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Colonoscopy results - Can patchy colitis be an indication of healing?

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Ulcerative Colitis
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Posted 9/3/2008 2:50 AM (GMT 0)
I received a copy of my recent colonoscopy results during my physical today. No deep ulcerations were present, but the report indicates patchy colitis mostly in the sigmoid and ascending colon, with "hit-and-skip" patches throughout the remainder. I tried Lialda back in June/July, but couldn't handle the joint pain, so I switched back to Azulfidine, but have been taking a higher dose.

I was diagnosed back in ~1980 and hadn't had any flaring for quite some time until last winter (increased job stress).

Since I haven't had any bleeding for a few weeks, I'm thinking that the Azulfidine must be doing its job.

Post Edited (Moo) : 9/3/2008 11:10:02 PM (GMT-6)

Posted 9/3/2008 7:42 AM (GMT 0)
Not with UC...sounds more like CD, however.

q
Posted 9/3/2008 8:29 AM (GMT 0)
Sounds like CD - which is the label they put on it but it's not necessarily either UC or CD - could be indeterminate colitis and if you had it all round before, it could be a sign of healing IN MY OPINION.
Posted 9/3/2008 3:15 PM (GMT 0)
Indeterminate would more than likely be more solid rather than patchy I would think. UC's pattern of healing doesn't usually follow as patchy from what I understand..definitely do the research and ask the doctor for clear explanations.  Start your list of questions.

q
Posted 9/3/2008 3:32 PM (GMT 0)
One of the differences used in differentiating UC from Crohn's is whether the inflammation is patchy or continuous. Patchy inflammation is one of the hallmarks of CD. Do talk to your doctor. Initially, the treatment for UC and CD is the same, but as you move on there are more medical options available for CD (good news), however colectemy is not a cure for CD (bad news.)
Posted 9/4/2008 3:29 AM (GMT 0)
Thanks for your input! I have never considered that it might be Crohn's.

The pathology report for the biopsies says "focal active chronic inflammation and crypt architectural distortion consistent with ulcerative colitis". I have a follow-up appointment next week and plan to go armed with some questions to ask my doctor.

I need to find my previous report from a couple years ago and see what it says. I'm going to do some research on the characteristics of UC when it heals. Just to satisfy my curiosity.

ETA: While looking this up on-line, I saw some evidence that UC can have some patchiness and lack of rectal involvement when quiescent and while healing. Took a while to find some pathology information though and it was pretty difficult to interpret at times . . .

Post Edited (Moo) : 9/3/2008 11:09:18 PM (GMT-6)

Posted 9/4/2008 7:28 AM (GMT 0)
paste the link here if you can find it.

Early CD can have the same pathology as UC if it hasn't penetrated farther into the colon wall.

q
Posted 9/4/2008 9:02 AM (GMT 0)
You need to check the biopsy for Granuloma - which is 99% of the time present in CD.
Posted 9/4/2008 2:48 PM (GMT 0)

My UC started out as patchy so the Dr. thought I had CD. But there were no granulomas and it every other way it looked like UC. So, I was diagnosed with UC, then CD, then indeterminate colitis. Now it looks like I have UC because the patchiness is not really patchy, upon further evalutaion, the clean parts actually have microscopic colitis. So, maybe that is what's going on with you. Just a thought

Donna

Posted 9/4/2008 2:52 PM (GMT 0)
I habe no Granulomas either but have a CD diagnosis as it is patchy. To be honest, doctors know nothing about IBD at all in my opinion.
Posted 9/5/2008 3:11 AM (GMT 0)
quincy - Here is one of the articles I read: http://www.medscape.com/viewarticle/561401

I didn't bookmark the other one and can't find it tonight.

LondonRed - I looked at the biopsy report again and it doesn't say anything about granulomas.

It would be hard for me to believe after having this for almost 30 years that it's possible that it's Crohn's vs. UC. I'll ask the GI about microcolitis. My photos show some inflammation but it's not anywhere near as scary looking as some colonoscopy photos I've seen on-line.
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