f you research the p-ANCA test it can be a bit confusing because the IBD spec. p-ANCA test is different than p-ANCA test for Vasculitis. I was really confused about this when I first started reading up on it. I had to look hard for info on the IBC spec. p-ANCA.
https://labtestsonline.org/understanding/analytes/anca/tab/test/ gives a reasonable analysis, I think.
I'm still confused about the VCAM-1 thing...???? in a nutshell what does it mean if I have an elevated level of them?
Can't say I'm an expert on the matter either. There's a whole bunch of different cell adhesion molecules that are part of the inflammatory response repair system but I gather there is elevated levels of them with the likes of chronic ischemia whether it be cardiac, intestinal, lung or any other sort ischemia when there is continual incidence of ischemia reperfusion injury. I think elevated ICAM and VCAM are responsible for increased vascular permeability.
Were you tested for other CAM's too or only VCAM-1? Were you given any reason why VCAM-1 was a target?
I have had a gastric emptying study done and the results were normal. But my gastro doc admitted you can have some slowing and still have a normal test result.
I was told by a highly respected GI surgeon that gastric emptying can vary by the hour, let alone from a day to day basis so a one off test is not a reliable indicator.
My first GES was just within the normal range, except no one told me to stop taking the motility agent I was on prior to the test. Re-tested 2 months later without medication showed a significantly delayed result.
I have also been having episodes for some months now of sharp quite painful upper right quadrant pain (where my liver meet my bottom rib).
Always hard to pin down a cause for these types of pain. I think you get a similar pain with hepatic ischemia from either Pancreatitis or Autoimmune Hepatitis. If the pain radiates to your right shoulder, it can be just a gallbladder thing.
Pain from Chronic Mesenteric Ischemia can be left sided, epigastric or right sided depending on which part of the intestine is affected by ischemia (can be anywhere from the duodenum to transverse colon) and is often mistaken for Pancreatitis. I don't think it's known for causing chronic fatigue though, it doesn't for me anyway.
I've never head of the ischemia condition. I will check out those links.
Seems it's rare for doctors to know about it too, in an outpatient population at least. I had a hell of a job trying to convince any of the specialists it was a possibility. In the end, my G.P. agreed to a trial of nitrates and low and behold, things improved dramatically. Paradoxically, vasodilators actually raised my low blood pressure too so there is something more amiss in my autonomic system other than GI dysfunction.
(
https://www.ncbi.nlm.nih.gov/pubmed/19685450 The role of ischemia in IBD)
I had to have a 2nd much more extensive surgery 6 months later and it was discovered that the Endometriosis had infiltrated through my colon wall requiring a full-thickness bowel resection (removed a piece of the bowel wall not an entire section).
Adhesions is something that can never be excluded as a cause of pain after any sort of surgery. Endometriosis surgery has a bad habit of ending in adhesion problems. Bowel surgery can result in intestinal microvascular ischemia through a process called no reflow phenomenon, the best hypothesis I have seen for this is that dead cell debris from the elevated number of adhesion molecules as the result of ischemia/reperfusion injury from stopping the blood flow during surgery can clog the micro vessels.
It might pay to have an abdominal CT Angiogram done too if you haven't had one before just to make sure you don't one of the pelvic congestion syndromes causing the pain.
I didn't realize until recently that I also have Nutcracker Syndrome (in my case compression of the left renal artery by a massively enlarged ovarian vein) after accessing test results that were not previously made available to me when I didn't agree with the motility specialists opinion that there is nothing further they can do for me. This had been dismissed as being no connection to the motility issues but I discovered that I also have reduced angulation of the superior mesentery artery/aorta junction which can result in SMA (Superior Mesentery Artery) Syndrome (which can also cause intestinal ischemia) but the same thing also Nutcracker Syndrome and it's not uncommon to have the two conditions together.
