How do doctors really know if it is UC?

Just curious.  My biopsies showed UC.  My recent flex sig showed no imflamation, (still awaiting those biopsy reports).  Anyhow, I've been wondering, Do UC cells look a certain way?  I heard one person say they were getting a blood test to see if they had UC.  I never had a blood test.  What are your thoughts.  Thanks guys!

I was told there are changes in the bowel wall that indicate UC,as regular Colonoscopies can detect if it's spread,even if remission at the time of the C-Scope.This info came from a qualified GI.Blood test will not show UC,but changes in the blood can be "inflammatory markers".They don't show where the inflammation is,but obviously if you are suspected for UC,and the blood test shows you have inflammation,it's a pointer to UC.

Obviously biopsies taken from the bowel are also used to indicate UC.Those are my understandings,hopefully someone else here will clarify a little more.

The biopsies taken when they do your colonoscopy are the most definitive diagnostic tool, but are used in conjunction with blood tests for what are called "inflammatory markers," stool tests to rule out infection and parasites, and your description of your symptoms. Usually colonoscopy is at the end of this process, when other causes have been eliminated and the doctor knows we're looking for some kind of colitis, most likely UC or Crohn's.

I'm not a pathologist so I can't tell you exactly how the cells change, but the cells in the wall of the intestine change when IBD is present. I do know that in UC only the inner layers of cells are affected, while in Crohn's the whole thickness of the intestinal wall can be affected. Occasionally they will find cell pathology that looks like UC, but with a patchy distribution in the colon that looks like Crohn's. In this case the diagnosis may be "indeterminate" colitis.

Thanks Judy. When I went in for my colonoscopy, it was at my request, I just called the doctor and said I had bleeding and that I wanted a colonoscopy and he ordered it. I suspected something simple like internal hem. That is probably why I never had the blood or stool testing done. I skipped right to the scope. However, now I am wondering if my doctor is being thorough enough. Do you think bloodwork and stool samples should have been done? Just curious, any advice will help. Bellski

My original dx was done by flex sig only. It wasn't until months later that i had a full scope and bloodwork. But i was bleeding very heavily at the time and in pretty bad shape. i don't think they wanted perforation with a full scope at the time.

Since your scope showed no inflammation, you may want to just wait for the scope report. Infections and parasites usually show inflammation. I would think the doc could also tell you from the exam if you have hemmies or a fissure that could be causing the blood.

Not to scold, but be sure you get your colonoscopies done regularly from now on. Most docs recommend every one to two years after you've had UC for ten years, to monitor for any dysplasia.

I will, the doc didn't find any hemmies. He found uc....yeah. If this biopsy comes back no dysplasia and if I don't have any symptoms, he said he wants to do another flexsig in one year. I suppose the flex sig is almost as good as a colonoscopy but the colonoscopies will be spaced out more. I do appreciate all of the replies, thanks!