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fewer surveillance biopsies?

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Posted 12/1/2017 1:03 AM (GMT -5)
Does anyone have a GI that does only a few biopsies for your regular surveillance colonoscopies?

I've been feeling fine and just went in for my surveillance scope ... my doc is traditional and took four random biopsies every 10 cm.... Was doing great but now I'm reminded of what it's like to have a sore and bleeding colon....I thought that's what we were supposed to avoid. Lol! And...he wants me to come back every year for the same thing.

I've read that random biopsies only have limited utility for surveillance, and most dysplasia is actually visible if the doc uses chromoendoscopy.

Does anyone have a GI that uses a "lighter touch" for your surveillance scopes?
Posted 12/1/2017 1:44 AM (GMT -5)
Nope. My GI takes a bunch. I really wonder if punching a bunch of holes in intestinal lining is a good thing for folks with UC.
Posted 12/1/2017 3:13 AM (GMT -5)
It's not.

In this study, 1 in 8 people had a flare after a colonoscopy:
https://www.ncbi.nlm.nih.gov/pubmed/17206634

My first flare was induced by a colonoscopy, two weeks after the fact. If your immune system is already on shaky grounds with your bowel, then tearing out tissue samples could send it over the top.

My flare regions continue to be where the original biopsies were taken: sigmoid, splenic flecture (where transverse meets descending), and cecum. Of course they deny it, but it's the obvious explanation for my patchy colitis presentation.
Posted 12/1/2017 8:26 AM (GMT -5)
but it's the obvious explanation for my patchy colitis presentation.

Or the meds have healed your colitis unevenly, making it look like patchy colitis when it actually isn't. Or it really is patchy colitis and you have indeterminate colitis/as of yet undiagnosed Crohn's colitis.
Posted 12/1/2017 9:08 AM (GMT -5)

Casey_LB said...
I really wonder if punching a bunch of holes in intestinal lining is a good thing for folks with UC.

They don't know either, and it probably isn't...but I can only assume they are worried about getting blamed if you develop cancer.

Of course if the inflammation-causes-cancer hypothesis is correct then there must be at least a tiny chance that the biopsies themselves cause it....

Perhaps it's just better to stay the heck away from them if you're feeling OK?
Posted 12/2/2017 8:33 AM (GMT -5)

fredflats said...
I've been feeling fine and just went in for my surveillance scope ... my doc is traditional and took four random biopsies every 10 cm.... Was doing great but now I'm reminded of what it's like to have a sore and bleeding colon....I thought that's what we were supposed to avoid. Lol! And...he wants me to come back every year for the same thing.

I've read that random biopsies only have limited utility for surveillance, and most dysplasia is actually visible if the doc uses chromoendoscopy.

Does anyone have a GI that uses a "lighter touch" for your surveillance scopes?

You could always get a 2nd opinion from a new GI who believes in a “lighter touch”.
Posted 12/2/2017 11:59 AM (GMT -5)
So...you are wanting less biopsies done?

If your biopeies results are unremarkable precancer-wise, then you don't need to have them done every year. I went from every three to every two years....and have had UC diagnosed for almost 29 years.

I have around 30 biopsies done each time.

q
Posted 12/2/2017 3:21 PM (GMT -5)

IamCurious said...
You could always get a 2nd opinion from a new GI who believes in a “lighter touch”.

I guess what I am trying to figure out is: do such doctors exist? Because every GI I've seen believes in a protocol as strict or stricter than the one I go to....

Basically what I need to communicate is that, if I am feeling OK, there is no chance that I will agree to colectomy based on the "grade" of dysplasia assigned to some random biopsy. Absolutely no chance whatsoever, so the random biopsies are useless information to me. If I'm going to live with no colon, I'm going to need to see something that looks obviously abnormal to my naked eyes.

So I guess I'm just trying to decide whether I need a new GI, or whether I need to communicate my position more clearly to my current one.
Posted 12/2/2017 5:21 PM (GMT -5)
There is a large variance among GIs, or at least there used to be. I had my first colonoscopy in 2008 which diagnosed me with UC. The GI prescribed Colazal and said I didn't need another colonoscopy for about 7 years. That was almost 10 years ago, but nowadays it seems most doctors recommend scoping much more often.
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