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Ulcerative Colitis
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Posted 2/21/2017 2:09 PM (GMT 0)
I had my follow-up appointment with my GI yesterday. He said that I am doing very well and healing up nicely.

I'm a bit confused about my diagnosis, though, and I failed to get clarification yesterday.

He told me that I had left-sided Colitis, but this seems to contradict the colonoscopy findings.

Under "Findings," it reads: "Marked friability and edema and erthema of mucosal surfaces extending from the rectum to approx 30 cm form (I'm assuming this should read "from") the anus, more proximally to the cecum and terminal ileum are grossly normal."

Under Endoscopic Diagnosis: "Rule out Ulcerative Colitis Left Sided."

Am I missing something, or does the colonoscopy suggest Proctosigmoiditis? Is this just one of those cases of the doctor being so busy, he forgot what his initial diagnosis was? Ultimately, does it matter much?
Posted 2/21/2017 3:32 PM (GMT 0)
I'd want clarification as the wording is definetly confusing. Certainly the biopsies are another piece of the puzzle and unless you have that report than you're not looking at everything used for your diagnosis.

Everything before the comma suggests a diagnosis of ulcerative colitis with proctosigmoiditis. Everything starts at the rectum and extends 30 cms (rectum and sigmoid involvement). They saw marked bleeding when the scope touched the mucosa surface (aka friability)n they saw swelling (aka edema), and redness (aka erthema) of mucosal surfaces. All typical, storybook UC findings suggestive of continuous inflammation. All you're missing is ulcers (characteristic of ulcerative colitis).

Everything gets more than a bit weird after the comma. Bad grammar and a bit muddled. Does it mean: That there was random, spaced spots of inflammation seen (proximally) to the ceceum? TI was normal? If so then you don't have ulcerative colitis.

It's possible they saw only random redness (erthema) and it was only from the prep, and biopsies confirmed it was not inflammation.

I'd call and ask for the biopsy report. And offer them a free grammar and spelling lesson ;-P
Posted 2/21/2017 3:52 PM (GMT 0)
Thanks, iPoop. I just wanted to make sure that I wasn't missing something. The GI said that the biopsy report did confirm UC. I will call and ask for a copy.
Posted 2/21/2017 11:04 PM (GMT 0)
UP UC UP-sigmoid is all just about the #of cm, which can easily change. The key part if the "U" either it is the chronic auto-immune or it is ordinary colitis.

Sounds like you UP is advancing into left side, but not so much yet.
Posted 2/21/2017 11:47 PM (GMT 0)
"He said that I am doing very well and healing up nicely."


just curious what criteria he is using to determine that -

when was you last scope ?
Posted 2/22/2017 1:16 PM (GMT 0)

soynomore said...
"He said that I am doing very well and healing up nicely."


just curious what criteria he is using to determine that -

when was you last scope ?

He's basing it on my current lack of symptoms. I have three more days of Prednisone. I suppose I'll really know how I'm doing after that.

I was scoped two weeks ago. That's when I was diagnosed.
Posted 2/22/2017 1:25 PM (GMT 0)
I picked up a copy of the biopsy.

Under Specimens 4 (Sigmoid) and 5 (Rectum), the diagnosis is "Active Chronic Colitis. Negative for dysplasia"

Under Specimens 1 (Ascending Colon), 2 (Transverse Colon), and 3 (Descending Colon), the diagnosis is "Colonic Mucosa with no diagnostic abnormalities. No evidence of idiopathic inflammatory bowel diseas, lymphocytic colitis or collagenous colitis. Negative for dysplasia or malignancy."

Most of you know far more about this than me, but the biopsy seems to indicate Proctosigmoiditis, not Left-Sided Colitis, right?

Maybe my GI doesn't differentiate between the two? I think he is a great doctor overall, but hasn't been very thorough with my diagnosis.





iPoop said...
I'd want clarification as the wording is definetly confusing. Certainly the biopsies are another piece of the puzzle and unless you have that report than you're not looking at everything used for your diagnosis.

Everything before the comma suggests a diagnosis of ulcerative colitis with proctosigmoiditis. Everything starts at the rectum and extends 30 cms (rectum and sigmoid involvement). They saw marked bleeding when the scope touched the mucosa surface (aka friability)n they saw swelling (aka edema), and redness (aka erthema) of mucosal surfaces. All typical, storybook UC findings suggestive of continuous inflammation. All you're missing is ulcers (characteristic of ulcerative colitis).

Everything gets more than a bit weird after the comma. Bad grammar and a bit muddled. Does it mean: That there was random, spaced spots of inflammation seen (proximally) to the ceceum? TI was normal? If so then you don't have ulcerative colitis.

It's possible they saw only random redness (erthema) and it was only from the prep, and biopsies confirmed it was not inflammation.

I'd call and ask for the biopsy report. And offer them a free grammar and spelling lesson ;-P

Posted 2/22/2017 2:31 PM (GMT 0)
Your biopsy report does support a solid UC proctosigmoditis diagnosis. Anything seen visually within your colonoscopy beyond the sigmoid was determined to be negative for inflammation (likely just irritated skin from the colonoscopy prep).

I see proctosigmoiditis and left-sided-uc used interchangeably, and I don't believe there's any real significance between the two phrases. I agree that the number of centimeters is irrelevant, as it does increase and decrease over the course of having it. I also have proctosigmoiditis and mine started around 12 cms, has been up to 70cms, other times 45 cms, and zero cms during remission with various scopes over the years. I always seem to stick to left-side involvement, and have never had transverse colon involvement.
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