Pathology report confusing. Is it Crohns or Colitis ?

Sounds like UC to me, although I am not an expert on this stuff. I found the following terminology fascinating:

"chronic inactive"

seems like a contradiction in terms to me

here's a broad explanation of "colitis" includes UC or Crohn's but there are many shades of colitis.
en.wikipedia.org/wiki/Colitis

The fact that your rectum is inactive but your large bowel is active points towards Crohn's because the inflammation is not continuous from the rectum upward. But the fact is you have an ulcer with inflammation.

Gi's are cautious with naming. Mine called my c-scope results "consistent with ulcerative colitis".

Just frustrating not having a firm diagnosis

Patchy indicates CD, not UC, that alone should make it easy for your doc to come to a firm DX...some docs are absolutely useless unfortunately.

My last colonoscopy report has "superficial ulcerations" mentioned (not polyps) and we all know full well that I have CD, so concentrate on the type of inflammation that's going on rather than terms in regards to "polyps" or "ulcerations". I had one GI years ago that did a scope and told me my colitis was active, I said I have crohn's, then he specified crohn's colitis...sometimes the confusion comes from the terms (or lack of) that docs use.

You're welcome (and sorry that you have IBD) crohn's colitis is basically treated the same as UC as far as meds go....the only good thing (if there's such a thing) is that at least with crohn's colitis, the rectum isn't necessarily affected all the time like it generally is with UC...little comfort I know but it's something at least...it just really sucks when CD is affecting more than one area at the same time...it was terrible (for me) when it was in my small intestine, colon, rectum and anus with perianal crohn's skin tags all at the same time in the beginning when I first became sick...it only lasted in my small intestines for the first 2 years, I honestly don't know how it cleared up cuz the only med my GI at that time ever put me on was prednisone (and he tried me on asacol for the CD inflammation affecting my colon and rectal meds for my proctitis---I was severely allergic to the asacol though) but it has stayed constant in my colon the entire 23 years now, as well as constant with the perianal crohn's skin tags..and on and off in the rectum throughout the years.

If you're using rectal meds, it's common for the rectum and sigmoid to look more quiescent and then active inflammation shows up again in the descending colon -- that can still be a presentation that is consistent with UC. If you're not using rectals, then this pattern would be more consistent with Crohn's.

Chronic inactive colitis usually means that the tissue isn't currently inflamed but has architectural changes associated with chronic inflammation in the past. Sort of pre-pre-pre-dysplasia.

Granulomas on biopsy would be definitively associated with CD, but looks like there were none of those.

As pb4 said, the medical management is pretty much the same. Your options fork a bit if surgery comes into play, but often the surgical options are more palatable for CD than UC (e.g. Crohn's colitis patients can have a straight resection, often without a diverting ileo; UC patients almost always remove the entire colon).

Patchy indicates CD, not UC, that alone should make it easy for your doc to come to a firm DX...

If the biopsies don't show it's Crohn's, then it's not as easy as that.

Erratic healing with meds can also sometimes lead to a patchy presentation.

Pesonally I'd rather have had UC, because I think the surgical options absolutely suck for Crohn's; resections are not simple, straightforward operations any more than colectomies are, plus having one resection tends to increase the risk of further surgery down the line. And don't talk to me about colectomies and Crohn's. You guys are lucky to have the option of a j-pouch and to have a surgery which removes your disease forever. My disease will probably return; I just have no idea when or how.

Absolutely hate Crohn's beyond words.

Just so utterly depressed with it all right now.

Post Edited (NiceCupOfTea) : 2/24/2014 3:37:20 PM (GMT-7)

Yes, inflammation in the rectum (proctitis) is more common for CDers that have crohn's colitis, but many that have crohn's colitis (CD affecting their colon) don't necessarily get issues with proctitis...it's also more common for CDers that deal with crohn's colitis to also have more perianal disease involvement as well, but again, that's not written in stone either (it's just more common)...IBD in the end has a mind of it's own.

here scum:

for your reading enjoyment:
www.cag-acg.org/uploads/firstprinciples/z_pdf/EN_GAST_09B.pdf