Any idea what I have?

Hi guys, I recently had a colonoscopy which came back with mild proctitis. Biopsies were taken which were consistent with "mild IBD". No one can seem to tell me though if it is UC or Chron's because the colonoscopy was only showing the mild proctitis in the rectum area. The GI doc has put me on foam enema meds. Can I just have proctitis without UC or Chron's? Is there any way this can go away with the meds? Very confused as to what I have and the Dr is quite unsure it seems too. My report for the left colon reads "The sections show colonic mucosa with crypt distortion including crypt shortening and branching. there are increased inflammatory cells in the lamina propria, with prominent basal lymphocytes and plasma cells as well as cryptitis. No granulomas or parasites are seen. There is no evidence of dysplasia or malignancy. Changes consistent with inflammatory bowel disease, mild. The Dr has put me on a foam that I shoot up my bum. Thanks for any help/replies am feeling quite lost

Thanks heaps for the reply... Much appreciated. My doc has prescribed me cortifoam twice a day. Generally what are the chances of this moving up past my rectum? Is there anything I can do to improve my chances of this not happening?

ok so it's steroid foam...

for how long? when do you see your doc? keep reading and researching, you will likely need to find your own answers , docs don't usually spend much time explaining this condition or the options...

IMO - to help prevent it from getting worse.. get on a Mesalamine regime (oral or rectal) and stay on meds for maintenance until this thing ever gets a cure or unless you end up needing stronger meds (hope not... )

This is a lifelong condition with ups and downs... their is no cure as of yet. you will learn to manage it, and live with it..

Yes, listen to the posters above about mesalamine enemas.

Sometimes it is really hard to tell between Crohn's and UC, and if your disease remains in the rectum and mild, it doesn't matter. The treatments are the same. The likelihood of your disease "spreading" is impossible to tell, but the best way to prevent that is to aggressively treat this onset and keep it in remission.

Sometimes proctitis can be caused by other things, like trauma to the rectum, but it sounds like the pathology from your scope has identified your condition as IBD.

My brother's had proctitis for 12 years and it causes him minor issues. He does not take meds (only during flares and then it's oral asacol) and has never done rectal meds. He's lucky. My daughter was diagnosed with severe pancolitis. You don't want what you have to become what she has (I've seen them both and one is really a minor inconvenience and the other is truly a living nightmare). I agree with the above, use the butt meds. Also, there's no point in posting scope pics. We're not qualified to read that stuff. I've spend years learning about this disease and I can't make head nor tails of the pics. You need to speak to your GI about why they think it's UC vs CD. Like Kazbern says, as long as it stays where it is and doesn't become more severe then it doesn't matter too much.

Hi..welcome to the forum!

Regarding the "consistent with" part....the initial question or assumption or suspicion of the doctor is usually at the top of the page that the pathologist gets with the biopsies.... OR...if there's diagnosis already, that's also at the top of the page when given to the pathologist with the biopsies.

The pathologist will analyse the biopsies, give the observations/findings and say whether they're consistent with or not consistent with. If there's discrepancy, the pathologist would probably suggest further testing be done to help determine a more in depth specific diagnosis.

The fact is, however, that you do have inflammation and changes in the cellular structure because of the inflammation (which might have been there for a while). No cancer/infection/parasites. Some things are off the list, which is good, narrowing down the diagnosis. The medication will hopefully deal with the inflammation as it is now.

What happens after the inflammation is down/gone should have a plan..

Did it state left colon or did you say that?

Proctitis can involve the rectum and just to the sigmoid...the left colon is usually including the sigmoid up into and including the descending colon.
Just needing clarification.

If your inflammation is into the sigmoid, you should for sure request to get on an oral 5ASA medication to help keep the rest of your colon calm.

What did the rest of the biopsies throughout your colon state? hopefully, the doc didn't just do a sigmoidoscopy.

q

If your IBD is in the left colon you should be on oral meds that specifically target that area, in addition to the enemas. You shouldn't wait months to start these, even if it requires a different doctor.

"Mild" is a medical term and not always reflective of what a UC'er experiences. My "mild" UC had really horrible symptoms. What is visible on a scope doesn't always reflect IRL symptoms.

Paleo-ish diet really helped reduce my inflammation and symptoms and made my life liveable because meds did not work for me (I still take some). The other popular choice is SCD which helps many (but not me). You'll have to try Paleo and see. It is a healthy diet of protein and veggies but many snack foods become off-limits. My husband likes Paleo a lot and he's non UC.

Good luck.

I responded to what you wrote: "The report did mention the IBD is in the left colon and the right colon is fine."

Is it normal with proctitis to be intolerent to milk? I have now found that flavoured milks give me really bad gut pains and diharrea, even when using the foam.

For most people with this crappy disease is it a combination of both meds and diet to keep it under control? I am finding the meds are getting me better but not completely symptom free. As soon as I eat crap I will need to go to the bathroom.. I am also feeling nauseous a lot.

Is it normal with the cortifoam to still have some diharea? I am doing a max of 3 BMs a day without any blood but sometimes there is still some diharea. I have been on the foam for over a week now twice a day. Does this mean this treatment is not working? Any ideas on what I should do? Thanks