Can my diagnosis really be correct?

Hi all. I'm new here...

This week i've seen a consultant following 4 months of miserable symptoms. She listened in detail to my symptoms and did a visual examination, and said that i had UC, prescribed me mesalamine granules and has booked me in for an urgent coloscopy this coming monday, "to see the extent".

But i just cant believe from what i've read that she can make that diagnosis before the coloscopy. Can i ask what you guys think, as you probably have more experience than her!

ya, it's possible to make a pretty good DX just based on symptoms - and mesalamine is a fairly safe, anti-inflammatory drug used for first line treatment of UC - take it and wait for the results of the scope -

good luck -

btw, what are your symptoms ?

Hi TroubledTurds (love the name ;-) , just how i feel!!). Thanks also for your reply. As above i will do just that, take the meds and wait.

Symptoms aren't completely typical as i've not had much pain (another reason for the doubt). But 4 months of progressively more and more severe bleeding, muscus, diarrhoea. BM 10-15 times per day, though its often just blood. Urgency in the night. Gas (that often turns out to be blood/mucus as well meaning i'm too afraid to be away from the toilet). Extreme tiredness, weight loss... that probably covers it ;-)

Thanks for your time to respond - wishing you all the best on your journey too.

Yeah, it could do. I wouldn't take the meds until you've had the scope. Those are classic UC symptoms you've just described - pain is less common in UC than it is in Crohn's.

Thanks NiceCupOfTea. I might hold off with the meds... after 4 months i dont suppose 4 days wait will make too much difference.

Thanks for responding. Warmest wishes.

If you have blood in stool than investigating IBD like UC does make sense. Alternatively, you could have infectious-proctitis or c diff, which is also possible. Have you had a stool test to rule out pathogenic causes like c diff?

From my experience, the flare severity directly impacted whether or not I had pain. With mild to moderate inflammation I had no pain, just discomfort (while still annoying it is much better to have a stubborn ache than be doubled-over in pain). With severe inflammation I had sharp knife-stabbing pains that came and went and they'd double me over; ouch! As I healed the pains got more mild, and then went away.

HorseyUK said...
Last question - if i'm taking the meds shes prescribed - will that make it harder for her to see whats going on when she does the scope on Monday?

Yes, my diagnosis was originally made based on symptoms , my symptoms were basically identical to yours, except I did have pain also. I was started on oral sulfasalazine (similar to meslamine , 5ASA) .. when I had my "urgent" scope 3 weeks later, all that was visible was mild inflammation in sigmoid colon & rectum. Not specific. Meaning they couldn't say whether it was UC. My symptoms were basically at a stand still at that point as well, I was then told it was possibly I had infectious colitis based on the extent of healing, they thought it may not be possible to have so much healing with UC on just 3 weeks. I was at max dose (4000mg) , I've been told by others they had quick healing too.. everyone is different. I was also following SCD diet which helped subside my D.

I won't know now until biopsies come back, so..... I don't know if I'd really say don't take your meds. But if you want a 100% concrete diagnosis , then hold off. In my case, I'm at the point where I don't really care that much because I was so sick and miserable atleast the meds helped with that, even if it takes another flare up for me to know if I have IBD or not.

Hope this helps

It could be correct. What's a visual examination? Did she do a flexible sigmoidsscopy? If not, then how did she inspect inside your anus? Without pathology, you can't say for sure what is going on, I'd request stool tests, but frequency, bleeding, loose stools, urgency are all much too familiar for people with IBD. I personally had pain, but only with severe flare ups. The medication could help your condition before Monday and possibly change things a bit, but I doubt it would make that much of a dent that you wouldn't be able to get a solid diagnosis. 10-15x a day doesn't heal that quickly usually. You never know though. Hopefully you get better, but hopefully you can get a concrete diagnosis so you know what you're dealing with.

IBD involves permant architectural changes to your intestinal cells and it would show up in biopsies whether you're exhibiting symptoms or not (argument for taking meds now). If you're not feeling bad and it's only a few days then you could wait. The gasteroenterologist could better see the pattern of active inflammation (argument for not taking meds now).

My symptoms came and went before initial diagnosis as well.

Some tips. Avoid NSAID pain relievers as they exasterbate IBD. A heatwrap/hotwaterbottle on the lower abdomen temporarily relieves an aching abdomen. High fiber diets aggravate IBD flares, so go light on it for now. Bland, nonspiced foods are great wgen your symptoms are bad: chicken, potatoes, rice, soups, and broths.

well pancolitis is new because the sig-scope did not see that far. but this is still visual, until the biopsy results come back. But, not very likely to change.

was the rating mild, moderate, or severe? were there any polyps?

when do you get pathology report?