking what symptoms to expect with PSC. In my case with Crohn's and PSC: chronic URQ pain, fatigue, dehydration, electrolyte imbalances, low potassium levels (currently 1.8 where 3.5-5.0 is normal), nausea, vomitting, liver stones, billiary strictures, mental fog due to elevated amonia levels, pruritis (itching), lack of appetite, mood swings, oral and esophageal yeast infections, elevated cANCA levels, elevated ANA levels, liver infections, vasculitis, DVTs, lower leg edema and pain and inability to maintain body mass. So, enough listed? Not really something to look forward to, believe you me. With PSC being terminal and only definitively treated by transplantation, my advice is to live with the Crohn's, treat the intermittent symptoms and enjoy the fact that your docs don't think there's enough evidence to make a definative diagnosis because once they do, you're in a whole new world with new rules. I know that's not exactly what you were hoping to hear. Regards, E p.s. IANAD (I Am Not A Doc), just a poor suffering medical anomoly.
    Eahlmunde 4 Replies
    • January 24, 2009
    • 02:42 AM
    • 0
    Flag this Response
Thanks! A moderator will review your post and it will be live within the next 24 hours.

Signs of a Psoriasis Flare

Know the five types of psoriasis and how to spot flares.

How Diabetes Medications Affect Your Appetite

Newer diabetes treatments can suppress appetite and aid weight loss.

What to Do For Dry Mouth

Try these tips to get your salivary glands back into action.

The Painkiller – Constipation Connection

Constipation is a common side effect of opioid and narcotic pain medicines.

9 Signs of Sensitive Skin

Is it sensitive skin or something else?