Can someone help me understand my colonoscopy?

There's not a lot there to understand. Everything from the terminal ileum to the sigmoid colon is reported as normal, with moderate UC in the rectum. I presume transition point means where the UC starts, but am not sure.

I know your doctor is new, but if he refuses to listen to you I would consider finding an even newer doctor. If the same old meds aren't working, then it's madness to keep on trying them over and over again.

Ditto on finding a new GI who will listen to you and try new treatments. If you are stuck in a rut then it's time to mix things up a bit.

I would ask for meslamine-based enemas (a.k.a rowasa), as they go further than canasa and have much more active ingredient than canasa does. Not sure canasa would go the distance, in this case 25cms. No doubt the enemas would. Try the enemas daily for a month or so and if that doesn't significantly improve your symptoms then I'd move up the medicine ladder and try an immunosuppressive med (6mp, imuran, aza). Good luck.

I don't think staying on cortenema is recommended because it can cause thinning of that layer of rectum with long-term use. Better to use melamine enemas long-term, few side effects (unless you are allergic to melamine) and much better than suppositories (Canasa) because enemas treat a larger area.

Canasa could be used when you have no symptoms but really try and get non-steroid enemas. Push hard to get them and use them.

If you cannot get mesalamine enema Rx from this GI then get a different GI.

I agree with everyone else. A mesalamine enema should be what will address your specific problem the best. It's available in generic, if cost is an issue. (Some HMO's frown on brand-name Rowasa because of the cost.) If your doctor won't prescribe this for you to try, I'd consider looking around for another doctor again. After all, neither you or he has anything to lose by trying it. You might even agree to continue on the oral sulfasalazine to start with if this makes him feel better about prescribing.

As a 17-year UC veteran, it's likely you know more about your disease than the doc does. (My GI openly admits this, and listens to me.) Don't let him push you around. Get the facts to back up your request: the meds are topical, oral meds may not reach the rectum, rectal meds definitely do. I want to try... Then present it to him calmly.

I agree with above comments. It sounds like you have some inflammation in the lower sigmoid, which Canasa is unlikely to reach, so Rowasa would more likely help there. You could also try Cortifoam to help the rectum-- because it stays where you put it, unlike the liquid retention enemas, so you might try it during daytime when you're up & about. However, as ipoop mentioned, it's possible to have rectal inflammation that does not improve with steroids, and if that is really your issue you do need to find a gastro who can treat your UC knowledgeably with 6-MP or Imuran as a next step. / Old Hat (33 yrs with left-sided UC; presently in remission taking brandname Colazal)