As earlier stated, husband had pancolitis in 2013, meds cleared all symptoms in less than a week and he just had a checkup colonoscopy in Oct 2018. His first stool he had blood on tp and thereafter every stool. Two weeks ago doc saw him, upped his mesalamine, added a short course of low dose pred and flagyl.
After 2 days the bleeding stopped and has stayed gone. Two week follow up today and doc is strongly insisting on an abdominal CT and suddenly says colonoscopies miss a lot of things and there is a 20% increase in cancer of the colon in UC patients and he just really needs to take a look another way. It has only been 4 months since the colonoscopy....
It is hard to go beyond the general responses you got already without more understanding.
I am not clear from what you wrote what was seen on the scope. Some biopsies were taken and that may be related to some short term bleeding. But how much inflammation was seen? They only tend to biopsy in inflamed areas.
I am wondering if your husband typically has few symptoms even when there is inflammation. For one, nobody goes from pancolitis to "all inflammation gone" in a week. Nobody
. Some people who don't have symptoms proportionate to inflammation, may go down to zero symptoms after a week on meds. But you can bet it took longer for the meds to clear the inflammation from the entire colon. Maybe they never completely cleared it, and since there were no symptoms you never knew.
The "remission" was based on symptoms, aka clinical remission. There was no followup scope to confirm histological (tissue level) remission. Worse case, there was under-treated inflammation for 6 years.
So it is hard to conclude "perfect health". Maybe, maybe not. If the new scope showed areas of active inflammation, then likely it has been there for all 6 years.
An important step is to get the report on scope and the separate report on the biopsies. If the biopsies showed active UC, not quiescent, then the doc may be responding to finding active UC in a patient that had assumed to be in remission. A little bleeding after scope/biopsy is typical, and not generally a reason to up mesalamine, add a course of pred, and also introduce a strong antibiotic. It reads like you think the doc made these changes only in response to the bleeding. You need to ask if it was in response to what was seen, or what he later read in the pathology report.
IF he did not see inflammation, and only upped long term med and added short term meds to respond to bleeding, and now only wants to do the CT in an abundance of caution (or maybe he owns the CT machine), then fine. No, it is likely not needed.
But, if he came to understand that there had been over half a decade of under-treated inflammation, and has a more case-specific concern about
colon cancer risk, then the CT starts to seem more justified.
Get the reports. Ask if he thinks the apparent 6 years of clinical remission was likely not a true remission. Ask if he has case-specific concerns that justify the CT, or if the dual use of scope and CT is just his standard of care.
Get these answers, and then make a decision.
Post Edited (DBwithUC) : 2/7/2019 2:47:44 PM (GMT-7)