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lovemyboys09
Regular Member


Date Joined Apr 2009
Total Posts : 249
   Posted 8/7/2009 11:16 AM (GMT -6)   
Can anyone tell me what  a cecal patch is?? I went to my dr and had them print out the notes that my GI had sent to my GP about my last visit. It states my diagnosis is severe ulcerative proctitis with a cecal patch. Just trying to figure out what that means.
 
thanks
Colonoscopy on 4/23-diagnosed with severe ulcerative proctitus
 Meds:
12 Asacol/day - don't think it actually is working
proctofoam at night
prednisone (10 mg) tapering - upped it again til august 6
Vitamin D
Calcium 
Azathioprine (50 mg)   serum sickness reaction 
pentasa  didn't work
canasa   didn't work
 
 
Waiting to feel healthy again and waiting on the next plan of action since can't take azathioprine....
 
 
 


Collicat
Veteran Member


Date Joined May 2009
Total Posts : 827
   Posted 8/7/2009 11:44 AM (GMT -6)   
Hi,
My son had the exact same diagnosis. It is fairly common, in ulcerative proctitis, for there to be an area of inflammation in the cecum. The cecum is the area just before the large intestine and very close to the appendix. In the old days some doctors used to say that this "patchiness" (inflammation in the rectum as well as in the cecum) was an indication of Crohn's. THIS IS NO LONGER THE BELIEF! As best as I know it is not really understood, but there seems to be some connection between the appendix (and cecal area) and ulcerative proctitis.
Hope this helps

lovemyboys09
Regular Member


Date Joined Apr 2009
Total Posts : 249
   Posted 8/7/2009 11:49 AM (GMT -6)   
Oh that definately helps!! And what is funny about what you said is that I was originally diagnosed with crohns disease and then switched GI's because I didn't care for mine. My new one said severe ulcerative proctitis with cecal patch. Hmm can I get my appendix out if it is connected to that issue and have all my symptoms go away. ..wish it was that easy!!
Colonoscopy on 4/23-diagnosed with severe ulcerative proctitus
 
Meds:
proctofoam
prednisone (15 mg)- staying at that for this minute
Vitamin D
Calcium
Discussing Remicade
 
Azathioprine (50 mg)   serum sickness reaction 
pentasa, canasa, asacol  didn't work
 
 
 
 
 
 
 


Collicat
Veteran Member


Date Joined May 2009
Total Posts : 827
   Posted 8/7/2009 1:19 PM (GMT -6)   
I believe that there are some statistics out there that say the people that have had their appendix out have a lesser chance to get ulcerative proctitis/colitis in the first place, but I don't know how strong these numbers are. I know there is some talk that maybe that means that if you had your appendix out that you could improve your ulcerative colitis. I believe most doctors think this is pretty hokie. Like you said, if only it was so easy....everyone would be getting their appendix out!

quincy
Elite Member


Date Joined May 2003
Total Posts : 31004
   Posted 8/7/2009 1:23 PM (GMT -6)   
yes, there's a form of UC where both ends are affected and not in between. It's believed this will eventually turn into pancolitis.

Whether it does or not....BOTH ends approach is most important, and anyone having this form should be treated with an oral med as well as rectal.

Rectal treatment itself isn't enough....for one's symptoms will continue or even more stubborn.

quincy
*Heather* Status: ...Asacol 3 twice daily; Salofalk enemas every 2nd night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


lovemyboys09
Regular Member


Date Joined Apr 2009
Total Posts : 249
   Posted 8/7/2009 3:30 PM (GMT -6)   
thanks for the information.  Well i am sure hoping that mine doesn't turn into pan colitis. All treatments have been failing me already to take care of just proctitus with the cecum patch. My dr is trying to pursuade me to do the remicade infusions....but not sure I want to yet. He says there are no other meds that would help me.  I had an appt yesterday with him and for the first time he told me that if the remicade didn't work or quit working that surgery would be some where in my future.  That just freaks me out! 
Colonoscopy on 4/23-diagnosed with severe ulcerative proctitus
 
Meds:
proctofoam
prednisone (15 mg)- staying at that for this minute
Vitamin D
Calcium
Discussing Remicade
 
Azathioprine (50 mg)   serum sickness reaction 
pentasa, canasa, asacol  didn't work
 
 
 
 
 
 
 


Collicat
Veteran Member


Date Joined May 2009
Total Posts : 827
   Posted 8/7/2009 6:19 PM (GMT -6)   
Try not to let all this freak you out too much. I am not sure how long you have been dealing with this crappy disease. I see in April that you had your colonoscopy. Was that at the beginning of all the trouble? If so that is not very long even though it may seem like a lifetime. As I said my son was diagnosed with ulcerative proctitis. That was two years ago. He has gone through 3 rounds of flares and we cannot get this last one under control. The first time a short burst of prednisone worked great but has subsequently lost it's power. We have gone the remicade route. There are so many people that remicade has worked amazingly for but sadly we are not one of them. He has had 8 infusions and they help somewhat but all the drug, as measured in blood tests, is gone within two weeks after infusion, so he gets sick again. We are now very seriously talking about surgery and have a tentative date of Oct 5th. My main point is that, at the beginning, I would never have dreamed of remicade and, god forbid, surgery. However my son, who is 18, is so fed up with missing out on his "life" that he wants to take control and get it back. In the disease world, we really are so blessed that we have the option of surgery....so many people are sick with other auto-immune diseases that they have no option except for these hard hitting drugs and just waiting for the next flare to occur. I truly hope that you can get things under control with medications, as the vast majority of ulcerative colitis patients can, however if the surgery route becomes inevitable you will be amazed, when you look into it, that almost everyone has the same complaint...that they did not do it sooner!

lovemyboys09
Regular Member


Date Joined Apr 2009
Total Posts : 249
   Posted 8/7/2009 8:49 PM (GMT -6)   
My first colonoscopy was Oct 07. I then had another one in April 09 and I am having a flexible sigmoidoscopy this coming Thursday. Since being diagnosed....I have never been in remission. I just hate the idea of surgery because I have 2 boys that are ages 5 and 11 months. My fiance is a baseball coach that travels alot which makes me have my boys alot of the time on my own. I know that if I had to have surgery that we would have to work something out. I am tired of going to the bathroom...the prednisone....the constant stomach pain...the nauseousness when I eat....and medicine. Eventually I will probably have to think about surgery (espcecially if the remicade fails)....but it was just a huge shock the first time the dr ever brought it up.
Colonoscopy on 4/23-diagnosed with severe ulcerative proctitus
 
Meds:
proctofoam
prednisone (15 mg)- staying at that for this minute
Vitamin D
Calcium
Discussing Remicade
 
Azathioprine (50 mg)   serum sickness reaction 
pentasa, canasa, asacol  didn't work
 
 
 
 
 
 
 


LondonRed
Veteran Member


Date Joined Oct 2007
Total Posts : 1198
   Posted 8/8/2009 1:03 AM (GMT -6)   
This is exactly what I have, inflammation on the left hand side and apatch of inflammation on the right hand side Cecum - I have a Crohns diagnosis. It doesn't matter though as the treatment is the same. The best treatment is Pentasa as that starts treatment in the small bowel and Cecum and carries on throughout.

Diagnosis Oct 07: Mild Crohn's Colitis. Also suffer from bleeding Peptic Ulcers. By the grace of God currently in remission. Current Medication: 1000mg Pentasa Tablets x 2 a day. VSL#3. Asacol Suppository at night.


lovemyboys09
Regular Member


Date Joined Apr 2009
Total Posts : 249
   Posted 8/8/2009 10:13 AM (GMT -6)   
I have tried pentasa and had no effect on me. I was originally diagnosed with crohns but when i switched drs due to the lack of knowledge and care of my first GI ...my new GI stated that it was not crohns that it was ulcerative colitis.
Colonoscopy on 4/23-diagnosed with severe ulcerative proctitus
 
Meds:
proctofoam
prednisone (15 mg)- staying at that for this minute
Vitamin D
Calcium
Discussing Remicade
 
Azathioprine (50 mg)   serum sickness reaction 
pentasa, canasa, asacol  didn't work
 
 
 
 
 
 
 


Collicat
Veteran Member


Date Joined May 2009
Total Posts : 827
   Posted 8/8/2009 11:49 AM (GMT -6)   
LondonRed that is very true that treatment is the same unless the medications are not working so well and one is possibly headed towards surgery and possibly a J pouch. I don't believe they will create a J pouch is it thought that you have Crohn's. I am happy that you are one of the lucky ones and am able to stay in remission.

TPT
Regular Member


Date Joined Feb 2005
Total Posts : 102
   Posted 8/12/2009 12:50 AM (GMT -6)   
The “cecal patch” in patients with ulcerative colitis

Kleanthis Dendrinos MDa, Sandra Cerda MDb and Francis A. Farraye MD, MSca

aSection of Gastroenterology, Boston University Medical Center, Boston, Massachusetts, USA

bDepartment of Pathology, Boston University Medical Center, Boston, Massachusetts, USA


Available online 11 July 2008.
Article Outline

Disclosure

CommentaryUC is a disease that classically begins just inside the squamocolumnar junction of the anorectum and extends proximally for a variable distance in a circumferential and uniform fashion, without “skip” areas. There are 2 types of segmental inflammatory change, however, that may be seen in patients with UC, and that may lead to confusion with Crohn's disease: backwash ileitis and the cecal patch; neither affects the course of the colitis. Patients with UC with backwash ileitis usually have involvement of the cecum and pancolitis, but may have only left-sided disease. An isolated cecal patch of inflammation, as in the present case, is present in many patients with left-sided UC or proctitis/proctosigmoiditis. We have learned that cecal inflammation may be part of normal cecal health, and that the cecum has a higher percentage of eosinophils, Paneth cells, and laminar propria inflammation than do other areas of the colon. The important lesson: don't diagnose Crohn's disease just because you see a patch of cecal inflammation in a patient with distal colitis. Pythagoras believed he could judge the height of Hercules from the length of his foot (ex pede Herculem), and from this it was extrapolated that from a sample one can judge the whole. This adage certainly is not evidence-based, and should not be used to rationalize judgment of the nature of colitis from the presence of a cecal patch
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