Patterns of Chrons Colitis?

[harvest_table]

Hi friends, just thinking outloud here.

I developed a canker sore (aphthous ulcer?) a couple months ago that isn't going away. Also, have a rash on each of my elbows(patchy edema?) which I noticed about the same time.

The morphologic findings in mildly active colonic Crohn's disease (CD) include crypt disarray, patchy edema, and small lymphoid aggregates with neutrophils, sometimes associated with aphthous ulcers.

Also,

A limited number of biopsy fragments may be incorrectly interpreted as lymphocytic or collagenous colitis. The temporal relationships suggest that these morphologic patterns precede typical active CD.

http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract

The last sentence is interesting. Anyone have any of these symptoms?

Love,
Joanna

[tex]

Hi Joanna,

Don't worry, you're not developing Crohn's disease. MC does not segue into Crohn's, (nor UC, for that matter). The patients in that study had already been diagnosed with Crohn's disease. "Crypt disarray, patchy edema, and small lymphoid aggregates with neutrophils", are simply pathologic markers in biopsy samples, which distinguish Crohn's disease. These markers are not normally present in MC biopsies. Also, these markers are not visable to the naked eye. "Crypts" are tiny pits, or depressios, and neutrophils are simply a special type of white blood cell.

In medical jargon, "patchy edema" refers to scattered areas of swollen soft tissues, as a result of excess water accumulation. What you have on your elbows, is probably excema.

Normally, a canker sore shouldn't last more than about two weeks. Are you by any chance using a toothpaste or mouthwash that contains the foaming agent sodium lauryl sulfate? SLS can cause, or aggravate, canker sores.

Have you tried some of the home remedies, such as this one:

http://www.nlm.nih.gov/medlineplus/ency ... 002065.htm

If it persists, you might need to have your doctor check it out, and prescribe some sort of anti-viral treatment. Of course, the bad news is that things like that are normally treated with immune system suppresents, such as oral steroids.

Love,
Tex

P S The last quote you mentioned:

A limited number of biopsy fragments may be incorrectly interpreted as lymphocytic or collagenous colitis. The temporal relationships suggest that these morphologic patterns precede typical active CD.

simply refers to the presence of MC markers mixed in with the markers of Crohn's, in biopsy samples. A misdiagnosis should be relatively easy to avoid, since Crohn's is visable to the naked eye, during a colonscopy, whereas MC is not, and the microscopic markers of Crohn's are not present in a biopsy sample from an MC patient.

[artteacher]

Hi Joanna,

People with lupus can have painless mouth ulcers. and mysterious rashes. I'll look up a site that shows examples. I don't think you have anything like that . . . but for us chronic researchers, hey, it's what we do.

Love, Marsha

[artteacher]

I remembered to send you a link. I'm sure you don't fit these descriptions, but, anyway, if you had lupus, this is what it would look like.

Love, Marsha

http://www.uklupus.co.uk/lsymp.html

[harvest_table]

Are we certain that MC cannot precede or segue into a Chron's DX?

This link only gives a brief abstract, can't read the article full article. It's regarding an infant with CC that develped into Chron's.

http://www.eurojgh.com/pt/re/ejgh/abstr ... 44!8091!-1

I've also found other MC/Chron's overlaps in some recent articles which I've bookmarked.

Tex, personally I'm not too concerned about my MC condition forwarding on to other problems because I'm eating such a healthy diet now and feeling great but you never know..... all these links we are finding to so many other auto-immune issues.

Marsha, a very belated thanks to the link on Lupus.

Love,
Joanna

[Polly]

I thought we determined some time ago that mouth ulcers seemed to go with MC. Did we do a poll or did someone cite a reference? I recall that it came up with Sue, who lives in New England and has a pond, and at a later time too, I think.

I'm not sure about MC morphing into UC or Crohn's. At least I haven't seen any articles about it, but I suppose it is possible. I'll check out your link, Joanna. Of course, we do know that LC can turn into CC (CC seems to be a more chronic stage than LC since it also has collagen deposits).

Love,

Polly

[tex]

Hi Joanna,

It seems that the only thing we can be certain about is the fact that nothing is certain.

Here, for example, is a article that suggests the progression of CC to UC:

http://www.unboundmedicine.com/medline/ ... ve_colitis

I think the bottom line here is the fact that there is more and more evidence surfacing that indicates that MC is actually a rather common condition in the general population. It's not a rare disease, as conventional thinking would have us believe. If it is indeed a relatively common condition, then it would certainly follow that it could often appear in sequence, or even in tandem, with other IBDs. This article supports that viewpoint:

http://www.sciencedirect.com/science?_o ... 742b3b824d

Here, for example, is a case where a patient had CC, UC, Celiac disease, and hyperparathyroidism, at the same time:

http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract

Actually, like Polly, I have some doubts that MC actually segues into UC or Crohn's. I think the thing to remember here is that having MC does not make us immune to other GI diseases, (or any other diseases, for that matter). Really, there's no reason why a patient can't have MC and UC or Crohn's concurrently. I would suspect that in those situations, most likely, the MC will be totally overlooked in the diagnosis of UC or Crohn's. (IOW, when you're describing the destruction caused by a tornado, you normally wouldn't take note of the fact that there was some hail damage to the roofs and windows of the buildings that were destroyed by the wind. When everything is reduced to rubble, the hail damage is pretty much irrelevant.) I suspect that's the case in most UC and/or Crohn's cases also - the superficial damage to the epithelium is pretty much irrelevant, (and probably often obliterated), because of the deeper and much more devastating damage caused by UC and /or Crohn's.

In this study, 40% of CC patients had one or more "associated" diseases:

http://www.unboundmedicine.com/medline/ ... 3_patients

Here is a link to 330 related articles, if you are interested in reading more. (A couple of the links in my post are from this list):

http://www.unboundmedicine.com/medline/ ... ve_colitis

Love,
Tex

[harvest_table]

Polly,

My mouth ulcer has disappeared and the only connection I can make to anything is that I started using B12 with folate on a daily basis a few months back. Who knows? I still have the patchy spots on my elbows that seem to wax and wane.

You mention CC is more chronic than LC and I believe I understand what you mean by that but whats curious is that I've noticed here on the board it seems like the majority of our members dealing with additional problems like Marsha/Lupus and Cristi both have LC.

Tex, I'm very interested in reading anything about MC. THANK YOU so much for all those articles! That should keep me busy for awhile.

Anyone out there with MC & Chron's?

Love,
Joanna

[mle_ii]

I've never had problems, that I know of, with mouth ulcers, nothing my Dentist or I ever noticed. Though my Dentist and I notice that I have a bad habit that I can't seem to break myself of, that is of chewing the inside of my mouth/cheeks. I find myself mindlessly doing that. Perhaps there's not enough cheek in my diet. ;)

As far as Crohn's and MC, I think that there is potential for one to develop into another, but not because of the disease, but by what caused or causes the disease. My guess is that environment, diet, genetics, health play a role as to which disease you get or how it progresses.

Mike