Crohn's Disease AND microscopic colitis??

I've been lurking on here for too long!

I was diagnosed with Crohn's Disease in August of '09, and thankfully, Remicade threw me into remission and I've essentially been symptom-free since then. I had a clean scope in '11, but then a couple months ago things started to change.

I've been having RLQ and LLQ pain, along with some cramping and softer stools. It's all been annoying but not life-changing (thankfully!). I went in for a colonoscopy a couple weeks ago, and my GI saw....nothing! Great, right? Except I was still having the pain. Got a breath test for possible SIBO which was negative, but then my doc's PA told me today that I had microscopic colitis (the lymphocytes showed up on the biopsies when I was scoped). She said it was distinct from Crohn's Disease and yet treated similarly.

This seems so strange to me. Since I've already been diagnosed with Crohn's (back in '09 it was very clearly Crohn's Disease), I assumed this inflammation was just the start of a flare or something. Apparently it's different.

I'm wondering if anyone else out there has also been diagnosed with Crohn's and microscopic colitis? My doctor's currently taking me off of the Apriso (Crohn's maintenance med) and putting me on Entocort.

Thanks!
-Bekah

My Daughter has Crohn's in her TI, but has recently spread to her cecum, and after her last scope, they found microscopic colitis throughout her large intestine.

I might be confused, but they call any inflammation in the colon, colitis, even though it's actually Crohn's in her colon, not ulcerative colitis. Could this be the situation you have?

What Pb4 stated about 2% of IBDers having both Crohn's and Colitis, is something I've never heard of before. What an unbelievable combination.

Hi probiotic, I read about it one of my CCFC journals. I have so many of them it would take me a while to try and find it and who may have researched it.

Coolgirl09. I was diagnosed with Crohn's in 2001, and just had another scope a few months ago. My doctor told me he now found Microscopic Colitis in the low part of my intestine or colon. So I was concerned and he told me he is just gonna leave it for now and treat it as if it is Crohn's. I don't know if he is doing this because I am on Medicare and disabled or because he doesn't want to do paper work. But yes, I just was diagnosed with Microscopic colitis and I already have crohn's. Don't know why he doesn't want to deal with it yet. He said he was just gonna group it in with the Crohn's. ?????

Hi coolgirl...I think MC and UC are different from each other...MC is also known as "collagenous Colitis"...

The two most common forms of inflammatory bowel disease are ulcerative colitis and Crohn's disease, but two others fall under that same umbrella: lymphocytic colitis and collagenous colitis. Of all the inflammatory bowel diseases, collagenous colitis is arguably the least serious, though it is harder to detect.

Microscopic colitis is actually composed of two similar, but separate conditions: collagenous colitis and lymphocytic colitis. The symptoms of microscopic colitis include chronic, watery diarrhea and cramping or abdominal pain.
Essentially, collagenous colitis is characterized by an increase in diarrhea, caused by an increase of collagen in the connective tissue between the large and small intestines. Unlike ulcerative colitis, it cannot be diagnosed through a routine colonoscopy, because there are no visual sores or ulcerations that indicate its presence. A biopsy is required to determine if the tissue is affected, and many patients elect to simply not know, rather than deal with the potential side effects of a biopsy.

Collagenous colitis is also different from ulcerative colitis in that the symptoms are far less pronounced. Both diseases produce an increase in diarrhea as well as abdominal cramps, but most collagenous colitis sufferers don't experience the bloody stools, weight loss, skin lesions, fatigue or anemia that are almost always present with ulcerative colitis. However, with both diseases, the symptoms come and go on a sporadic basis, and there is no way to cure either one.

If you are diagnosed with collagenous colitis, it is doubtful that you will be immediately placed on a treatment regimen. With ulcerative colitis, most patients are started on drug therapy as quickly as possible, but collagenous colitis often resolves itself through simple lifestyle changes. Reducing the amount of fat consumption, eliminating caffeine, increasing the amount of sleep you get, and avoiding aspirin can reduce or even eliminate the symptoms.

If lifestyle changes don't work, however, collagenous colitis sufferers may be given medications to help control symptoms. Drug therapy usually begins with something mild, such as anti-inflammatories, to reduce the damage done to the colon and intestines from increased diarrhea. Patients are also encouraged to take OTC medications such as Imodium to help for short-term relief.

@73monte--I'm currently on Remicade 8 mg/kg and Imuran 100mg. I've had 3 GIs in the past three years (one of them one of the most highly recognized in the country) and they all have been sort of apathetic about the Imuran. All of them would tell me it would help prevent me from developing the antibodies, but then in the next sentence we'd be talking about the scary T-cell lymphoma or telling me how we needed to "simplify the regimen" (this was when I was pregnant with my daughter) or how I was doing so well maybe I could go off of it in a while. All of the talk about the Imuran made me realize how much of an art treating Crohn's Disease is. Because of that, I make sure I have a GI who listens to me and allows me to have input in treating my disease. I know myself/my pains/my body better than my doc. For instance, i know that right now I'm having pain consistent with inflammation (it's so similar to what I had when I was diagnosed), and so finally the microscopic colitis has been recognized and I'm getting treatment in the form of Entocort (we'll see how it goes!).

My current GI talks about the Imuran as if 100mg is nothing. The Remicade is really what is doing all the work. The Apriso was simply to help prevent colon cancer (guess there's a study that shows that all the 5-ASA drugs combined with folic acid greatly reduce the colon cancer risk). Here's hoping the Entocort kicks all those extra lymphocytes out of my colon!

P.S.--Thanks pb4 for the info on microscopic colitis! Mine was lymphocytic, so I'm thinking that might change a bit how it's treated. Hoping to figure it out soon!

--Rebekah