Does anyone have any idea what this means??

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sweetnakira
Regular Member


Date Joined Apr 2010
Total Posts : 119
   Posted 4/22/2010 6:19 PM (GMT -7)   
Hello Everyone, I was able to get my report faxed over to me regarding the endoscopy and colonoscopy so I can bring it to my primary care doctor. Besides what The rude GI doctor wrote, I was reading the results from the bipopsy's taken.
Here is part of what the doctor wrote:
UPPER ENDOSCOPY PROCEDURE NOTE:
Procedure: Endoscopic was introduced under direct visialization per os and advanced through the oral pharynx, through the esophageal inlet, esophagus and GE junction. The gasric body was entered, the scope retroflexed, and all areas well visualized. The scope advanced into the duodenal bilb and second portion of the duodenum. The scope was retracted into the gatric body and multiple random gastric biopsies were obtained and sent to pathology for tissue indentification and to rule out H. pylori organisms. The insufflation was suctioned out and the scope was retracted the length of it's insertion and removed per os.
 
Findings: The esophagus was normal. The GE junction was about 40cm from the incisors. The gatric body and antrum revealed patcy erythema, biopsied. The duodenal bulb was clear. The second portion of the duodenum was normal, biopsy taken from spure
 
Impressions: mild gastritis, no obvious source of iron deficiency found.
 
COLONOSCOPY:
Indications: h/o crohn's disease, fe deficiency anemai and weight loss
 
Exam: Extent of exam reached: Colonscope is passed to the cecum with ease, the cecum identified by ilcal cecal valve and appendiceal orifice, Terminal Ileaum, ileum intubated, mucosa edematous, crythematous, nodularwith large area of ulceration, biopsied, hard. Mucosa in rectum revealed patchy erythema, biopsied. Mucosa in cecum, transverse colon, decending colon, sigmoid colon appeared normal. Peri rectal anal fissure noted, draining light green drainage, large external hemorrhoids. Retroflexion done in rectum.
 
Findings: Severe ileitis, peri anal disease, anal fistula.
 
PLAN: check path, surgical evaluation, flayl tid for 2 weeks for anal fistula. follow up in office in 3 weeks
 
Colonscope was slowly withdrawn with periodic reinsertion and withdrawl of the colonscope to make every effort to inspect all folds and fexures
Tolerance: Good
 
RESULTS OF BIOPSY:
Final Diagnosis
 
1. Iluem, biopsy:
-Ileal mucosa showing acute inflamation, cryptitis, increased lamina propria inflamation, erosion, with flattened and the broad villie. No granulomas or dysplasia is seen.
 
2. Rectum biopsy:
-Colonic mucosa showing moderate increased chronic inflammatory cells in the lamina propria. No active inflamation, granuloma, or dysplasia seen.
 
Gross Description:
1. The specimen is lableled ileum and with the patients name. The specimen is received in formalin, and consists of multiple, soft, tan-pink fragments of tissue ranging from 0.2 to 0.4 cm in maximum dimension. Entirely submitted. One cassette
 
2. The specimen is labled rectum and with the patients name. The specimen is recieved in formalin, and consists of two, soft, tan-pink fragments of tissue ranging from0.2 to 0.4 cm in maximum dimension. Entirely submitted. One cassette
 
Ok, well that is the end of the report. I hope I typed everything correctly. My question is, does anyone have a clue what this is saying? It sounds real bad and I am so nervous, I will be seeing a sergeon this Monday coming up and I want to have an idea on what to expect. Does this sound like severe crohn's? I am really very scared and what makes it worse is my doctors are all idiots. I can't get anyone to explain anything to me at all. I understand they have other patients and can't explain every part of this report but my doctor said nothing except it's severe and take flagyl and see her in 3 weeks. After my husband calling to find out why she didn't come out and let him know anything she finally called back and just blurted out "You have severe crohn's and find a sergeon". I hope someone understands this and can explain it to me. My husband and I wanted to know exactly what do they mean when they say acute. Does that mean "Severe"? I want to thank everyone in advance who takes the time out to read this long post and if especially if it can really be explained to me because there are so many words I have never heard of like: cryptitis and so many other words.
 
I pray it's not as bad as it sounds but I have to know the truth, if I like it or not sad .
 

pimfram
Veteran Member


Date Joined May 2009
Total Posts : 506
   Posted 4/22/2010 6:35 PM (GMT -7)   
What I get out of it:

Slight case of gastritis, swelling of stomach lining. Wouldn't worry too much about that.
Severe ileitis - swelling at the ilium, the last segment of the small intestine before it enters the large bowel. Common in CD.
Peri-anal, just means the CD affects the anus, in this case as a fistula. Probably what you'll be seeing the surgeon about. Will likely get a seton placed.
Biopsy shows active inflammation of both rectum and ilium.
Diagnosed with CD July 2007
Currently on Remicade, Imuran, probiotics, folic acid, multivitamin.
Resection December 2009

Amor fati - Nietzsche


sweetnakira
Regular Member


Date Joined Apr 2010
Total Posts : 119
   Posted 4/22/2010 10:20 PM (GMT -7)   
Thank you pimfram, WoW.....this is so scarey for me. So do I have crohn's in the rectum? If so does that mean I will have to get it removed? I'm sorry if I sound stupid but I am so nervous. The doctor makes me feel like its the worst case of crohn's she has ever seen and from the report (I know it doesn't sound good) it didn't seem like it was severe crohn's. I thought maybe I went from mild to moderate but not from mild to severe :-(. What would be the reason for the swelling of the stomach lining? Is that from crohn's? I know sometimes I might feel like I have an ulcer or something but not often. Since the colonoscopy and endoscopy 2 weeks ago sometime after I eat I start to feel a wierd feeling, almost as if I can feel my food moving through the area that is inflamed and I have never felt anything at all before (just constantly running to the bathroom). Im also confused about why as soon as the procedures were done I ran a high fever all night and the doctors have no clue why. I think everything is making me more nervous now since the procedure because they said they have never heard of anyone running a fever unless the intestines have been prefferated (sorry if i spelt that wrong). I'm thinking now, if I couldn't habdle a simple procedure that people have all the time how will I be able to tolerate those strong medications or surgery :-(. If anyone has more info regarding the report I would love to know. Does this sound like severe crohn's? Does it make it worse because of the whole rectal abscess and fistula? Will I ever live a normal life again or is this it? Sorry everyone, Im getting a little depressed.

Usher CD
Regular Member


Date Joined Oct 2013
Total Posts : 155
   Posted 11/24/2013 1:33 PM (GMT -7)   
sweetnakira,

You have to calm down. No one can predict CD. I've been lately diagnosed with CD, gastritis and GERD. Almost similar colonoscopy results like yours.

I've been having fever like feeling, sweating at night, nausea, no appetite and son on. I was actually doing well before and during my diagnosis.

Gastritis is the inflammation of the stomach lining. It could be cured. It has nothing to do with CD. I've been prescribed pantoprazole. But, I've been looking for a natural remedy. I just came to know that pine nut oil is good for gastritis. I've ordered it online.

Don't panic. Just listen to your body and eat only the food that your body likes. At the same time try some supplements and anti-inflammatory natural stuff. Do some meditation to stay away from anxiety.
25 year old male living alone in a foreign country and diagnosed with CD, GERD, gastritis, chronic anal fissure, anemia on 29.09.2013.

Medication: Pantoprazole 20mg 1-0-0, Mesalamine 1.5g - 1-0-1 1-0-0, Budesonide 9mg 1-0-0, FERRO SANOL duodenal 100mg - 1-1-1

gumby44
Veteran Member


Date Joined Nov 2007
Total Posts : 4100
   Posted 11/24/2013 1:51 PM (GMT -7)   
Hi sweetnakira,
You have active Crohn's in your ileum and anus. The Flagyl should help with infection if you have one related to your fissure. You need a GI doc who is experienced with Crohn's so you can try medications and see if you can get the inflammation to settle down. If your fever continues, you need help right away to make sure they didn't perforate anything. You need to take this seriously, because your disease is active, but it does not sound like it is a horribly severe case, and you don't need to panic. If you can tell us where you live, maybe someone has a suggestion of a good GI doc near you, or if you are in the US, then go to ccfa.org and they have a doctor referral site. Most of the time the docs try to control disease with medication first and then surgery is the last option. I'm sorry your doc was rude...sounds like he isn't very familiar with managing Crohn's.
54 yr. old female, diagnosed with Crohn's in terminal ileum Sept-Oct. 2007. Also have GERD and IBS (Dx. with c.difficile 1/12- now resolved)

MEDS: Pentasa- 6 500mg pills per day, Dexilant, Metamucil, colace, miralax as needed, probiotics .25 xanax for sleep prn

Ides
Forum Moderator


Date Joined Nov 2003
Total Posts : 7077
   Posted 11/24/2013 5:45 PM (GMT -7)   
Are you still on Remicade or did you stop it when you got pregnant? I am guessing you stopped it since things have gotten worse. As gumby said, please tell us where you live so people here can recommend GOOD GI doctors near you.

Why are you seeing the surgeon on Monday? Do NOT rush into surgery for anything other than help with the fistula without talking to a GI who specializes or is good with CD. {see above paragraph.]
Moderator Crohn's disease, Osteoarthritis and Irritable Bowel Forums

CD, Ankylosing Spondylitis, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, pulmonary hypertension, degenerative disc disease, asthma, severe allergy and a host of other medical problems.

JaSanne
Veteran Member


Date Joined Oct 2006
Total Posts : 2044
   Posted 11/26/2013 12:06 PM (GMT -7)   
I tend to think some GIs are more interested in the trip than watching the home movies. By that I mean some GIs are better at doing the scopes than bothering to explain to the patient just what it all means.

You asked about the term "acute"; it usually means sudden onset in medical terminology, as opposed to "chronic". I think in your case it means you have active infection at the ileum. You're in an active flare, which like most of us, you don't need anyone to tell you that as you're too well aware.

I agree that you should keep a look out for fever since there is real concern with having a scope during an active flare. I've had to be hospitalized after one, but I wasn't put on antibiotics as your GI did you. That's not to scare you but just to be aware. If your symptoms suddenly spike, you need to go to an ER.
54 yr. old. Ileocolitis since early teens. Enteropathic arthritis. Fistulae since '97; occasional episcleritis. Hemicolectomy-left side in 2001. Severe chronic pain and muscle spasms due to spinal cord injury, scoliosis, rotator cuff injuries, and the arthritis.
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