Dysplasia question

I recently posted about a colonoscopy report that said among other things;

"indefinete for dysplasia "

The whole thing said :

"moderate to severe acute/chronic colitis with acute cryptitis.
epithelial glandular atypia associated with inflammation is noted.
indefinite for dysplasia

the inflammatory changes are histologially compatible with inflammatory bowel disease/ulceratice colitis."


The recommendation is Canasa suppository in 6 months, then a repeat sigmoidoscopy, which you also agreed with.

This thing I need to know is if it comes back "dysplasia" again in 6 months what exactly does that mean?
What will my options be?

My MD said he really doesn't think it will come back as that, and said that the "discussion if it does come back positive will be an hour long, with many things to talk about like what we will need to do"

I need to know what he is talking about...he's away on vacation until June 2nd and I am not comfortable with his associates.

1.What will it mean if it comes back dysplasia?
2.WHat are the options that he is talking about?
3. Surgery?
4.Chemo?
5..Does it mean that I have colon cancer?
6. does this diagnosis ever come back and 6 months later it's negative? I mean, does inflammation really cause this "indefinete" for dysplasia diagnosis?
7. is there really a chance that the medicine will reduce the inflammation and therefore the " indefinite for dysplasia" will be gone as well?



It scares me to think of it, and 6 months is a long time to worry.

Thanks,
J

[Kevin Pho, MD]

To answer your questions:
1) If the dysplasia continues, the polyp that contains the dysplasia may be removed.  If the dysplasia is within the bowel wall, more frequent sigmoidoscopies can be done to monitor it.  

2) Difficult to speculate without examination.  If the dysplasia again comes back treatment can range from more frequent surveillence endoscopies to removing the area of dysplasia.

3) Surgery is possible if the the dysplasia is severe.

4) Chemotherapy is reserved for colon cancer, not dysplasia.

5) No, if you had cancer, the biopsy would have specifically said cancer.

6) The "indeterminate" means that the biopsy cannot make a conclusive diagnosis.  Repeating the biopsy may help.

7) There is a possibility that the medicine can reduce the inflammation, maybe reversing some of the dysplasia if present.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[jfem]

THANK YOU so much for all of your answers...

J