Confused

I was first told that I had ulcerative colitis (actually the dr. at my college called it "illeitis") 30 years ago, but was given no treatment except antibiotics and sessions with the school psychologist (not sure why) and wasn't given the sense that anything could be/needed to be done. Had flares for the next 20 years, but never really knew what they were. Ten years ago I ended up in the hospital for ten days with severe ulcerative colitis throughout my entire colon -- I  had been getting sicker and sicker for three months, was bleeding heavily, and was up to 20 bm's a day, but kept thinking it would go away. I had had a colonoscopy about a year before, with no biopsies, and my dr. said that "everything looked fine."

Anyway, I have been having colonoscopies with biopsies regularly since the hospitalization (first every 1 1/2 years; the last time we waited three) and am taking an immunosuppressant. The first biopsies showed the length of time I had had colitis (not exact, but "for a very long time" according to the g/e) and that it went throughout the colon. One time the biopsies showed "glandular disorder," one time there was too much active colitis to finish, two times everything was "fine," and the last time the biopsies showed "mild inflammation."

Should I be concerned about the inflammation or does it just mean I might be heading toward a flare? Did the glandular disorder (which my doctor first described to me as my cells being "in complete disarray" but now says it was "glandular disorder") go away? Is it something that comes and goes?

Thanks.

[Ratnakar Kini, MD]

Hi,
Since you are on medications, the disease activity would be controlled. But there might be flareups in bettween which is shown by the inflammed colon.
The disease activity and the severity is assessed using various criteria based on it the medications are to be adjusted.
Thus UC needs a regular follow up and adjustment of medications.