Colonoscopy didn't reveal much that was new in terms of inflammation:
- Ascending colon has defined vasculature that may show previous inflammation but no current visible inflammation
- Transverse colon normal
- Proximal descending colon normal
- Distal descending colon to proximal sigmoid colon has sharp and defined inflammation pattern that lasts for about
20cm. Inflammation is severe with superficial ulceration.
- Distal sigmoid colon normal
- Rectum normal (oddly, with 2 small apparent ulcers and no inflammation)
In sum, there is a patch, roughly 20cm long of severe inflammation that starts approximately 45cm from anus. Everything else is mostly normal.
GI thinks this is strange for UC and is considering changing diagnosis to Crohn's.
GI took about
12 biopsies all along colon which will inform updated diagnosis.
Given Crohn's potential, GI does not think 5ASAs will achieve remission, and believes biologics are most potent option. Does not feel more or different rectal meds will be effective.
GI is evaluating that subset of biologics that aren't strictly anti-tnfs like Entyvio. In addition to lymphoma considerations, need to go through screening for blood or immune issues that would contraindicate biologics.
Plan to stay on steroids (40mg) until biologic option evaluated.
Love your thoughts, they have been most helpful from above!
Diagnosed 2002 w/ proctosigmoiditis
Diagnosed 2015 w/ pancolitis
In remission from 2015 to 2017 on 2.4g Mezavant (Lialda) Daily
Status: Flaring since early May 2017 - Trying to get into remission
Meds: 40mg Prednisone daily, 4.8g Mezavant (Lialda) Daily, 2g Salofalk Enema in morning and again at nigh
Vitamins/Minerals Daily : Curcumin 750mcg, Vitamin D - 1000 IU; Calcium-1300mcg
Post Edited (jkingfrt) : 5/20/2017 11:00:59 AM (GMT-6)