I've been in endoscopic remission for the last 2-3 years, but recently, did a calprotectin that showed in the three-hundreds, so went in for a colonoscopy.
Doctor said colon actually looked pretty good. The only findings were mild inflammation in the sigmoid colon (lack of visible vasculature). PA and I decided to try some melamine enemas for a month since this is the optimal place for mesalamine to work, and then see if the calprotectin score comes down.
However, in the last 3-4 years, my biggest issue has been a running battle with constipation. And I'm finding the mesalamine enemas is actually making this worse. I did a little research and found constipation is a known side effect for the enemas. Has anyone experienced this, and if so, how did you deal with it?
(On a side note, I've had a couple biopsies during scopes (including this one) that showed granulomas, which is apparently specific to Crohn's not UC. The gastro's office didn't even comment on it, but I have asked for small intestine CT scan to see if there's anything going on up there. I'm not expecting much as I had a CT there three or four years ago and it showed nothing that looked like Crohn's, but still, I want an current look since these granulomas keep popping up in biopsies, even while the coon is calm.) Seems like my diagnosis may be evolving from UC to Crohn's.
You say in sigmoid...but is that including /rectum and into sigmoid?
MODERATOR - UC FORUM *Heather*
MODERATOR - UC FORUM *Heather*
No, just sigmoid. Rectum looked fine.
Seems CD... considering the granulomas and rectum not involved. But did you get the biopsies pathology results, and if yes, what were rectal results? Early CD can mimic UC.
Re enemas...it's not the enemas causing the constipation...it's the inflammation. But usually with rectal inflammation limited to or within. You could try the steroid enemas . I have UC...so I would assume your inflammation pattern and symptoms can work differently (which Ive not experienced).
Keep us updated on how you're doing.
q
MODERATOR - UC FORUM *Heather*
Re enemas...it's not the enemas causing the constipation...it's the inflammation. But usually with rectal inflammation limited to or within. You could try the steroid enemas . I have UC...so I would assume your inflammation pattern and symptoms can work differently (which Ive not experienced).
Keep us updated on how you're doing.
q
MODERATOR - UC FORUM *Heather*
No rectal biopsies taken as it appeared normal. Only sigmoid colon.
If it's Crohn's and not UC, it's playing a really long game. I've had two different small bowel CTs over the last 11 years (since UC diagnosis) and neither showed any signs of Crohn's. But Thursday we'll see what the current state of affairs is. I've also had biopsies that didn't show granuloma, so it's hit or miss.
I've had intermittent constipation for about the last 5 years, including when (while) my colonoscopies showed endoscopic remission. So, while the mild inflammation in the sigmoid could be responsible for my normal level of constipation, what I'm experiencing since Day 1 of starting the mesalamine enemas is a whole different level. And as constipation is a listed side-effect of the enemas, I'm more inclined to believe they are responsible for the sudden increase in constipation.
If it's Crohn's and not UC, it's playing a really long game. I've had two different small bowel CTs over the last 11 years (since UC diagnosis) and neither showed any signs of Crohn's. But Thursday we'll see what the current state of affairs is. I've also had biopsies that didn't show granuloma, so it's hit or miss.
I've had intermittent constipation for about the last 5 years, including when (while) my colonoscopies showed endoscopic remission. So, while the mild inflammation in the sigmoid could be responsible for my normal level of constipation, what I'm experiencing since Day 1 of starting the mesalamine enemas is a whole different level. And as constipation is a listed side-effect of the enemas, I'm more inclined to believe they are responsible for the sudden increase in constipation.
It's unfortunate you didnt get biopsies from the rectum since it's youve been diagnosed with UC. Its the cellular level that tells moremthan just a visual. CD wont always happen in the the small intestine and ruled out if it's not...since it can happen anywhere from mouth to anus. Do any of your past c-scopes have pathology results of rectal biopsies?
q
MODERATOR - UC FORUM *Heather*
q
MODERATOR - UC FORUM *Heather*
Yes, I had pancolitis so I've had biopsies from all over the colon over the years.