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Colonoscopy results - help

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Ulcerative Colitis
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Posted 6/27/2014 5:55 AM (GMT -5)
So just had a colonoscopy and as always the docs don't sit and explain what the report means.

I thought I'd ask on here, I know we're not doctors but you've got such experiences. Two questions really, it says I have confluent proctocolitis from rectum to splenic flexure. What's proctocolitis?

It also says 'distal rectal sparing' what does that mean?

Thanks
Posted 6/27/2014 9:11 AM (GMT -5)
I think it means you have chronic inflamation through the sigmoid and left colon. The rectum itself looked good.

Unless there is also histology that describes cell changes consistent with idiopathic UC, this could still be infectious UC, or allergic reaction, or something other than the relapsing remitting autoimune kind.

Usually and detailed discussion of reports are done at followup visits, which can be weeks later, or even get lost if you primary had sent you to a gi for diagnosis - because then it is unclear who will follow you. I had to make several calls to find out I was getting a gi appointment, and then to get the nurse to have some prescriptions sent in the meanwhile.

the language you see seems to be part of a standardized naming system called SNOMED. I had not hear of it before, but the phrase popped up in google.

www.snomedbrowser.com/Codes/Details/369445005

systems.hscic.gov.uk/data/uktc/snomed
Posted 6/27/2014 10:21 AM (GMT -5)
OK thanks for all that information. What's proctocolitis?
Posted 6/27/2014 10:41 AM (GMT -5)
http://en.wikipedia.org/wiki/Proctocolitis
Posted 6/27/2014 1:39 PM (GMT -5)
proximal rectal is 6cm - 12cm. Distal rectal is anal verge to 6cm....so it means that the lower part of your rectum has sparing. Not very much.

The rest of your rectum up to the splenic flexure has continual inflammation.

Your biopsies will tell more regarding the structural changes/architecture as to the consistency with UC, CD or other.

q
Posted 6/27/2014 2:01 PM (GMT -5)
Ah OK. Thanks. Makes sense. I've been on balsalazide now for months and by the look of it, it's not working.

The strange thing is, I don't have any discomfort, only have 1-2 bms a day and rarely have blood. So I'm happy with that. I'm guessing it's not that bad at the moment but I'll need to get it even more well mended.
Posted 6/27/2014 2:16 PM (GMT -5)
Yes, I hope your doc changes your oral med to another 5ASA...oral Salofalk could be a good start.

You're in the UK?

q
Posted 6/27/2014 2:50 PM (GMT -5)
I am in the UK yes. I started on the mesalazine granules for 6 months. Had a little flare and he popped me on balsalazide. Since I've been on them things haven't cleared up as well so I'll be suggesting going back to granules.

I can see how any of this is that bad with only a couple of bms a day with rare blood.
Posted 6/29/2014 4:48 PM (GMT -5)
Balsalazide is the preferred oral 5-ASA med for left-sided UC, which seems to be what you have. (Since c-scope report mentions inflammation from splenic flexure downward to rectum, which looked partly O.K.) But you also said you flared while on mesalamine granules-- so if you go back on them it could happen again. I'd suggest asking your doctor which section of left colon showed the worst inflammation during scope. If that was the sigmoid or below, you could try adding Salofalk liquid retention enemas to your Balsalazide regimen. The oral med + retention enema might be enough to get you to a solid remission within a month or 2 if you see no blood & only have 1-2 bms daily. In the UK you also have the option to try the mesalamine foam retention enema, which treats inflammation in rectum & anal canal. / Old Hat (33 yrs with left-sided UC; presently in remission taking brandname Colazal)
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