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colonoscopy results and questions

I am a 42 year old non-smoking male.

I have had colon symptoms for about 6 months now.. Started at as severe indigestion (about one month) then diarrhea started and continued for about 5 months. Now I am experiencing flat stools and some colon cramping and gas. No blood in stools. FOBT stool samples have been negative for blood. I have always been prone to indigestion and non-regular bowel movements (sometimes I go 5 times a day then I will have periods of times I won't go for a couple of days).

I have recently had a colonoscopy with the following report (three samples were taken for biopsy)

1) Biopsies, Ileocecal Value
-Microscopic colitis without cryptitis or crypt abscess formation
2) Biopsies, Sigmond at 40cm:
-Microscopic colitis with single focus of cryptitis, no crypt abscess formation
2) Biopsies, Rectosigmond at 10-15cm:
-Chronic colitis without cryptitis or crypt abscess formation

Comments: There is no evidence of crypt abscess formation in any of the specimens. Likewise, there is no evidence of dysplasia or malignancy.

I have always had red blood count and hemoglobin serum levels at the low end range of normal (4.53 m/uL and 14.1 g/dl respectifully). Also, my ANA serum test came back sligthly elevated (10 on a 0-9.9 scale). Sed Rate however is normal at 7 mm/hr (0-15 normal range). Serum CRP=<2.0 mg/L (normal 0.0-9.0 mg/L). White Blood Count=5.8 k/uL (normal 4.8-11.0 k/uL)

My doctor completed numerous stool tests and found no bacteria or "bugs" as he put it

My doctor told me he is not sure at this point if colitis will persist or resolve on its own. He gave me information on Ulcerative Colitis but said may not apply to me at this point. He has me taking Ciprofloxacin for 10 days and then said if bowels resolve themselves then no other action is needed. If, however, I do continue to experience diarrhea, bloating and cramps to start taking Asacol. But he left that decision up to me. He wants me to come back in a year (repeat colonscopy) and be rechecked to see how things look.

Question: could colitis (microscopic or chronic) turn into Ulcerative Colitis in the future? Should this be something I should be concerned about? What is the different between what my colonoscopy shows and Ulcerative Colitis? What are the issues with taking Asacol? Will I need to keep taking it (for life) once I start?

I am concerned about cancer and wonder how proactive I should be at this point.  I guess I just don't know what to do at this point, pursue some active treatments or just let things resolve on their own.

I also had an endoscope done of my throat and have a throat ulcer (acute and chronic inflammation) so I am taking Protonix for this and will go back for a repeat endoscope in Dec.

Regards, John
3 Responses
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233190 tn?1278549801
MEDICAL PROFESSIONAL
To answer your questions:
1) It is possible for the colitis to evolve into inflammatory bowel disease like Crohn's or ulcerative colitis.

2) Close followup is recommended.  At this time, there is no conclusive diagnosis - repeating the colonoscopy in 1 year is reasonable.

3) Ulcerative colitis would have a more definitive biopsy, as opposed to the "grey area" that is presented here.

4) Asacol is generally safe, with side effects including nausea, headache, fever, and rash.  The duration of therapy would vary on the disease severity and response.

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_
Helpful - 0
Avatar universal
Hi John..
I am not a doctor, but I do have crohn's, an illness simular to what you might have.

Biopsies, Ileocecal Value
-Microscopic colitis without cryptitis or crypt abscess formation

This is colitis in the part of you intestine connecting the small bowel to the large bowel.

Biopsies, Sigmond at 40cm:
-Microscopic colitis with single focus of cryptitis, no crypt abscess formation

This is colitis in the lower part of your large bowel
2) Biopsies, Rectosigmond at 10-15cm:
-Chronic colitis without cryptitis or crypt abscess formation

This is colitis in the part of your intestine connecting the large bowel to the rectum.

Comments: There is no evidence of crypt abscess formation in any of the specimens. Likewise, there is no evidence of dysplasia or malignancy.

NO PRESTAGE CANCER OR CANCER FOUND!


I have always had red blood count and hemoglobin serum levels at the low end range of normal (4.53 m/uL and 14.1 g/dl respectifully).

This is cause your colon small bowel/colon isnt functioning as it should.

Also, my ANA serum test came back sligthly elevated (10 on a 0-9.9 scale).
ANA can indicate an immune disorder, but many healthy ppl have an elevated ANA and this test alone says nothing.

Sed Rate however is normal at 7 mm/hr (0-15 normal range). Serum CRP=<2.0 mg/L (normal 0.0-9.0 mg/L). White Blood Count=5.8 k/uL (normal 4.8-11.0 k/uL)

This is ALL good!

My doctor completed numerous stool tests and found no bacteria or "bugs" as he put it

My doctor told me he is not sure at this point if colitis will persist or resolve on its own. He gave me information on Ulcerative Colitis but said may not apply to me at this point. He has me taking Ciprofloxacin for 10 days and then said if bowels resolve themselves then no other action is needed. If, however, I do continue to experience diarrhea, bloating and cramps to start taking Asacol. But he left that decision up to me. He wants me to come back in a year (repeat colonscopy) and be rechecked to see how things look.

Ok.. The reason he is treating you as if you don't have colitis, is because you have only been ill for 6 months. IBD is very hard to diagnose, but if I were you I would be taking the Asacol after those 10 days, unless my bowels were back to normal.

Question: could colitis (microscopic or chronic) turn into Ulcerative Colitis in the future? Microscopic colitis is a form of colitis. Try to google Microscpic colitis and read a bit about it.

Should this be something I should be concerned about?
Yes! It is a chronic illness and shoud be taken care of with meds, so that you can keep it under control. Colitis is inflammation of the intestines and can be a serious illness with no cure and can be threatening if it isnt treated.

What is the different between what my colonoscopy shows and Ulcerative Colitis?
Do some reading on the internet and educate yourself!

What are the issues with taking Asacol? Will I need to keep taking it (for life) once I start? You will need to be on some kind of medication for the rest of your life. Depending on how active the illness is. Some people go into remmission and stay well for years on end, while some people have bad flares that they can't harldy ever get under control.

I am concerned about cancer and wonder how proactive I should be at this point. I guess I just don't know what to do at this point, pursue some active treatments or just let things resolve on their own.

I also had an endoscope done of my throat and have a throat ulcer (acute and chronic inflammation) so I am taking Protonix for this and will go back for a repeat endoscope in Dec.

Good luck with this.. This is also normal for people with colitis/crohns to have (including myself)

Best wishes..
Helpful - 0
Avatar universal
Shebah- thanks for your comments! Sounds like I should be proactive in this. thanks again
Helpful - 0

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