Sure glad to help translate the medical jargon.
Another UC Mum said...
Pot C: D2
Biopsy D2: Her duodenum is the first part of the small intestine, just past the stomach and it appeared 100% normal, with nothing unusual found. This was taken during upper-endoscopy.
Pot D: Transverse x 1 (1 sample taken in the horizontal part of the large intesine)
Pot E: Descending Colon x 2 (2 samples high up on the left side of large intestine)
Pot F: Sigmoid x 2 (1/2 way down the left side of large intestine)
Pot G: Rectum x2 (end of the left side of large intestine)
Biopsy for D-G:
Inflammation seen that has characteristics of both acute (infectious) and chronic inflammation. It's common to see acute changes in newly spread inflammation that has not been around long enough to have chronic changes. Chronic always trumps acute when both are seen, and chronic means an IBD like UC.
The inflammation was very shallow (affecting only the shallow lamina propria layer of intestinal tissue), which is an important clinical finding for a UC diagnosis.
Chronic changes were mentioned earlier, but now we get into what exactly were the chronic changes seen. A normal large intestine's surface is like waves on a pond with high peaks and low valleys. In medical jargon, the valleys are known as crypts. Crypts are of special interest in UC diagnosis, as we almost always have permanent architectural changes to our crypts and that's rather distinct to just UC diagnosis. What did they see? The normal pattern of crypts was distorted; a permanent architectural change. The crypts were clogged with junk that did not belong there (abscesses made up of immune cells), and the crypts were inflamed (a cryptitis).
Ulcers are distinct to UC diagnosis (in the name Ulcerative Colitis) and they were seen.
Your daughter does NOT have colorectal cancer (No evidence of dysplasia/pre-cancer or malignancy/cancer).
Conclusion: mild gastritis and moderate pan-colitis in keeping with ulcerative colitis.
Is this a definitive ulcerative colitis diagnosis? Yes, for the reasons cited above. A misdiagnosis is very, very unlikely. What you describe is pretty much a storybook case of UC, and I'd say 99% odds that a second opinion from another doctor would full-heatedly agree with her current diagnosis. UC can rapidly go into a remission, and she's normal while in it. That's common, and expected of UC patients. We all do flare eventually, even when we are the posterchild for taking our medications daily and do everything we are all supposed to. Part of the definition of UC mentions periods of remission and flares, and that's exactly what was experienced.
Has this been downgraded from Severe to moderate?Not all the inflammation seen is directly due to UC. The prep from the colonoscopy can temporarily inflame a bit as well.
What is a D2?That's sample number D2, from the duodenum, just beneath the stomach.
What does acute-on-chronic mean?Both infectious/acute and chronic changes were seen. Recent inflammation looks acute, old inflammation looks chronic. Again, one mention of the word chronic trumps all mention of acute. The acute inflammation seen will become chronic after more time.
Moderator Ulcerative Colitis
John, 40, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasaMy reviews on Yelp and Trip Adviser will be terrible: @$10,000 a night with uncomfortable beds and awful food, but at least the drugs are good at this hospital.
Post Edited (iPoop) : 6/14/2018 9:06:03 AM (GMT-6)