For any of those that may go through what I did: I went in for a colonoscopy last November and they found the typical active inflammation in my rectum with inactive chronic colitis throughout the rest of my colon. They also found what they thought to be an inflammatory polyp arising from the active inflammation in my rectum. Path results came back and it was found to be a dysplastic polyp (which is the type of polyp commonly found in older folks). My GI doc said that since this was a dysplastic polyp arising from active inflammation and that I was a younger patient (29), that he classified the polyp as a DALM. Current guidelines recommend total colectomy as the DALM can be an indicator of underlying cancer. So, I had the polyp removed as well as more random biopsies taken out. The polyp was removed in its entirety, no evidence of dysplasia in the area surrounding the excised polyp, and no other dysplasia throughout the rest of the colon. My doc still advised me that this didn't put me in the clear and that colectomy was still advised. I did my own research and came upon the following report at http://sadieo.ucsf.edu/course/old/AdenomaDALM.pdf
This guy basically said that if a DALM was found and was amenable to resection, that it was removed in its entirety, and there was no further evidence of dysplasia elsewhere in the colon, than colectomy is not needed. This was all regardless of the age of the patient. Frequent surveillance is of course needed. I even mailed this guy (Dr. Rubin) my whole story with path results and surprisingly he gave me a call a week later (he is one of the top GI docs based out of Mt. Sinai). He basically repeated his recommendations from his paper. So now I have to get scoped every three months for the first year and if nothing further is found I will get yearly scopes thereafter. Much better than getting the whole thing taken out! My UC has always been fairly mild even while flaring. I think getting polyps (other than inflammatory) is pretty rare for those with the UC that are young. I just wanted to put this out there for anybody else who happens to fall into a situation like mine. Never take what the doc says at face value. Unfortunately I'm limited to who I can see since I'm in the military and that's too bad because my GI doc is not an IBD expert. Yeah the current guidelines may recommend colectomy but everything in the medical world changes frequently. The new guideline may later change to just frequent surveillance.