I have about decided he is Looney Tunes. I explained how 9 mg is constipating me and 6mg allows the diarrhea to come back. He started out saying I think you are doing fine on 9 mg. Lets stay on that. He said if your bowels move 3 times a week that's fine. I said no you don't understand - when I say constipated, I mean no bm for 5 days. He said ok I think your fine on 6 mg. Lets do that and I'll see you in 4 weeks. I tried to question him again about diet and he finally said well you could try the FODMAP Diet if you want to. Then he says lets do that. 6mg Budesonide and stay on the FODMAP Diet and I'll see you in 4 weeks.
What keeps going around in the back of my head is that in the beginning when he first got the results of the biopsie, he said "the results are not "definitive" for MC but I think that's what you have". Is it possible they could be "not definitive"? What if that's not even what I have?
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grannykathy
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Some gastroenterologists apparently believe in second-guessing pathoiogists. They mistakenly believe that they actually know what they're doing concerning MC.
The fact is, more than 10 lymphocytes per 100 enterocytes is abnormal, and an indication of inflammation. But the minimum threshold for an official diagnosis of LC is 20 lymphocytes per 100 enterocytes. The area in between has no official description, except for the fact that cases of paucicellular LC are always associated with less than 20 lymphocytes per 100 enterocytes. And there are architectural differences that sometimes come into play. But the point is, if the pathology report says LC, it doesn't matter what the GI doc says, the patient has LC. LC is often overlooked (missed), but it is never incorrectly diagnosed. Many gastroenterologists apparently do not understand that simple fact.
Tex
The fact is, more than 10 lymphocytes per 100 enterocytes is abnormal, and an indication of inflammation. But the minimum threshold for an official diagnosis of LC is 20 lymphocytes per 100 enterocytes. The area in between has no official description, except for the fact that cases of paucicellular LC are always associated with less than 20 lymphocytes per 100 enterocytes. And there are architectural differences that sometimes come into play. But the point is, if the pathology report says LC, it doesn't matter what the GI doc says, the patient has LC. LC is often overlooked (missed), but it is never incorrectly diagnosed. Many gastroenterologists apparently do not understand that simple fact.
Tex
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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grannykathy
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Hmmm so when he said its not "definitive", that probably means I was somewhere between 10-20 lymphocytes per 100? Which would mean I have MC but maybe its not as severe as a lot of people have? I know even when I was at my worst, my diarrhea has never been as bad as some on this forum. I was having 4-5 episodes a day but VERY urgent. On Budesonide its down to 2 in the morning and not so urgent - alternating with constipation.
And as far as the FODMAP diet, I looked it up and it is more for IBS and is quite a bit different than what is suggested for MC and yet off the top of his head when I pressed him about food he said "lets have you follow the FODMAP diet and I'll see you back in 3 months". I've been seeing him since April and he has never mention the FODMAP diet or any other until now.
And as far as the FODMAP diet, I looked it up and it is more for IBS and is quite a bit different than what is suggested for MC and yet off the top of his head when I pressed him about food he said "lets have you follow the FODMAP diet and I'll see you back in 3 months". I've been seeing him since April and he has never mention the FODMAP diet or any other until now.
It's impossible to guess what his reasons were — he might have been referring to the fact that the lining of your colon doesn't look inflamed through the scope, but almost everyone's colonic lining doesn't look inflamed. He probably just doesn't understand the disease, so there's no telling what he based his reasons on for making that statement. No one who understands the disease well would ever make such a statement because there's no way to predict the severity of clinical symptoms based on pathology or scope results.
According to research, lymphocyte count is not associated with the severity of clinical symptoms.
For a comparison/analysis of the respective diets often suggested for treating MC, see the latest Microscopic Colitis Foundation Newsletter. You can download a copy here:
http://www.microscopiccolitisfoundation ... 294749.pdf
or read it online here:
https://app.robly.com/archive?id=76f3e4 ... 826&v=true
Tex
According to research, lymphocyte count is not associated with the severity of clinical symptoms.
For a comparison/analysis of the respective diets often suggested for treating MC, see the latest Microscopic Colitis Foundation Newsletter. You can download a copy here:
http://www.microscopiccolitisfoundation ... 294749.pdf
or read it online here:
https://app.robly.com/archive?id=76f3e4 ... 826&v=true
Tex
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.