New to Crohns, not new to IBD

I don't get it. Was it definitely Crohn's they saw in the terminal ileum? Pretty crap change anyway, to be honest. Sorry about that.

My diagnosis has always been the same, but my surgeon changed it from Crohn's to colitis for about 5 minutes earlier on this year. I argued about it and said what about the terminal ileum. She said something about backwash ileitis. In the end she checked her own notes from 3 years ago (when I had my first surgery) and found that she had written I had "classic" Crohn's of the TI. After that, she changed her mind, said she had been wrong and that it was definitely Crohn's after all. I asked about indeterminate colitis and she told me to forget about that as well. Apparently the biopsies from my surgically removed colon didn't show Crohn's or UC.

Bit of a farce really. Many years before that, though, I had a doctor express puzzlement over my colon, saying it didn't look like Crohn's. It was almost a throwaway remark, muttered to himself rather than me, and I didn't ask about it. But I was always officially described as having Crohn's and so will you be from now on, with the small bowel involvement.

I don't really get it either. I got the pathology report after surgery, but it wasn't terribly illuminating from what I remember.

I don't need sleep, so I dug it out. Not gonna copy the whole thing but here's a few phrases: "There is transmural inflammation in the form of diffuse and follicular lymphoid cell aggregates"; "the mucosa shows severe acute and chronic inflammatory cell infiltrate in the lamina propia"; and so on. It (almost) ends with "the appearances are in keeping with severely active pancolitis."

So, the biopsies deffo showed inflammation, but not a word on whether it was Crohn's or UC. There are features of microscopic inflammation that are unique to Crohn's or UC, that's about all I know. For example, granulomas are unique to Crohn's but not everybody with Crohn's has them, so whatever. I guess I must have been missing all of the unique features.

I re-read my pathology report from surgery just out of curiosity and it it said something about inflammation consistent with Crohn's but it wasn't very specific. NCOT....at first I thought you meant that you had normal biopsy results, but the description you shared is abnormal, so it makes more sense.....doesn't answer the Crohn's vs UC question though I guess.