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uc dxd after cd

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Ulcerative Colitis
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Posted 9/1/2009 7:07 AM (GMT 0)
Hello,

I got dxd with crohn's disease in 2003 based on a colonscopy. For the past few months my symptoms have really changed and I had another scope done. Based on this one, they say it is uc. My doc said people can go back and forth between the two. I've never heard that before. Has anyone else had this experience or heard this?

I've been taking colazal and prednisone and now they are going to start me on immuran. My inflammation is throughout the colon. I've been under a lot of long-term stress and feel like that probably has a lot to do with my problems.

So I guess I'll be spending more time visiting you all and hoping to learn from you how best to manage this, and see if it's any different that with cd. I'm confused and have an ibd identity crisis going on smilewinkgrin

Also, I always thought bloody d was the norm for uc. I don't have any bleeding. Was I misinformed?

Post Edited (heatmiser) : 9/1/2009 1:11:11 AM (GMT-6)

Posted 9/1/2009 11:04 AM (GMT 0)
Hi, welcome to the Uc forum :) Did your doctor specifically say it was ULCERATIVE colitis or just colitis? Because there is a form of CD that involves only the large intestine and this is known as Crohn's colitis. But if he did in fact say that it was UC and that it can go to Cd on occasion.................well I would find another doctor! lol

Bloody d is usually the norm for Uc but it doesn't always have to be. Many of us have flares with no bleeding.
Posted 9/2/2009 4:48 AM (GMT 0)
Yes, she did say ulcerative colitis. I was crohn's colitis before, with the granulomous and skipping areas. I didn't typically have diarrhea very much. I find myself wondering if since I have been taking 40mg of prednisone before they did the scope, it has lessened the inflammation enough that it looks more like uc right now. I guess in the end it doesn't change treatment. I'm sure these diseases are way more complicated than our doctors can figure out at this point.
Posted 9/2/2009 4:57 AM (GMT 0)
Hi and welcome. Did your doctor perhaps say that for some people, the diagnosis swings between UC and CD? Because that *is* possible, simply because it can be hard to distinguish between the two at times. Honestly, if you were diagnosed with Crohn's colitis before, I doubt the treatment will be much different at all. As to the bleeding, I didn't have much, even when I was flaring very, very, very badly, and it was the first symptom to go away as I moved toward remission.
Posted 9/2/2009 5:30 AM (GMT 0)
Yes, the treatment is the same for Uc and crohn's colitis, no CD and Uc don't swing back and forth in a patient, there is a small percentage (2%) of patients that do have both UC and CD though, very rare, I read somewhere a few days ago that 11 cases had been reported.

I find it odd that if your entire colon is inflamed that you don't have bleeding but everyones symptoms do vary (even from flare to flare for each patient), but I would get a second or even 3rd opinion on if you have crohn's or UC...with CD the inflammation can go through the many layers of the intestinal lining, with UC it's limited to the surface of the mucosal lining.

If your CD is severe enough the entire colon can be inflamed, it's a matter of how deep the inflammation goes to define whether it's CD or UC.

Since your original DX of crohn's in 2003, did you have have any small bowel involvement or fistulas, strictures, abcesses or blockages aywhere in your GI tract?

:)
Posted 9/4/2009 12:32 AM (GMT 0)
The small bowel looked fine in both my scopes. Never had other symptoms like those mentioned. Mostly sharp pain, loose stools and on rarer occasions diarrhea. This time, the diarrhea has been up to about 10x per day at 40mg pred, but in the past the only bleeding was extremely minor, probably more from the frequency. They did mention hemmies this time. But the last scope showed the granulomous that they expect to find with cd. The initial dx wasn't 100% sure, but based on later symptoms (ie, space between areas of inflammation/pain) they did feel they had made the correct dx. This is a different dr, different state, different symptoms.

Maybe it's possible the cd healed a bit with the pred so now it looks different in this scope. I guess more time will have to pass and another scope might one day give me the answers, but maybe it doesn't matter at this point.
Posted 9/4/2009 1:08 AM (GMT 0)
Just be real careful, when you mentioned hemmies, I cringed, I have CD and was misDX with having hemmies only to find out later they were actually perianal crohn's skin tags which can slightly resemble hemmies but are nothing alike. Perianal crohn's skin tags are linked to CD only (never UC)....if you want I can post a link that shows pictures of hemmies and of perianal crohn's skin tags to see the difference between what each look like.


:)
Posted 9/6/2009 3:33 AM (GMT 0)
How do docs tell the difference between hemmies and skin tags? I don't think the hemmies are bad as I have no bleeding and don't seem to be feeling anything. I'll go do a little research and if I can't find it, I'll ask for that link.
Posted 9/6/2009 3:48 AM (GMT 0)
Here's the link...

http://www.emedmag.com/html/pre/fea/features/011504.asp

The first set of pics show hemmies, the second set below the hemmies are the crohn's skin tags, not just any doc can tell the diff, even some GI's/colon and rectom surgeons can't always tell if they don't have the right training.

I post the link for you cuz a while back I had a heck of a time finding anything online about perianal crohn's skin tags, let alone pics of them.

:)

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