Questions after MD appointment

I saw my GI to go over the colonoscopy report...

report said :
moderate to severe acute/chronic colitis w/ actue cryptitis.
epithelial glandular atypia associated with inflammtion is noted.
indefinite for dysplasia.

the inflammatory changes are histologically compatible with inflammatory bowel disease/ulcerative colitis.


He said that the area was so small and mild, that he is treating it as "proctitis"...

He is baffled because he said I am atypical for Ulcerative colitis in presentation ; I don't have diarrhea, very tiny blood and mucous, no weight loss etc...and sudden onset at age 40. ( sigmoidoscopy 8 months prior was negative)

My sypmtoms are upper abdominal pain ( endoscopy was negative except for mild gastritis), lots of gurgling, at times- nausea and loss of appetite, bloating, and feeling full easily.

Occasionally blood ( when I strain - tiny hemrhoids), and occasionally mucous in my stool.
Also, sometimes, I do have rectal pressure, but it's usually relieved by a bowel movement.

My questions are :

1. I am allergic to Sulfa - ( I think SUlfa, it's what I took a long time ago for a UTI)...and when I read the precautions for Canasa, it said not to take it if you are allergic to Sulur? Is that the same thing?
Can I take it?
Are there many side effects...?


2. he was most concerned with the "dyplasia" that was found. He said it could mean that there are changes that are consistent with what "could" become cancer?
Can you explain that to me?

He recommended that I have a sigmoidoscopy in 6 months, but I am nervous, should I get one sooner?

If it truly is "dysplasia" on the next report, does that mean that I have colon cancer?

3.Finally, he has no idea what the stomach thing is and said if it's not better in 2 weeks, I should get a CT scan...
I have already had a colonoscopy, endoscopy, multiple lab tests, stool cultures, and an abdominal xray...
All were negative.
WHat else would a CT scan be looking for?
Haven't most of the "big and bad" ( i.e.-cancer) diseases been ruled out by those tests?



SOrry for all the questions, but I have my 4 kids with me, and I could not ask all the questions then.

Thanks,
J

[Kevin Pho, MD]

To answer your questions:
1) Canasa comes as a rectal suppository.  Caution must be taken if you have a sulfa allergy and this should be discussed with your personal physician.  Side effects can include headache and bloating, amongst others.

2) Depending on the type of dysplasia, there is the possibility that cancer can arise.  However, the reports suggested it was indeterminate - repeating the biopsy can be considered.  Repeating a sigmoidscopy in 6 months is reasonable.

3) Many of the major GI disorders would be ruled out with the tests you have had.  If you continue to have upper GI symptoms, the CT scan can evaluate the liver and gallbladder, pancreas, as well as any upper abdominal masses.

These questions can be discussed with your personal physician.

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_

[my3reasons]

Hello.  Before you get the Canasa ask the pharmacist if it will be safe for you to take or not.  Usually if you can't take something the pharmacy can call your dr. to get a prescription for something else.

[jfem]

thank you for answering my questions...

I do have an allergy to Sulfa, and I told my MD that, and he said it was OK?
I also told the pharmacist, and she was checking it out.

Thanks, hopefully there is something else that I can take.


Thanks for the advice!!
J