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Ulcerative Colitis
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Posted 6/11/2024 7:42 AM (GMT 0)
Hi All,

I wonder could I get an opinion on my latest 3-year colonoscopy and gastroscopy. I read this as being a good report but not quite in full remission on the left side.

Gastroscopy: Mild reflux changes in lower osephgus but otherwise normal to the descending duodenum and negative for Helicobacter

Colonscopy: Mild colitis and scaring of the colon to the splenic flexure (scaring more likely due to previous years when colitis was much more active). The colon proximal to this is normal to the caecal pole. Biopsies showed minimal inflammatory changes in the distal colon otherwise normal.

Symptoms: No mucus, No blood, Mild left sided pain and cramping, CRP negative. Calpro normal, Mild joint and muscle issues

Opinion: IBD appears in reasonably good remission on current treatment
Posted 6/11/2024 5:03 PM (GMT 0)
Do you have the breakdown of the biopsies pathology?

Mild colitis to the splenic flexure doesn't spell any aspect of the word remission...improvement yes! It is a positive opinion report, but the pathology is what's most important. Do you have Crohn's Colitis?
q
Posted 6/11/2024 5:25 PM (GMT 0)
You have mild, active inflammation on your left side of the large intestine (rectum, sigmoid and descending colon). Biopsies confirmed inflammation, minimal.

Scars aren't unusual in UC patients, generally a lot less concerning within the wide large intestine as opposed to Crohn's patients with scar in in smaller diameter small intestine. Significant scars can cause IBS like symptoms in UC patients.

So you're not within a remission.
Posted 6/11/2024 6:46 PM (GMT 0)
Thanks for this Q & IPoop. I have UC; previously in pancolitis form even to backwash ilietis. The report I gave was based on the pathology findings of scopes last month. I've requested a copy of this.

Q & iPoop, Would you react to this report by looking to up meds? I'm on Mtx and Humira. I was thinking of asking for steroid foam enemas. I do not get results from 5ASA meds.

Post Edited (Charlie789) : 6/11/2024 11:15:55 AM (GMT-8)

Posted 6/12/2024 4:36 PM (GMT 0)
I'm all for rectal meds and definitely worth trying. You could consider Uceris as well, which is released into the colon. I dont know how long the usual course dosage is. Curious how long you've been on the Mtx and Humira?
And when is your next scope?

q
Posted 6/14/2024 2:05 PM (GMT 0)
Yes, corticosteroid (hydrocortisone, budesonide, or prednisolone) retention enemas or rectal foams would be a great way to combat mild inflammation with in the rectal and sigmoid areas.

Not all foams reach the sigmoid colon, so verify yours will. Varies by country, brand, etc.
Posted 6/14/2024 9:32 PM (GMT 0)
"reasonably good remission" is a bit of an oxymoron, no?

There are different definitions of remission but endoscopic remission means no visible inflammation...if it were me I would want to up treatment in one way or another because low level inflammation can escalate into a bad flare.
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