The point of the scope (for everyone else) is to get diagnosis and/or check remission status. they look for ulceration, the look at patterns of ulceration/inflammation, and they take biopsies that either will or will not show the histological changes of UC.
In this case, as I read what has been posted, the biopsies in 2010 DID NOT SHOW UC, and the diagnosis was made based on other symptoms. This is questionable since histological changes are required. Maybe they just did not biopsy the exact right spots. But diagnosis (even provisional) does give a basis for prescribing and for insurance reimbursement. The alternative would be more extensive, likely expensive, and maybe not readily available tests to figure out exactly what if not UC. Sounds like in 2010 they decided to assume UC and treat.
However, the pattern of flares being small, resolving so quickly, staying quiet for months w/o any anti-inflammatory meds, and then predictably returning - well that is possibly UC, but it is an odd pattern. Sorta not very UC'ish.
Now some recent labwork also fails to show evidence of UC even thought you are flaring. That is super-odd. That is why the new doc wants to get your colon figured out. If you don't have UC you might have something rare but curable. Or you could have something real serious that needs to be found. -- But, you could just have an atypical case of UC.
Since you do not describe recent labwork it is hard to have more insight. If the labs tested serum and stool markers of inflammation, and tested blood counts and eosinophils and antigens... etc, and all were normal that is much more odd than if they just tested one marker of inflammation.
Having symptoms "unmasked" is a good idea for getting your colon figured out. If the histological signs are there when things get a little worse, then the diagnosis is complete, and the question, "Is this something else?" can be put to rest. It is an unfortunate idea for getting this flare resolved quicker. But it seems to be an option you have, while someone suffering more from flares could not afford to get worse. Further, your history of responding quickly also argues for risking getting a little worse - because there is good expectation to have good response to meds after scoping.
You may choose not to do this. You may choose to find a GI who will just continue to treat the symptoms. But what this GI wants to do makes a lot of sense.
Blood and mucus is generally colitis, but it can be other things.
Post Edited (DBwithUC) : 10/22/2013 2:47:28 PM (GMT-6)