New To This

Hello! I'm 27, and have been dealing with celiac disease for a number of years. I went to my GI doctor today, and he wants to do a colonoscopy to check for colitis and polyps. I *occasionally* have blood in my stools, and this is why he wants to do the scope. He wants to rule out colitis. I was just wondering what your symptoms were, and if any of you ended up having colitis with very few (or no) symptoms. I worry about the increased risk of cancer with CD, and now the possibility of UC in addition is overwhelming. How is UC even treated? I read that one of the commonly used medicines to treat colitis has a small chance of causing lymphoma or skin cancers?! What the heck?!

Any advise/info you want to give me is welcomed and MUCH appreciated!!

If biopsies taken during the scope show the chronic inflammation signature of UC, then oral and/or rectal meds are used. At the start mesalamines. SOme of the stronger meds do incread the risk of lymphoma slightly - but the risk of colon cancer due to untreated UC is higher.

Start with resources thread at the top

Occasional blood in your stool could be caused by hemeroids, uc, pathogens (e.g., cdiff) and other things as well. A colonoscopy with biopsies, and a stool test are done to rule out other causes. Certainly, I wouldn't put the cart before the horse.

If you are diagnosed with uc, a chronic, autoimmune disease, then anti-inflammatory medications are first tried (meslamine-based medications like asacol, lialda, etc) to combat the symptoms of the immune systems attack (that is, inflammation). If that's not enough then immunosuppressive medications or biologic medications are tried, and yes they have a very statistically small odds of causing lymphoma. It's all about balancing risks versus benefits, when treating any illness. And the risk is very small compared to the benefit.

I guess I'm confused because it will be ONE bowl movement every now and again. It's not like every single BM is bloody for a week, and then it goes away. It's not even an entire DAY of bloody BM. It's a single BM. Once in a blue moon. That just doesn't sound like UC to me, from what I've read.

I've never had a hemorrhoid and I would only bleed on occasion at times with formed BM's with my crohn's colitis (which is crohn's affecting the colon). You can have constipation with crohn's, UC and IBS, it's a good idea to get scoped and biopsied because you can have more than one bowel disorder/disease coexist together. I think you can occasionally have bleeding with Celiacs as well...but never with IBS unless there's a hemorrhoid.

My symptoms usually go like this (mild at top to severe at bottom):
1. Usually nausea as a 'warning'.
2. Abdominal pain in lower left side of abdomen.
3. Worsening of pain and and nausea, often with loud and uncomfortable gurgling on lower left side.
4. Diarrhea with bleeding. As the bleeding gets worse it becomes more obvious ie. it is red in the toilet.
5. Pain and nausea come in spasms throughout day. Increased blood in diarrhea, increased frequency and often go to toilet just for a bleed.
6. Toilet trips last up to an hour at a time, bleeding into toilet and vomiting into bucket in lap at the same time. Very painful and will be exhausted afterwards.
7. Hospital usually around this point if not responding to oral steroids. I did throw up a bit of blood once, but it just looked like coffee grounds so it wasn't a huge amount.

With UC you will have periods of remission, where you feel well, and sometimes you will have a flare-up and be ill. People vary hugely with how successful they are at staying in remission. I was in remission for years after my 1st major flare, but have had minor flares since my 2nd major flare on and off.

Brief outline of treatment:
1. UC is treated with 5ASA's, eg. mesalazine, as a preventative to help maintain remission, this is for the rest of your life. They can be taken orally, as an enema or as a suppository.
2. When you are ill you may be given extra mesalazine on top of your usual dose. If that is ineffective you may be given steroids, 1st orally and then by IV in hospital if that doesn't work.
3. If you don't respond well to these treatments you may then be given immunosuppressants or biologics as extra maintenance meds in addition to the mesalazines.
4. People also try diet, supplements etc.
5. You will probably be anaemic and need to take iron pills too.

I've probably forgotten loads there but that is a basic outline. If you do get diagnosed with UC, then the disease is more dangerous than the drugs, in my opinion, so it is very important to treat it following your doctors advice, and not try to avoid the meds.