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jmgrus 04-21-2005 06:02 AM

Crohn's, Colitis question on biopsy report ....
I know you guys are not doctors, my follow up with the GI doc on this is May 12th. I guess I am just a bundle of nerves, trying to find out before then what's going on and if I'm going to need drugs or what. Ok, here goes:
A. Ileum Biopsy: Small Bowel Mucosa with benign lymphoid aggregates
B. Ascending colon mucosa biopsy:
Colonic mucosa with lymphoid aggregates and mild acute colitis. (see comment)
C. Sigmoid Biopsy: Colonic Mucosa without diagnostic abnormality.
Comment: The biopsy from the ascending colon shows the presence of an acute colitis. The mucosal architecture is distorted with glandular atrophy, branching and shortening. A crypt abscess is identified and there is focal acute cryptitis. The lamina propria is expanded by a mixed inflammatory cell infiltrate consisting of lymphocytes, plasma cells, neutrophils, and eosinophils. In addition, there are prominent lymphoid aggregates. Granulomas are not identified. In view of the architectural abnormalities, the histological appearances are suggestive of inflammatory bowel disease. As the sigmoid biopsy is within normal limits, the possibility of Crohn's disease should be considered.
My symptoms are diaherra lasting for one day, usually occuring about once every three weeks. Some of the times I have seen a little bloody mucous. Other times no. One other thing to note is that after the doc did the colonoscopy he said everything looked good. He found a little irritated part of the colon but it didn't look like anything to be concerned about. Found a benign polyp and found a hemmroid (that is where I thought that the occasional blood was coming from). My question is basically where will I go from here? If this is Crohn's will I have to go on medication for the rest of my life? I have no really life altering symptoms of anything now, I am normal with normal bowel movements. I may come up with diaherra tomorrow but in the past it has always been resolved within a day with Immodium AD and I have no big time pain. If this is Crohn's (or even Colitis) what type of meds do they put you on and do I even have to go meds? Currently I am having no big time symptoms of anything. I do have gas, with belching and flatulence, is that a sign of Crohn's or Colitis? Just worried, nervous, don't know what the future holds with these meds and this disease. I have heard the meds have some pretty big time side effects. Ok Quincy, spill the beans on this stuff!

quincy 04-23-2005 12:51 AM

Re: Crohn's, Colitis question on biopsy report ....

Sorry I haven't answered sooner (missed the last sentence).

There are only 2 inflammatory bowel diseases -- CD and UC. If UC were suspected, then your rectum would have inflammation and be non-skip upward, which yours isn't.

Your ileum is inflammed (it seems characteristic to CD as per the suggestion in the report), as well as the ascending colon (the top part of the colon). It says colitis, inflammation of the colon, but it wouldn't be UC because that's not the pattern, as well...the ileum isn't affected in UC (unless it's a backwash when the whole colon is affected).
You also have obvious physical changes within the bowel wall of the ascending colon.

As far as medication....there are a few out there. Since you're not having many symptoms, the doctor might just have you on a 5ASA med. There are also immunosuppressants and immunomodulators that people are taking in infusions when they are flaring. Some doctors only push steroids. I read way too many horror stories about patients being on that stuff for waaaaaaay too long, as well as ending up suffering from the side effects (many for life-long) during and after the meds have been stopped.

No, you might not have to take medication for the rest of your life....but you might have to take medications periodically during your lifetime (if you have CD).

I'm not up on all the terminology...just pick out all the words and do a search on them. At least it'll give you a better idea of what they mean.

It's all a matter of degrees with inflammation. Some people suffer with severe symptoms and visually things don't look so bad, and it can be the opposite where some people don't have many symptoms and visually it's clearly inflamed.

CD affects the entire wall depth of parts of the digestive system from anus to mouth. UC affects only the colon and sometimes the cecum.

You might find that changing your diet will help with some symptoms.
Many people with CD or UC follow the Specific Carbohydrate Diet. I don't, but many seem to find relief.

As far as the other symptoms you're having...hmmm, it could be related or not. I do know of many people with CD who suffer from belching and upper discomfort. Have you had a small bowel series or an upper gastro scope done?

You'll definitely have to wait for the doctor to say to you what you have. He/she will give you options for medications.

You must to a thorough search via the internet and the library (medical as well) to find out all about CD. That way, when the doctor discusses options, you'll make informed decisions. Get REALLY SMART about it all, especially about the meds. You don't have to take what you don't want to.

Let us know what the doc says about your diagnosis and what options are available to you.

Hope this helps somewhat...If I find out anything else, I'll post.

Hang in there till you know exactly what you're dealing with. Not that it's easy to do, but try not to let the stress overtake you.


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