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Colonoscopy Results/questions

I am a 40 yo female w/no sig med/surg hx.
In Dec 2005 after taking Levaquin,  I started having nausea/lack of appetite/fullness/bloating. 2-3 times per day light colored stool.( had a dose of Clindamycin in AUg 2005 which caused 2 weeks of bad diarrhea,too)

Endoscopy. blood work.Abd u/s, pelvix u/c,stool cultures, sigmoidoscopy... all negative

april 2006- rectal pressure/very little mucus/blood...mostly on the tissue, and at times on the stool, streaked.
Colonscopy- mod-severe inflammation, acute cryptitis, questionable dysplasia. Results are histologically compatible with IBD/UC.
Some hemorroids as well.

dx: proctitis vs UC
started Canasa supp, once a day for 3 months,rectal pressure better, blood a little better.
-had a prometheus blood test: negative

Repeat colonscopy was 7/28...
Results of the GI report: moderate proctitis ( which meant it was getting better), and ilieal ulcers.( he never checked the last time)

he feels that it is Crohn's now.
Wants me to take the Canasa supp bid X 2 weeks
Asacol t.i.d
hydrocortisone enema X 2 weeks

THe biopsy results won't be in for another week.

My questions:

1. I still have bleeding once in a while, usually when I strain.
How do you know that it's not from the hemmrhoids?

2. how do I know that it's not cancer? colon or stomach?

3. is Asacol the same as the Canasa supp? I'm allergic to a lot of meds,( Sulfa, PCN, E-mycin,Motrin) and I have tolerated the suppositories well, so knowing that the Asacol is the same ingredient makes me feel better.

4. Is it definetely Crohn's because of the ilieal ulcers, right?

5. WHat is the usual time frame for taking the Asacol? 2 weeks, 1 month?

6. do I need frequent sig or colonoscopies to monitor if the ulcers are healing?

7. I have upper abdominal pain ( epigastric) never lower like I have read is where it's common for Crohn's, and I never have diarrhea( except for those 2 weeks in Aug)...could it be something else,too?

8. if I don't have symptoms, of I should say what I have is mild compared to what I have read...does that mean it's coming?
IS it going to get worse, like full blown Crohn's, or can you have a mild case?

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233190 tn?1278553401
To answer your questions:
1) Hemorrhoids are possible, however the colonoscopy would give the more definitive answer.

2) A colonoscopy and upper endoscopy are the most comprehensive tests to rule out colon or stomach cancer.

3) Asacol and Canasa are both mesalamine.

4) Ulcers would make it more likely to be Crohn's.  A biopsy would give a more definitive diagnosis.

5) It would depend on the response.  Taking it for an extended period of time (i.e. months) would be a reasonable initial course.

6) That would depend on the severity of your lesions as well as your GIs preference.

7) Possibly.  The upper endoscopy would rule out many major upper GI disorders.  You can also consider an ultrasound to look at the liver and gallbladder.

8) Can't say without examination.  I would discuss this question 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.
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