Colonoscopy results today.

Great news for you!! Glad to hear you are doing so well!!

Great news!!! I'm always glad to hear of anyone who's winning against this disease. I'm one of the ones that's usually railing against Pentasa. I certainly won't attempt to tell you that it's not working.

Only thing I would contend, is that you just might be in remission either from your last pred use, or just naturally. Not suggesting that you change anything, and not suggesting that it isn't the Pentasa. Just think you should keep up with your regular appointments and stay on top of things.

I'm wishing you continued success with your current treatment plan. Hopefully, that will be all you need for many years to come.

Glad to hear you're doing well/better, but of course I can't resist touching on the Pentasa issue:

1. Do you know for sure that you have Crohn's colitis and not ulcerative colitis?

2. You've been on more than just Pentasa. It's more likely the colifoam is working than the Pentasa is working - or maybe the prednisone course you were on knocked the inflammation back and the colifoam is keeping it in check.

3. If you review the studies when they compare these meds with placebo, you find that 20% to 30%, and sometimes even 30-35%, of people who receive the *placebo* show improvement in symptoms and in scope results. In other words, the disease can come and go for reasons unknown. The studies show that Pentasa is no better than those rates, ie, giving you a placebo may have had the same result.

So your disease may have improved for other reasons besides Pentasa (unless, as mentioned, it's actually ulcerative colitis, not Crohn's colitis).

Good for you!

There are cases, many of them, with UC having inflammation in the terminal ileum - it's called "backwash ileitis" in this case. There are also instances in which the inflammation appears patchy in UC. As NCOT pointed out, Crohn's and UC are more a continuum of diseases with some overlap. Really determining whether it's Crohn's requires specific features to be seen in tissue biopsies; or you could develop fistulae, or strictures in the small bowel. But even then there are cases where tissue biopsies are inconclusive, and there are cases where people developed strictures but biopsies were consistent with UC, not Crohn's. So it's not always a simple either/or of it being UC or Crohn's.

In any case, like I said, glad you're doing well, so it's all an academic argument at this point.

But again, yes, in drug trials, the 30% response rate for placebo has been quite consistent over many decades. Some conditions have very low placebo response rates, but with IBD - conditions that often wax and wane with no understood reasons - the placebo rate is relatively high. That means that drugs have to have even higher rates of success in order to beat placebo, and Pentasa has not been able to beat placebo consistently. Remicade, Humira, Entyvio, etc, have been able to do so quite easily, and 6mp and imuran have done so as well, though not to the extent that the biologics have.

So is there any test to actually determine what disease you have? Weather it be UC or Crohns.

No. A subset of IBD patients (about 10-15%) have ambiguous disease features which makes it impossible to diagnose UC or Crohn's with any certainty. Some people's diagnosis changes from UC to Crohn's, and vice versa, over the years. I actually had that happen to me once. For 16 years I had a Crohn's diagnosis, then earlier on this year my surgeon tried to tell me it wasn't Crohn's. I argued with her about it, she checked her notes, and then changed her mind when she saw that I'd had "classic" Crohn's in the terminal ileum. She'd removed my colon and terminal ileum 3 years earlier, but had clearly forgotten that bit!

Basically her explanation for the confusion was that my colon biopsies hadn't shown signs of Crohn's. But apparently they hadn't shown signs of UC either - I just had colitis apparently. No other doctor had ever flagged up anything as being atypical except just once, many years earlier. He was muttering to himself rather than to me about it: he seemed a bit puzzled by my colonoscopy results.

Sorry, I went on a bit there. But it's just to demonstrate that UC/Crohn's isn't always a binary, clear-cut distinction. Unfortunately I never found out whether mesalazine would have worked for me, because I couldn't tolerate the stuff. But given the eventual severity of my disease, I don't think it would have done.

^Yep, drinking a litre of whole milk is an effective treatment for Chrons.

Unfortunately it's not an effective treatment for Crohn's, which is what this forum is about.

**Rolleyes**

That's fantastic news!!

I'm also on pentasa, as well as salofalk enemas and pentasa suppositories. I think we chatted on another thread abut our symptoms, I've responded really well to pentasa except I'm still getting blood at least half the time (some I flmamtion was at bottom of descending colon and doctor has now put me in enemas to see if they can treat that). From the quick glance I had of my biopsy results they just said "inflammatory bowel disease", so I don't think my inflammation showed classic signs of crohns (yet). The diagnosis was crohns colitis because the inflammation was patchy...

What doctor so you see at CDD? I see Dr Suhirdan Vivekanandara