See my inline responses below:
I’m getting annual scopes but the biopsies can easily miss dysplasia?
Biopsies are generally taken randomly, but can be targeted to a specific area if it looks unusual.
You can always ask for a Chromoendoscopy given your family history with colorectal cancer. Essentially a dye that's applied makes unusual areas more vivid and easy to spot. It redcues the odds of missing something.
Or should I start Entyvio and hopefully go into long term remission despite the risk of reactivating TB and the other risks of immunosuppression?
You could ask for Entyvio, we've had some patients take entyvio here after getting cleared of TB by an Infectious Diseases Doctor. They did fine afterwards.
You could ask for immunomodulators (imuran/azathioprine or 6MP).
I'd mention the thoughts to your doctor and see what he/she thinks. Overall, your quality of life is much better when UC is in a deep/quiescent/histological remission, and your long term odds of colorectal cancer are reduced. As long term inflammation causes dysplasia which becomes cancer. You want to be as well managed and trouble-free for as long as possible!
I'd strongly recommend finding the safest and best solution to control your UC and get into a histological remission. Biologics, immunomodulators, whatever is the best choice for you given your risk factor of CRC and past TB issue.
We're not doctors, so cannot say exactly what you should do. We can offer up opinions though!
Moderator Ulcerative Colitis
John, 39, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasaU.C. = Unimaginable Crapnado
Post Edited (iPoop) : 11/27/2017 7:55:32 AM (GMT-7)