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Colitis - Perminant damage to your bowel?

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Ulcerative Colitis
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Posted 6/19/2010 11:48 PM (GMT 0)
Something I have always been curious about is does a flare up leave perminant damage on your bowel?

Colitis was once described to me as the bowel eating away at itself. When colitis is in remission has your bowel gone back to normal or is some perminant damage done during a flare up?

This may be a completely naive question - I have had colitis for 6 years and have only just stumbled accross this forum. It is fantastic and I am learning so much about my condition from people all across the world! Please forgive my constant posting of new questions but you guys are great! I have only ever had the oppinion of my specialist and he is a straight forward speaker who doesn't believe in natural treatment or see a need to take probiotics or suppliments. You guys have opened my eyes up so much!!!
Posted 6/20/2010 12:36 AM (GMT 0)
I'm very curious about this as well. My very uneducated guess would be that there would be some sort of scar tissue formation. I've also heard that when you have a flare after being in remission that the disease goes right back up to the spot it was at before (does that make sense?!) So I would think the damage would be permanent...but again, I have no idea, just guessing
Posted 6/20/2010 6:37 AM (GMT 0)
Over time ulcerative colitis tends to thin the mucosa (innermost layer of the colon) and it gradually shrinks the colon lengthwise. That's why gastroenterologists take biopsy specimens during colonoscopy. The pathologists examine specimens to gauge what is happening to colon cells. Whether or not a patient has scarring in the colon depends on the severity & number of flares he/she experiences. The best case scenario is that your doctor prescribes maintenance medication(s) that help you to achieve and stay in remission most of the time, which avoids serious complications. For further info., check the ccfa.org Website-- as a start toward self-improvement of your situation. Knowledge gives you better control. / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 6/20/2010 7:17 AM (GMT 0)
Chronic inflammation can cause permanent damage....considering that UC starts in the rectum, that's sometimes an area that is very difficult to treat and control. With the continued inflammation or structural changes, the messages can get screwed up that are being sent to the rest of the colon and function of bms can sometimes be severely impaired. Even after one has healed from a flare, the impairment can sometimes continue.


One can also have hemmies and fissures, not related to UC, but as an added bonus to the package. Chronic wiping and inflammation can also execerbate those...causing permanent damage and change to one's anus, internal and external.

Mega colon and lead pipe syndrome are some things that can happen because of loss of functioning and "elasticity" in the colon.

The "bottom" line.....deal with the inflammation via appropriate meds, and if you can take the 5ASA that's a good thing. As well...fibre supplements and probiotics, balanced food intake, etc can help keep your digestive tract exercised and functioning as well as it can given its impairment during flaring. With hemmies and fissures....meds, food intake, exercise, etc can help. Of course, there situations that can exacerbate hemmies/fissures....again, all should be dealt with when they arise.

Fibres, probiotics and some supplements also help to heal the mucosal layer and protect it from other possible invaders.

There will be cellular changes and sometimes visual changes from chronic inflammation, but if healed after flaring, the functioning of the colon and rectum will continue to be well.

quincy
Posted 6/20/2010 3:05 PM (GMT 0)

My understanding is that once you obtain remission normal healing will occur resulting in a normal colon.  That's why the biopsy samples during a flare can come back with chronic inflammation, etc...  However after getting on the normal medication it will come back normal colonic mucosa.  When you see the pictures it's striking, from blood riddin thin mucosa to noraml light pink mucosa.

So I don't believe it does permenant damage.  It can cause scar tissue though.

MyUC

Posted 6/20/2010 7:08 PM (GMT 0)
scar tissue is permanent damage....as well would be cellular architectural changes via biopsy.


I think, however, it depends on how often one has inflammation, for how long from initlal onset

and how long without treatment, etc., possibly the type of meds used for treatment...


I definitely have some architectular changes on the cellular level that shows chronic disease, but there was no inflammation at that point visually or cellularly. The change is permanent.


q
Posted 6/20/2010 7:17 PM (GMT 0)
Threads like this make me so angry I listened to my primary care doctor for the two or two and a half years I bled with no other symptoms. He'd say "you have an internal hemroid," or "you have a little fissure there, drink mineral oil." I live on the same street as him and have to see him almost daily. GRRR! This is why I now pay attention to every little detail to prevent all the damage I can and jump on any problem with an increase in meds. GRRRRRR!!!!
Posted 6/20/2010 7:21 PM (GMT 0)
LOL...is he still your doctor?
q
Posted 6/20/2010 7:27 PM (GMT 0)

Q:

I know you know your stuff but I have a sincere question.  Why then can biopsies come back completely normal?  Meaning at some point someone has a flare and colonscopies are done and the path report comes back chronic inflammation, loss of achitecture, etc...  After going into remission another colonscopy is done and the path report, for the same area, reads normal colonic mucosa.  I understand that in some areas the ulcerative colitis has been so severe it can cause permanent scar tissue but in other areas the area can completely heal?  As if that person never had UC in the first place.  That's what I understand, am I mistaken?  Remember I am not an elite member just a regualar member, go easy.

MyUC

Posted 6/20/2010 7:35 PM (GMT 0)
I didn't say it WILL cause damage, I said it COULD....mine come back unremarkable to which I'm pleased, all other stuff is "normal" except the rectum has the architectural changes.
...to clarify the changes...they aren't lined up looking like ||||| they look like YYYYY or something like that.

I don't know everything, and my understanding of the word "damage" is subjective. Some things can be reversed....some not. If all is working well....then the damage isn't debilitating. If one loses the ability to function, then to me it is....but again, subjective.

q
Posted 6/20/2010 7:42 PM (GMT 0)
Yes, he's still my doctor. No reason to switch, a lot of the other doctors in town are as obtuse, insensate, and just plain ignorant as he is. A friend's dad had a heart attack about ten years ago and drove himself to a very well respected heart center 70 miles away rather than going to the local hospital, haha.
Posted 6/20/2010 9:12 PM (GMT 0)
Anecdotally I remember several members of this forum saying that their colons were free of scarring and clean as a whistle as if they never had UC. I believe Subdued was one of the members, (Subdued can you help us out here?) I believe they credited glutamine (which is supposed to repair intestinal tissue), and aloe vera juice. You can learn so much in these forums. And I found this on the internet:

http://www.nrjournal.com/article/S0271-5317%2807%2900187-X/abstract
Posted 6/20/2010 10:09 PM (GMT 0)
My inflammation was particularly bad for the bottom, oh, 14 inches or so early on, for a long time, (it took about 10 months to get my initial onset flare under control, and because I'd been dxed with UP three years earlier, who knows how long there was "some" inflammation before I realized something different needed to be done...)
All of which is to say, when I've seen my colon upon scoping, even if it's completely in remission, that bottom 14 inches or so is smoothed out, lacking the ridges of a normal healthy colon - results of scar tissue.
But, MyUC, if I'm not in a flare, the path results don't say anything about that weird scarred area; I guess the cells register as "normal." I wouldn't even know about it if I hadn't seen it or if the doc hadn't told me about it!
Posted 6/20/2010 10:20 PM (GMT 0)
I've had UC symptoms on and off for 10 years. My first scope 2 years ago showed angry pancolitis. My last scope in April showed an almost normal colon with "loss of vascular pattern in transverse and descending colon". My GI said that is the triangular part of the colon. He said its normal for someone that has IBD for a long time to have that and its no big deal.
Posted 6/21/2010 1:50 PM (GMT 0)

pseudopolyps are definitely a form of permanent damage caused by inflammation. My colon has hundreds, it's gross. And, it's nearly impossible to differentiate a pseudopolyp froma regular polyp, which makes cancer detection much harder. My last scope (about 2 1/2 yrs. ago now!) showed about 10" of active disease, ulceration, etc. & hundreds of pseudopolyps thruout the entire colon. I'm sure a scope now would show only active inflammation low in the rectum, but still hundreds of pseudopolyps. Gross.

Posted 6/21/2010 1:59 PM (GMT 0)
I was thinking about this thread and the l-glutamine thread last night. I wonder if taking that amino acid regulary could prevent some of the UC-related permanent bowel damge since it helps repair and tone the walls of the colon?
Posted 6/21/2010 9:00 PM (GMT 0)
I would think it would help if the inflammation hasn't continued for a long time or that the inflammation hasn't gone to the submucosa level.

It's all about maintenance and treating flares early.

I had 3 years of diarrhea hell before my doc sent me to a GI....and that was after the bleeding started, so I'll safely say that my flare started 3 years before diagnosis. That's a long time without intervention.

q
Posted 6/21/2010 10:14 PM (GMT 0)

Songlady:

I get where you are coming from.  You are in remission, meaning no clinical symptoms and no pathology to report.  It's as if your UC came and went.  I guess the original question to this thread was in regards to permanent damage to the bowel.  Yes, I guess it depends on waht the definition of permanent means.  If it means you bowel can't recover then answer is clearly no otherwise we all be having our colons removed at the first onset of UC.  If it means your colon can heal and function well and if you were to take your colon biopsies after it has healed a pathologist may never even know that person had it in the first place.  All I was trying to contribute was the notion that given the right situation the large colon can heal itself and go into remission and live a long productive life.  Yes there may be some signs of previous damage here and there depending on the severity in the past but who cares, it can recover and make good poo!

MyUC

Posted 6/21/2010 10:33 PM (GMT 0)
My UC - right, I understand and I agree. I am doing so well, better than I have in some years! I do have multiple poops per day - usually 2, sometimes 3 depending on the foods eaten the previous day - and I imagine that scarred colon is the reason for the multiple poops. But, other than popping pills, it's as if I'm healthy. I am so thankful for this - !!
I started with a new GI almost a year ago, and he scoped me about 8 months ago. In our first appointment, looking at my records and seeing pancolitis since 1989, he promoted 6-MP - but after a while, he admitted that I was doing fine, despite extensive disease, with 5 ASAs and the occasional cortenema course.
Overall, UC has not taken over my life, for which I am thankful!
Posted 6/22/2010 4:55 AM (GMT 0)
My GI said I have no scar tissue at all from my flares. Just like skin on your body, it can repair itself. Sometimes it leaves scars. Not always.
Posted 6/22/2010 2:55 PM (GMT 0)

BabeintheWoods said...
Anecdotally I remember several members of this forum saying that their colons were free of scarring and clean as a whistle as if they never had UC. I believe Subdued was one of the members, (Subdued can you help us out here?) I believe they credited glutamine (which is supposed to repair intestinal tissue), and aloe vera juice.

Yes. Supplements can help. I've been taking a lot of them (different kinds, low dosage) over many years. Some of them are for skin. Plus, I listen to self-hypnosis healing MP3s before going to sleep at night. I tend to heal very fast in general.
Posted 3/1/2012 12:34 AM (GMT 0)
Great thread. Just found out a bunch of pseudopolyps (as in massive pseudopolyposis) threw a party in my ascending colon and I'm trying to figure out my next move. Working on fecal transplants and trying to feed my gut anything that will possibly heal the lesions.
Posted 3/1/2012 12:58 PM (GMT 0)
This is interesting, my GI doc said when doing a scope, my colon would never look like someone without UC, ever. However I've read many accounts of people having perfectly normal scopes after periods of remission.
I'm just guessing here , but it seems to me, if the inflammation is well controlled by meds, or just luck, the mucosa heals and returns to a normal state.
It seems to me, like every other disease, it's all about the inflammation and how it's handled.
Posted 3/1/2012 1:39 PM (GMT 0)
With regards to the post question....NO, I don't think permanent damage can take place from a flare. Meaning, the colon heals like the mouth, extremely fast when damaged. That said, ongoing inflammation can cause ongoing damage.
Posted 3/1/2012 1:51 PM (GMT 0)
     Wow, this is an old post, written about a week before I had my surgery.

     I do believe that constant inflammation causes permanent damage to any organ, colon or otherwise.

     I suffered from ongoing inflammation of the rectum for twelve years.  The day after my operation, my surgeon said to me that I had made the right decision because my rectum was badly diseased.

     My paternal grandmother died from cancer of the rectum and I was recently told that her symptoms were the exact same as I had suffered.  She passed in 1952 when I was only six years old.  Back then, not many people spoke of these ailments.  Ironically, she died at the same age as I am now.

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