My understanding is that once you obtain remission normal healing will occur resulting in a normal colon. That's why the biopsy samples during a flare can come back with chronic inflammation, etc... However after getting on the normal medication it will come back normal colonic mucosa. When you see the pictures it's striking, from blood riddin thin mucosa to noraml light pink mucosa.
So I don't believe it does permenant damage. It can cause scar tissue though.
I know you know your stuff but I have a sincere question. Why then can biopsies come back completely normal? Meaning at some point someone has a flare and colonscopies are done and the path report comes back chronic inflammation, loss of achitecture, etc... After going into remission another colonscopy is done and the path report, for the same area, reads normal colonic mucosa. I understand that in some areas the ulcerative colitis has been so severe it can cause permanent scar tissue but in other areas the area can completely heal? As if that person never had UC in the first place. That's what I understand, am I mistaken? Remember I am not an elite member just a regualar member, go easy.
pseudopolyps are definitely a form of permanent damage caused by inflammation. My colon has hundreds, it's gross. And, it's nearly impossible to differentiate a pseudopolyp froma regular polyp, which makes cancer detection much harder. My last scope (about 2 1/2 yrs. ago now!) showed about 10" of active disease, ulceration, etc. & hundreds of pseudopolyps thruout the entire colon. I'm sure a scope now would show only active inflammation low in the rectum, but still hundreds of pseudopolyps. Gross.
I get where you are coming from. You are in remission, meaning no clinical symptoms and no pathology to report. It's as if your UC came and went. I guess the original question to this thread was in regards to permanent damage to the bowel. Yes, I guess it depends on waht the definition of permanent means. If it means you bowel can't recover then answer is clearly no otherwise we all be having our colons removed at the first onset of UC. If it means your colon can heal and function well and if you were to take your colon biopsies after it has healed a pathologist may never even know that person had it in the first place. All I was trying to contribute was the notion that given the right situation the large colon can heal itself and go into remission and live a long productive life. Yes there may be some signs of previous damage here and there depending on the severity in the past but who cares, it can recover and make good poo!