Updates: sigmoid inflammation, uceris, Crohns?

Hi all, I'm here with some updates after my recent colonoscopy. I met with my doctor yesterday and here's where I'm at. He found a small amount of inflammation-first he thought it was in the secum and the sigmoid, but after doing biopsies, only the sigmoid had it.

He's going to have me go on Uceris for a few months to see if that is enough to boost me into remission. With my history, I'm prepared to find myself in the same place as I am now once I stop it, but I know that's not the best attitude to have! I've never been on Uceris before, so I'm reading up on it and seeing that it doesn't cause all the crazy side effects that prednisone does, but I'm still worried about any potential side effects. I'm staying on Humira. As for the Lialda, I can choose to stay on it if I feel it's helping a little or go off of it.

If this plan doesn't work, I'll most likely be going on Imuran. If all else fails, Remicade or Entyvio.

One interesting thing he talked about was that the fact that he saw a random "patch" of inflammation led him to wonder if I have Crohns. I doubt it and he doubts it, but he just wanted me to be aware of that possibility. He said that with UC, the inflammation usually starts at the rectum and goes up through the colon instead of appearing in isolated places. I did do a small bowel follow through when I first started seeing him and it confirmed UC only, but I'm assuming since my disease was in a different stage back then, Crohns is still possible. I hope not. I don't even know if what I just wrote makes any sense.

So here I go, off to argue with the pharmacy about my insurance so that my new prescription doesn't cost $1900.

Sounds like you have a good plan moving forward.

Uceris is still 10 percent systematic, so you can experience some of the milder steroid side effects, but you're talking less cumulative side effects and likely only the milder of them.

It's weird there's no rectum involvement as that's a staple of UC. For now try not to worry, rather keep that info for future use. Further scopes or biopsies could change your diagnosis to Crohn's, chron's-colitis, or indeterminate-colitis. Generally the same meds and treatments are used for all (with some newer meds like stellara only for Crohn's). Not impossible to have your diagnosis changes later, but certainly not high probability.

I wouldn't worry too much much about UC versus Crohns unless you get to a point where you are considering surgery. The medical options are basically the same for UC and Crohns in the colon. My disease was always left sided colon and rectum only. I went from Crohns to indeterminate colitis to UC and finally after pathology from surgery Crohns Colitis. It never changed my treatment options until I had to start considering surgery.