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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had Colonoscopy, Endoscopy. All Symptoms Point To IBS. Possibility Of Crohns Or Ulcerative Colitis?

I ve recently had a clonoscopy and endoscopy . Biopsies show duodenal mucosa with gastric foveolar and active inflammation. No helicobacter organism found. Random colon biopsy old increase in lamina propia eosinophils scattered ceroid macrophages, basal crypt apoptosis with increased mitotic activity. They say possible medication induced reaction. I don t take any medication ever apart from thyroxine . What else could cause this? All other symptoms point to ibd. Is it possible that this is early stage crohns or ulcerative colitis?
Thu, 27 Dec 2012
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General Surgeon 's  Response
Hello!

Thank you for the query.

It is very hard to answer your question not knowing what symptoms do you have. And yes, Crohns disease is possible as neither colonoscopy or upper GI endoscopy does not shows small intestine condition and Crohns usually affect small intestine first. It is more possible if you are young person (about 20-30 years old). I suggest you to have abdominal CT with oral contrast (enteroclysis) to check small intestine as well.

Hope this will help.
Regards.
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Gastroenterologist Dr. Charles S Narasi's  Response
Hello, princess_sparkles,
Your duodenal biopsy shows mild duodenitis ,if severe could lead to
an ulcer. Depending on the type of symptoms you are having, you
may need to take a course of PPI therapy for 4-6 weeks.
The finding on the biopsy of the colon is interesting.
The presence of eosinophils, some macrophages with crypt
changes do suggest some form of colitis.
Presence of crypt abscesses would have indicated ulcerative colitis.
You don't show that. There is a condition called "Microscopic Colitis".
There are two types, one is called "Collagenous colitis" and the other
is "Lymphocytic colitis". Symtoms are usually, watery diarrhea and
abdominal pain.
Eosinophilic colitis is associated with nausea,vomiting,diarrhea,weight loss
blood in the stool and anemia. Scope exam may show small ulcers and the
biopsy shows eosinophils in the large intestine. Some times this is also
associated with other allergies to certain food elements.
Have blood tests for Celiac Disease also to rule this out. If you have had
a small bowel x-ray series, that might pick up changes of Crohn's.
I wish you well.
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Had Colonoscopy, Endoscopy. All Symptoms Point To IBS. Possibility Of Crohns Or Ulcerative Colitis?

Hello! Thank you for the query. It is very hard to answer your question not knowing what symptoms do you have. And yes, Crohns disease is possible as neither colonoscopy or upper GI endoscopy does not shows small intestine condition and Crohns usually affect small intestine first. It is more possible if you are young person (about 20-30 years old). I suggest you to have abdominal CT with oral contrast (enteroclysis) to check small intestine as well. Hope this will help. Regards.