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Colonoscopy Impression

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Ulcerative Colitis
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Posted 2/25/2017 10:46 AM (GMT -6)
Recently diagnosed as of February 2 with Ulcerative Proctitis at the age of 38. Please help me understand the following:

Diffuse erythema and edema noted in the distal 20 cm of the rectum.

It indicates no abnormalities until 20 cm from the anus at which point the diffuse erythema and edema with associated superficial mucosal scattered throughout the entire distal 20 cm of the rectum.

Wouldn't 20 cm go beyond the rectum? Also, Dr. never did stool test, etc. and straight to colonoscopy, which from reading here does not seem to be the norm.

I am on mesalamine enema 4gm/60ml daily thus far and improving.
Posted 2/25/2017 11:55 AM (GMT -6)
Yes, it would be on its way to the sigmoid.....i would suggest that oral mesalamine be added to your regimen.

KUDOS for your doc to prescribe retention enemas 😎..
What is the designated time regarding use of them, and do you see your doc in a month or so for follow-up?

Welcome to the forum,
q
Posted 2/25/2017 12:15 PM (GMT -6)
I will go back to Dr. in 3 weeks. He should inform me then of what to do. Any questions that are important to ask on that visit as he will also discuss biopsy results? Thanks.
Posted 2/25/2017 12:24 PM (GMT -6)
Do you have a copy of the biopsy pathology results?
q
Posted 2/25/2017 1:23 PM (GMT -6)
Nope, not yet.
Posted 2/25/2017 3:13 PM (GMT -6)
I'll translate.

Redness (erythema) and swelling (edema) starts at the sphincter and appears continuous (distal and diffuse) for 20 cms. That includes both the rectum and the sigmoid colon which would be proctosigmoiditis not proctitis. Although it's possible the biopsies confirmed actual inflammation within the limits of the rectum, making it a true proctitis diagnosus. Anything else could have been just irritation from the colonscopy prep.

I'd question your doctor as 20 cms is sigmoid colon. Get a copy of your biopsy report.
Posted 2/25/2017 3:43 PM (GMT -6)
Thanks for translation. I'll question Dr. and get copy of report. The Mesalamine enema is thankfully helping thus far.
Posted 2/25/2017 8:17 PM (GMT -6)
it does and doesn't matter. 20cm is easily reached by enema. some oral med is good to keep it form spreading, but treatment is about the same for procto and procto-sigmoid

depending on severity of symptoms it is not unusual to skip stool test. They are so prone to false negative. It was only after I had antibiotics 6mo into treatment and got a lot worse, that I had my first test for c-diff.
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