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mcaguie
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microscopic colitis diagnosis

Post by mcaguie »

Hi all forum members,

I just joined this forum and have read many entries, WOW. What a resource this is! I was recently diagnosed with MC after a colonoscopy that included biopsies since I have been dealing with explosive D and other symptoms since 12/21/2015. That day I ate at 2 pieces of sushi and a salad at a popular restaurant. I'm not a sushi lover but my family and guests chose that restaurant. One of the 2 pieces of sushi didn't taste quite right to me, but since I never eat sushi I just thought I didn't like it. However, 30 minutes after that meal I was on the toilet with explosive D and had severe cramping.

My Dr. performed several blood tests, and stool tests to rule out parasite and other possible causes but all tests came out "normal", so she concluded that it was IBS. I had lost my well paying job in Nov. and was very worried about my finances, and she said that was a contributing factor to my IBS. I was frustrated with traditional medicine so in April I chose to do a 21 day Cleanse (Dr. Junger's) and after that my D stopped and symptoms disappeared for several months. In late August the explosive D and other symptoms (stomach cramps and gas) returned. I had already strictly excluded gluten, dairy, and soy after the Cleanse as I had identified them as trigger foods.

Now, after my MC diagnosis my Dr. has me on 2 tablets of Pepto Bismol 3x/day for 6 weeks. He also said that I could eat anything I wanted, which of course I knew I couldn't. I'm also working with a Homeopathic therapist who has me on Nux Vomica, Chelidonium, and Dulcamara. I'm 65 yrs. old and for some time during pre-menopause and post I took Ibuprofen PM (2) nightly to help me sleep.

Does anyone have ideas/answers to these questions:
1) Could the bad fish in the sushi be the initial culprit?
2) Did taking Ibuprofen PM have caused the inflammation in my colon?
3) Does the Pepto Bismol have negative interactions with the Homeopathic remedies? Therapist said "No".
4) If I already know that corn and eggs aren't triggers is it OK to continue eating these while taking Pepto?
5) I've ordered "Breaking the Vicious Cycle" and intend to follow that diet. Is that a good idea?

Thanks so much for any/all ideas/answers,
mcaguie
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Post by HappyBird »

Welcome Siegfried & Mcaguie glad you found us!
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tex
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Post by tex »

Hi Mcaguie,

Welcome to our Internet Family. To answer your questions, the most likely scenario is that years of use of Ibuprofen predisposed you to MC. The stress from financial issues added the second prerequisite (chronic stress), and the transient bacterial infection from the sushi provided the immediate inflammation escalation that initiated the chronic inflammatory process that leads to MC.

The Pepto Bismol shouldn't have any negative effect on the homeopathic remedies. Nothing would be likely to negatively affect them because they are fairly potent toxins. For example, nux vomica contains strychnine and brucine, 2 deadly chemicals. In Victorian times it was the major ingredient in rat poison, and it reportedly killed many people over the ages. Presumably the dose you are being given is below toxic levels, but I see no reason for you to be taking it, unless you're trying to prove how tough you are. The fewer harsh chemicals we put into our gut, the faster we are able to recover.

Chelidonium is used as a purgative (laxative). No one who has diarrhea-predominant MC needs a laxative.

Is that Solanum dulcamara? If so, it contains solanine, which is toxic. Both chelidonium and solanum have been historically used to treat skin problems, but I would be very hesitant to ingest them, especially if my guts were already inflamed with an IBD.

The point is, all 3 of those "remedies" contain inflammatory chemicals. Our intestines are already highly inflamed, and that is the reason why we have MC. Why take something that is guaranteed to perpetuate or add to the inflammation?

If you are sure that you are not sensitive to corn and eggs, then sure, it should be OK to eat them while doing the "Pepto" treatment. 6 weeks is about 2 weeks short of the standard "Pepto" treatment, but if you are already avoiding gluten, then Pepto is probably effective enough to mask the effects of corn and eggs (while you are taking the Pepto), even if you are sensitive to them. But please be aware that it is very common to react to foods that we "know" are safe, so you may have to keep them in mind after the Pepto treatment is ended, if your symptoms should begin to relapse.

The problem with the specific carbohydrate diet (SCD) is that it allows yogurt and cheese, both of which are loaded with casein, and most of us are sensitive to casein. If you eliminate dairy products from the SCD, you have the paleo diet. Therefore it's simpler to just start with the paleo diet, and eliminate the paleo items that you cannot eat. Please don't misunderstand me, the SCD diet may work if you ignore the advice to eat yogurt and cheese (and totally avoid them). But the vast majority of us who have MC cannot tolerate yogurt and cheese (or any other dairy products).

Again, welcome aboard, and please feel free to ask anything.

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.
mcaguie
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Post by mcaguie »

Thanks Tex! I thought homeopathic remedies were made from naturally occurring elements. Are the chemicals you mention elements on the Periodic Table or compounds? I agree that anything with laxative effects would be contraindicated in my condition.

I have been so frustrated dealing with this limiting condition, especially since I'm a runner and it really negatively impacts that since I find D gets worse after running, that I don't know what to do anymore. For now, I'm going to continue with the Pepto Bismol as it seems to be a fairly successful.

Do you have any experience with Naturopaths? Some friends of mine have recommended a doctor but having tried so many different healing paths, I'm reticent to spend the money. I'm pretty sure Medicare won't cover a visit to a Naturopath.

Thanks again; really appreciate your comments,
Cristina
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Post by brandy »

Hi Cristina,

Welcome to the forum! We get a lot of runners as members (not me.) You might be interested in some of the earlier discussions by runners. After 5 posts I think you can do searches on the forum. I have no experience with Naturopaths I think hanging out on the forum is one of the most productive ways to promote healing.

Brandy
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Post by Gabes-Apg »

Welcome Cristina

the tough part about seeing any practitioner (doctor, specialist, nutritionist, naturopath etc) is that MC is not fully understood. It is not the same as other IBD's...

Here is a section where I have collated various discussions about natural therapies etc
http://www.perskyfarms.com/phpBB2/viewforum.php?f=59
Gabes Ryan

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tex
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Post by tex »

Christina,

Yes, homeopathic remedies (and many allopathic medications, for that matter) are based on naturally occurring toxic compounds. And many toxins are used for medical purposes. But they are used for purposes other than to treat IBD. Arsenic for example, would be an example of a toxic element, but the chemical ingredients in the remedies you are taking are are all compounds, not elements. The only toxins associated with the treatment of MC that I can think of are in the cleanout solutions used to purge the gut prior to a colonoscopy exam, and those products are extremely caustic. In fact, some of them have been taken off the market because they were shown to actually cause MC for some patients.

As Brandy mentioned, we have many members who are runners. They have to limit their activities while they are recovering of course, but most of them go on to enjoy the sport as much as ever, after they are able to heal their digestive system.

For the money, Pepto Bismol is hard to beat, because in combination with diet changes, it is actually more effective at bringing remission than the prescription drugs. The problem is that some of us cannot tolerate it because bismuth can cause tinnitus, and in some cases, other neurological issues.

I have no experience with naturopaths, but many members here do. As Gabes pointed out, the problem with most naturopaths (and most other physicians as well) is that they don't understand that MC is unlike any other disease, and they try to throw way too many herbal treatments at it. Not only are most of those a waste of money, but they can prevent remission, in many cases. With MC, less is more. IOW, the less we put into our digestive system while it is inflamed, the faster the inflammation will resolve, and healing will begin.

The fastest and surest way to remission is a simple, bland, diet consisting of a few foods that we know are safe for us. After we are in remission, then we have the luxury of time and improved health to allow us to fine tune our diet so that we can develop a safe diet that will provide the nutrition we need to maintain optimum health for the rest of our life.

You're most welcome, and I hope that you will begin to see some substantial improvements soon.

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.
mcaguie
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Location: Boulder,CO

Post by mcaguie »

Thanks Brandy, Gabes Ryan and Tex for your helpful responses. I will definitely check out other runners posts and continue to read others on this site. I think for the time being I will follow a very restricted diet and continue taking the Pepto Bismol tablets as this combination seems to be relieving my symptoms (D and cramping). I'm glad to have found this site!!!!
Cristina
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Post by tex »

Cristina,

Here are a few old posts that turned up (among many) when I searched the archives for the word "marathon", older posts are listed first:

http://www.perskyfarms.com/phpBB2/viewtopic.php?t=277

http://www.perskyfarms.com/phpBB2/viewtopic.php?t=4236

http://www.perskyfarms.com/phpBB2/viewtopic.php?t=7707

http://www.perskyfarms.com/phpBB2/viewtopic.php?t=10472

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.
mcaguie
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Joined: Sun Nov 01, 2015 3:18 pm
Location: Boulder,CO

Post by mcaguie »

Thanks Tex! Just ordered your book too. I'm learning so much.
:-)
mcaguie
Siegfried
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Biopsy results for resent endoscopy/colonoscopy

Post by Siegfried »

Hi Tex,

As I previously mentioned, I was diagnosed with CC back in 2008 after an endoscopy/colonoscopy. Starting in 2009, I went gluten free. I believe that removing gluten from my diet made a big difference in the D, although my stomach continues to give me fits.

I just received the biopsy report from my endoscopy/colonoscopy that was done on 10/29/15, and it states no evidence of CC. Is that possible to be diagnosed with CC in 2008 but not in 2015? Under diagnosis it states "The presence of fundic-type glands in the duodenal mucosa may present as a nodule endoscopically. It may be metaplastic due to ongoing peptic injury or a congenital heterotopic process". And also states "Antral and transitional mucosa with minimal chronic gastritis". Does this make any sense to you? Do you think that it would still be beneficial to do the EnteroLab testing?

Thanks very much for your help,

Joe
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Post by tex »

Joe,

Yes, it's certainly possible that the T-cell inflammation in your colon has declined to below the diagnostic threshold, and it's possible that the collagen bands in your colon have returned to normal thickness. But CC is known to segue back and fourth to LC, so if they didn't actually check your T-cell count (lymphocytic infiltration rate) in your colon biopsy samples, it's possible that the disease simply converted into the LC phase, and they missed it. Does your pathology report mention any lymphocyte counts for the colon biopsy samples?

Chronic gastritis can be caused by an H. pylori infection, but it can also be due to the same type of inflammation associated with LC, namely T-cell infiltration into the mucosa and sub-mucosa regions of the epithelium. The problem is that most GI specialists do not recognize that CC and LC can affect any part of the GI tract, similar to Crohn's disease. Most simply consider it to be a disease of the colon (because of the name, colitis) and because of the inadequate original description of the disease that has never been corrected.

If you are still having symptoms, then EnteroLab test results might be helpful. At least they could rule out any food sensitivity issues.

You're very welcome.

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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Post by Siegfried »

Hi Tex,

I do not see anything on the report that mentions lymphocyte counts. Below are the Microscopic Descriptions and Diagnosis for the two biopsy samples that were taken during the colonoscopy.

Thanks again for your help,
Joe

Microscopic Description: (Specimen 1)
Colonic mucosa shows preserved crypt architecture and normal cellularity of the lamina propia. There are scattered macrophages containing brown lipofuscin pigment. There are no features of idiopathic inflammatory bowel disease, lymphocytic colitis, or collagenous colitis. No dysplasia or malignancy is seen.

Diagnosis:
Melanosis coli. No evidence of active or any specific colitis. Negative for dysplasia or malignancy.

Microscopic Description: (Specimen 2)
Colonic mucosa shows preserved crypt architecture and normal cellularity of the lamina propia. No neutrophilic activity is identified. The subsurface collagenous plate is not thickened and there is no increase in intraepithelial lymphocytes. No dysplasia or malignancy is seen.

Diagnosis:
Colonic mucosa with no diagnostic abnormalities. No evidence of idiopathic inflammatory bowel disease, lymphocytic colitis, or collagenous colitis. Negative for dysplasia or malignancy.
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tex
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Post by tex »

That was way too few biopsy samples to diagnose (or rule out) MC. With only 2 samples, it becomes very easy to miss the inflamed patches. Some doctors mistakenly believe that the entire colon should be uniformly inflamed if MC is active, but that's totally incorrect. MC always exists in randomly scattered patches, typically more numerous in the ascending (right side) colon and the terminal ileum. When an inadequate number of biopsies are taken, or when none of the samples- are taken from inflamed areas, that can lead to a false negative result.

It's certainly possible that there is no inflammation in your colon. But that can't be legitimately concluded based on only 2 negative biopsy samples. The GI doc doing the colonoscopy exam dropped the ball.

Melanosis coli is somewhat uncommon. It's typically associated with youth or a history of frequent use of laxatives.

The interpretations of the 2 samples that were taken are indeed correct — they rule out both LC and CC in the areas from where they were taken.

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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