Dear Dr. SerVaas: In the March/April issue, a "Medical Mailbox" reader asked whether there is a definitive test for either Crohn's or ulcerative colitis.
Approximately 15 years ago, I was sure I had developed colon cancer. I knew the symptoms, and I knew how bad it could be. My family doctor sent me to a gastroenterologist who examined me thoroughly and finally told me that I did not, after ail, have colon cancer. What I had was Crohn's disease.
I remember very well my response: "Thank God. What's Crohn's disease?" At that point anything sounded better to me than colon cancer.
Regular colonoscopies and checkups through the years led the doctor to wonder if what I had might not actually be ulcerative colitis. He ordered a relatively new test from Prometheus Labs in California. It is believed to tell the difference.
Their test gave me the good news that I have ulcerative colitis instead of Crohn's. Neither is wonderful. But ulcerative colitis is better than Crohn's, and both are better than cancer.
Don Sutton
Indianapolis, Indiana
Dear Reader: We understand that Dr. Steven Targan, a well-known gastroenterologist, was one of the investigators on this test being performed by Prometheus Labs in California. Should you wish a second opinion, we have much confidence in the work of Dr. John Hart at the University of Chicago.
Even with the best of gastrointestinal pathologists, there can sometimes be differences of opinion when diagnosing Crohn's disease and ulcerative colitis. The University of Chicago with Dr. Stephen Hanauer and Dr. Hart, Mt. Sinai Medical Center in New York with Dr. Daniel Present, and Cedars-Sinai Medical Center in Los Angeles are leaders in these important and poorly understood diseases.
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