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Ulcerative Colitis
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Posted 4/2/2014 5:27 PM (GMT 0)
Hi all well after being in a flare for 2 months I went for another colonoscopy today to see what was going on. They had a really good look and took loads of biopsies. Visually I was very inflamed up to 10 cm (better than two years ago on diagnosis when was 20 cm inflamed) and also had some ulcers in a patch on my transverse colon (right in the places I keep getting pains and they thought I had gallstones).
I've got an appt with my Ibd nurse at the of April so will get a chance to discuss results along with biopsies but until then wondered if anyone could shed any light on the results.
Why would I have a patch of ulceration seperate to the rest? Is that normal? Is it possible that more of the colon was inflamed at the start of the flare and that parts just stubborn?
Also is it normal for my rectum to still be so inflamed after 2 months of treatment (started on pentasa rectally for a month then been on pred supps and colifoam for another month)
Thanks in advance
Posted 4/2/2014 6:08 PM (GMT 0)
I can't say anything about the higher up ulcers but I do know that inflammation in the rectum can take FOREVER to heal. I know some say they have been battling it for years. Keep plugging away with the rectal meds!
Posted 4/2/2014 6:10 PM (GMT 0)
Hmmm UC is continuous inflammation starting at the rectum and moving up the pipe, so to speak. Crohn's, on the other hand, can be patchy in appearance. A patch of inflammation then clear for a while, then another patch of inflammation, mix and repeat. I wonder if you have Crohn's instead of UC?

Your rectum can still be inflamed even after 2 months of treatment, if you are not on strong enough medications to get your UC in check. Maybe next is immunosuppressive medications (e.g., 6mp, Imuran, Aza)?

Also, Pensa isn't going to treat your inflammation within your transverse colon. Pensa doesn't reach that high.

I would ask or expect to be asked those things when you see your GI next.
Posted 4/2/2014 6:50 PM (GMT 0)
surgpathcriteria.stanford.edu/gi/ulcerative-colitis/printable.html

As this article states patchy UC is rare - but it does happen.

I was diagnosed with "patchy" ulcerative colitis ten years ago. Although on my latest colonoscopy the diagnosis is now pancolitis it's still patchy. At the moment most of my UC is in remission but I have a patch of ulcers on the RHS. Sometimes I have ulcers on the left and a patch at the caecum. My biopsies support the diagnosis of UC to date.
Posted 4/2/2014 9:27 PM (GMT 0)
I am in the same position now as well. I have had ulcerations and inflammation in the rectal area to about 10 cm I also have had ulcerations and inflammation in the cecum (near appendix). My doctor goes back and forth on UC v Crohn's. this Standford article gives a good explanation.
Posted 4/2/2014 9:36 PM (GMT 0)
Really good article from Standford. Def keeping that one.

This I believe I had heard before:
"The appendix and appendiceal orifice may be involved in the absence of other right side disease and does not constitute grounds for changing the diagnosis"

so I am glad to have a reference for it now. :)
Posted 4/3/2014 8:51 AM (GMT 0)
Thanks guys thAt article was indeed interesting. I'll await my biopsies to see if they can shed any further light.....
Posted 4/3/2014 2:08 PM (GMT 0)
For many of us, the proctosigmoid area does seem to be the hardest to heal. When first diagnosed, I had pancolitis. The standard 5-ASA drugs controlled all but the sigmoid and rectum, and I've never had inflammation higher than that since. Nothing, even Prednisone, would control the remainder, and it required Remicade to get into full remission.
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