Colonoscopy Shocker

Just had my routine yearly colonoscopy today. As many of you know, I was able to break out of an almost 2 year long flare with the triple anti-biotic combo. I have been doing GREAT, with no traces of blood or mucous or other symptoms.

My previous colonoscopy (a little over a year ago when I was still flaring) showed a normal U.C. pattern with mild/moderate inflammation in the rectum and sigmoid with some microscopic colitis in the traverse, while the ascending and ilium were totally clear.

Today, my colon was completely healed throughout with no trace of U.C., yet there was some minor isolated inflammation in the ileum.

This just seems so bizzare. I have never had any symptoms of Chrohn's in the 9 years since I was diagnosed.

This is a head scratcher and I have no idea what to think. I know some people have indeterminant colitis where it is like patchy U.C., instead of the normal continuous pattern. I'll have to see what the doc says when I see him in the follow-up visit.

I'm sorry C_G_K. My path to a CD diagnosis was similar to yours, but quicker. My first colonoscopy was perfect UC: 25 cm up, severely inflamed (hamburger meat he said) and then absolutely perfect a millimeter later. In 2010 it was Crohn's colitis. Then, last year, I had two "small, discrete" ulcers in my ileum and I thought I was feeling pretty well at that point. I'm interested in what your doc's opinion is on your case after you go back for your follow up appointment.

I know UC can't transform into CD so to speak, but with cases like ours, that is almost the best description for the visible evidence.

How did you get him to go along with the triple antibiotic therapy?

There were two small ulcers in the terminal ileum that appeared to be superficial. Everything else was pristine including the rest of the ileum, although there was extensive scarring from the bad flares I had previously, two of which landed me in the hospital.

As for how I got the antibiotics, I faxed over the details to my docs triage nurse of the study from Japan showing the triple ABX therapy is safe and effective and she called in the script to my pharmacy. Simple as that.

I'm sure the biopsy will show inflammation consistent with U.C., not Crohn's, but will have to wait to be sure once the results come back.

So you had two small ulcers in your TI also. Hmm.

It was my understanding from how my GI described it that a biopsy will only see evidence of Crohn's disease (granulomas or whatever) 10-15% of the time. That is why he said someone can have patches of inflammation or ulcers in their ileum yet the biopsy not be consistent with CD.

I live in southeastern North Carolina, what about you? I switched Pentasa from Apriso and also started 6mp.

I haven't done any upper GI testing yet.

My doc got the pathology back and the biopsies show colitis type inflammation. Diagnosis stays U.C. for now anyway. Could just be backwash ileitis since I was originally DX'ed with pancolitis.

Except for the slightly odd pattern of inflammation, the most shocking thing is how the antibiotics cleared up the entire left side, traverse, and most of the ascending completely. No wonder I feel almost completely normal.

My vote is backwash.....UC. Also, have you ever considered an FT at this point? You may want to consider this (at home), since the abx would have altered your tut flora. The unknown of course, is, did your flora repopulate itself to a balanced state? Regardless, at this point...I suggest heavy probiotics to top things off. Continued success.