Can a colonoscopy indicate IBD symptoms even when you are in remission?

Hello,
I am 19 years old, and I have had bowel problems since I've hit puberty. I've always just lived with it, but my symptoms reached a peak last year so I finally decided to see a gastroenterologist. I've always had colon spasms while eating, followed by abdominal pain and diarrhea. My episodes were never consistent (bad at times but fine at others), but my stomach sensitivities have always been there. My symptoms seem a lot like IBS-D but I do have a family history of autoimmune disorders and ulcerative colitis. I am scheduled for a colonoscopy next week.

However, the past few weeks, I've noticed that my stomach has gone into remission. It is not in an active flare up. I haven't had diarrhea in a while (for my standards), and I'm barely even having the colon spasms I was used to having when I'd start eating. Obviously, this is a good thing, but I am concerned that the colonoscopy will not show up with any tangible results. I feel as if my symptoms might return any week now, but I have no way of knowing how long this period of remission will last for.

If I do have ulcerative colitis, is it possible that a colonoscopy could still diagnose me even when my stomach is in remission? Are there traces of colitis even when someone is not undergoing an active-flare up? I'm just really worried that I'm going for this procedure and it won't be able to tell me anything just because of the timing of when it is. Again, I do have a family history of autoimmune disorders, and my brain fog and chronic fatigue have been bad the past few weeks (as they have been for years), but my gastrointestinal symptoms have gone down recently. Could someone please help me make sense of this?
Thank you!!

It sounds like you are in "symptomatic remission" which is different than "clinical remission". The c-scope will definitely tell the story of how much inflammation you have and where it is located. So don't be afraid it won't have any value. It will also provide a baseline for future c-scopes.

But I understand your concern. Like having a car problem and when you take it to repair it just won't make that noise you hear. I spent $1000 on that one time and they didn't fix the problem. That's life I guess. Don't be afraid to check under your hood with a colonoscopy. But also don't link your c-scope findings with your symptoms. Some people have "mild" UC and have horrible symptoms and others just the reverse.

Good luck

PS Your spasms after eating might be food-related IBS (not IBD) which does not show up on a c-scope. I have a cranky gut that is intolerant of many foods. I asked my GI if I had IBS along with UC and he said no, he would put all my symptoms in the UC column.

as others note colon and stomach are independent in IBD, but perhaps some of what you call "stomach" was really GI track.

But, the spasms and such sound more like IBS. IBD is about inflammation that produces unpleasant symptoms and can lead to cancer.

The hallmark is not really visual signs of inflammation, but distinct cell deformations seen in biopsies. These signal chronic inflammation. They will show chronic colitis even if you have had a good week.

hopefully a pro in the IBD world is doing the scope-they know what to look for. Also, they know where the biopsies should be taken and have regular radiologists do the interpretations. I know there are some colonoscopy "factories" out there, who are poor screeners. You might need blood tests to help them diagnose too.