Tex a question

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lando
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Tex a question

Post by lando »

My daughter had her colonoscopy. The Dr said it came back normal. Now what confused me, she had one done in 2012, and she told me yesterday that she had a low grade active colitis, in her large intestine. When we got the results after the first one, she never mentioned that. She just said my daughter was lactose intolerant. Now, after the 2nd one, she isn't LI anymore.
Now, the Dr. wants to do a MRI, and a pill cam. I wanted the Dr. to put her on mesaline(sp) to see if it would help, but the Dr. refused and said it had too many side affects. She gave her some antispasmodic pills I couldn't get the count of cells, like you suggested.

My daughter symptoms, are pain in lower right abdomen, some D, and major urgency issue(but where you don't have to go).

Any insight on what she might have, I know you are not a DR. and it is your opinion only.
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tex
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Post by tex »

Hmmmmmm. If the "low grade active colitis" was noted during the original exam, but the doctor didn't mention it until years later, I've had that happen to me also, where a GI doc withheld information collected during a colonoscopy. IMO, withholding such information should be illegal, but that's another issue.

Without a copy of the original pathology report, it's difficult to guess what your doctor is referring to. If the "low grade active colitis" was a gross observation (visible through the scope with the naked eye), then it would possibly be suggestive of the early stages of Crohn's disease. That information would be noted in the original endoscopy report (written by the GI doc). But GI docs often withhold information about MC, because they don't consider it to be a major problem, so the reference might have been to the possibility that the pathologist might have diagnosed your daughter with MC, but your doctor didn't see the need to pass that information on. That information would be found in the pathology report (not the endoscopy report).

But I'm confused. After reading your post, it's not clear to me when the "low grade colitis" was observed by the doctor. Was it in the earlier colonoscopy, or the more recent exam?

Since it's impossible to detect lactose intolerance with a colonoscopy exam, I'm assuming that your daughter was given a conventional lactose tolerance test (both times). Since that's not standard procedure, it's interesting that such a test would be ordered each time that a colonoscopy exam was ordered. Apparently that's part of the doctor's standard MO.

Since lactose intolerance is typically a result of inflammation in the small intestine (except for those individuals who are chronically lactose intolerant because of genetics,surgery, or some other cause), then if your daughter is actually not lactose intolerant now, inflammation must not be a problem. But that wouldn't be consistent with the doctor requesting an MRI and a pill cam. So either I'm confused about what you are telling me, or the lactose intolerance conclusion is incorrect.

If that doctor is afraid to prescribe mesalamine because it has "too many side effects", then there is no effective anti-inflammatory medication available that she could prescribe to treat an IBD.

Based on the symptoms you mentioned (and the tests requested), the doctor is probably trying to rule out Crohn's disease in the jejunum or the ileum. Of course those symptoms also match the early stages of MC for some cases. UC is not an option because it always begins at the bottom of the GI tract, and if any UC lesions were present, they would have been noted during the colonoscopy exam.

A fecal calprotectin test might offer some useful information if she is trying to rule out an IBD, and it's a much better test for measuring inflammation levels (with regard to a possible IBD) than a lactose intolerance test. I'm kind of surprised that the doctor has not ordered that test.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by lando »

Yes, the active colitis was found in 2012 but I didn't find out until 2 days ago, when she was comparing the results of the 2. Yes, in 2012, she was told she was LI, now she was told she wasn't.
The Dr. is trying to see what is going on in the Small intestine. Where the endo and colonscopy can't get. I guess to see if there is any inflammation.
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Post by tex »

Thanks for clarifying it. That's the way that I initially read your post, but the sequence of events seemed so unusual that I wondered if I had misread it. The additional tests should provide some clues, if anything is going on in the small intestine.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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