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Colonoscopy results - help

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Ulcerative Colitis
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Diss_UC
New Member
Joined : Apr 2014
Posts : 13
Posted 5/4/2021 12:03 PM (GMT -6)
Hello

I had flare up around christmas time (calprotectin 1400) so my GI scheduled a colonoscopy. Before the c-scope I had 2 more calprotectin tests (42 and 29, so normal results). I had the c-scope a week ago and still waiting on the results from the biopsies.

My GI said that the colon looked very good and the only thing he noticed was a small red spot in the terminal ileum. Since I have been diagnosed with UC I was wondering if the redness in terminal ileum is normal. Does redness always mean inflammation or could it have been because of the bowel prep (irritation)?
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Simon1729
Regular Member
Joined : Apr 2021
Posts : 44
Posted 5/4/2021 1:18 PM (GMT -6)
I had the same experience as you...bloods looked really good all yea, no symptoms, scope showed mild redening of the distal colon but my GI was happy....are you getting any right sided pain
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UCyousee
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Joined : Feb 2014
Posts : 470
Posted 5/4/2021 4:11 PM (GMT -6)
I have patchy UC (it's not continuous) and quite often have a patch by the caecum, along with pain in the lower right side. Biopsies show this to be UC and not Crohns.
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Diss_UC
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Joined : Apr 2014
Posts : 13
Posted 5/4/2021 10:07 PM (GMT -6)
I don't have any lower right pain and according to the GI the cecum looked normal. There was only mild reddening in the terminal ileum. I'll get the biopsy results in 3 weeks. Hopefully, it will show no inflammation at all.
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Simon1729
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Joined : Apr 2021
Posts : 44
Posted 5/5/2021 2:44 AM (GMT -6)
Patchy inflammation is usually a sign of Crohns. However, and this is a mistake I see a lot on this site, patchy inflammation will also present in UC when it is medicated. UC will develop continuously but does not heal under therapy in a continuous way and so can give patches of the colon that are not yet as healed as much as others. Cobblestone appearance of the patches is the more definitive sign of Crohns.
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VanJordan
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Joined : Dec 2019
Posts : 428
Posted 5/5/2021 3:55 AM (GMT -6)
I have cecum inflammation that extends into the terminal ileum along with patchy inflammation in my colon. My official diagnosis is pancolitis at this point because the patches merged and became continuous, but originally I had a patch of inflammation at each turn in the colon (the "plexuses") and then continuous inflammation in the last 12 cms of colon. They gave me the dx "interdeterminate colitis". To this day nobody can tell me 100% if it's UC or Crohn's or what. In my reading of the research about disease presentation, it turns out that there is still some lack of clarity about distinguishing the two. Some people are clear cut cases but a lot aren't. I unfortunately am one of the not so clear ones.

It's not uncommon for left sided UC flares to have right sided pain because there is a huge amount of lymphatic/immune tissue at the very end of the terminal ileum called Peyer's Patches. It's how the immune system activates in the bowel. When flares are severe these can really swell up.
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Diss_UC
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Joined : Apr 2014
Posts : 13
Posted 5/5/2021 5:22 AM (GMT -6)
I noticed I was a little bit unclear. I was diagnosed with pancolitis in 2013. Since then I`ve had 2 colonoscopies which showed minor inflammation in the left side. This was my 3rd one and it was only showing minor redness in terminal ileum. I just thought it was weird that the colon looks good but TI is mildly reddened.
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UCyousee
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Joined : Feb 2014
Posts : 470
Posted 5/5/2021 5:46 AM (GMT -6)

Simon1729 said...
Patchy inflammation is usually a sign of Crohns. However, and this is a mistake I see a lot on this site, patchy inflammation will also present in UC when it is medicated. UC will develop continuously but does not heal under therapy in a continuous way and so can give patches of the colon that are not yet as healed as much as others. Cobblestone appearance of the patches is the more definitive sign of Crohns.

Simon1729, to clarify, I was diagnosed, unmedicated, with patchy UC. This isn't due to medication healing my bowel in a non-continuous way. My Gastro believes that I probably still have microscopic UC in the areas that don't visibly show ulcers, but my diagnosis is patchy UC.

In my case this is no mistake. Although this is atypical, apparently it's not rare:

https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4071881/

Post Edited (UCyousee) : 5/5/2021 5:58:01 AM (GMT-6)

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Simon1729
Regular Member
Joined : Apr 2021
Posts : 44
Posted 5/5/2021 6:05 AM (GMT -6)
I agree with you. Lots on this site seem to link patchy inflammation with Crohns. It does have a greater prevalence but it simply is not a diagnostic tool. Patchiness can indeed be found in UC.
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16373
Posted 5/5/2021 12:47 PM (GMT -6)
Yes, redness can be entirely from the harsh colonoscopy prep. Biopsies tell if it's superficial (from the prep) or actual Inflammation.
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