Can colonoscopy make things worse?

The prep can at most cause mild erythema (red coloration) within the large intestine. It's like a sunburn appearance. It's superficial, extremely shallow and a biopsy would identify it as being from the prep and not any active ulcerative colitis inflammation. True ulcerative colitis inflammation goes much, much deeper. As far as histological findings go, mild erythema is extremely minor finding for uc patients and not a whole lot of concern. Many things are much, much worse and cannot be caused by a prep, like ulceration, inflamed/swollen, and active bleeding, and they all are unequivocally from active inflammation.

My gastroenterologist has seen mild erythema within me and said it was likely from the prep or very mild inflammation at most, and my biopsies will clarify. And I was diagnosed as being in histological remission once those biopsies came in. It was all from the prep.

So, it's a long, roundabout way of saying: yes, a prep can cause very minor red coloration that looks like very mild inflammation or at least irritation of the intestinal surface, but biopsies would clarify it's only from a prep. Often our gastroenterologist suspects it's from the prep when nothing but a little bit of red is seen in an area, and the biopsy clarifies it. I think it's very, very unlikely that the prep caused you to be pancolitis when you were not.

I've had some scopes where I was in really bad shape, and they didn't make me worse. They didn't make me better either. I've had scopes where I was doing well, and I also didn't get worse. Of course we all worry about these things, but it's probably better to get the scope and see what's going on so you can properly form a treatment plan.

Are you still on a high dose of prednisone? When was your last scope?

Toward the end of my UC days, my GI was doing a lot of calprotectin stool tests instead of scopes. They aren't as accurate, but it's a lot easier than a scope and you can do it a lot more frequently.

Good luck on Thursday!

How recent was your last scope then, if it's too soon?

So you flared Sept 4th, have been on 40 mgs of pred and a corticosteroid suppository, 2 lialda, and canasa. It's been over a month, so you should have definitely had improvements by now if your medications and doses are sufficient (btw that's a low lialda dose, should be 4 a day, you're a pancolitis patient any reason you're not on enemas?).

Have you improved? Or are you still going 6 or more bms a day? Have you tried tapering any of the steroids and have you succeeded or failed?

A scope is justified as a diagnostic tool when you initially flare (to access how severe, how far, and prescribe an appropriate treatment), or when you aren't improving and unable to exit your flare (like being prednisone-dependent after a failed taper) and might therefore justify much stronger medications. A scope is a "What the hecks going on in there?" kinda scenario when we're talking flares.

If you're steadily improving then a scope is unnecessary.

I'd agree with the gastroenterologist who said wait until you're off of the steroids. 1 bm a day is great. At this point the only purpose of a scope is to confirm a deep remission with histological findings. That's irrelevant when you're on steroids. Really, a scope at this point is completely optional. You can just say no.