Microscopic colitis and biopsy results

[crocusgirl]

Hi - I’m newly joined here and undiagnosed at present. I’m thinking I may have MC. I am 43 and have bouts of intermittent diarrhea with BM’s up to 4 times a day which started in January 2012! By April 2012 I was run down so went gluten free and things improved! I saw a gastro who did an endoscopy which was clear for Celiac as were blood tests (although I was 6 weeks gluten free at time). I am now dairy and egg free as well, seen one gastro and one colorectal doctor and managed to rule out a number of things but am now left with MC.

I have no bleeding, no raised ESR, CRP. A Sigmoidoscopy was normal but the biopsy report said that microscopically “histology shows fragments of mostly normal colonic mucosa with some oedema, and denudation of the surface epithelium”. The sigmoidoscopy was normal but rushed and only went as far as the Descending colon because it was extremely painful. A CT scan showed thickening of sigmoid.

At first I had cramps just with “D” episodes only but now have pain in lower left & right and mid. I also get pain before, during and after a BM. I also have incredibly foul flatulence, nausea, fatigue, unexplained acne, joint pain (currently sacro pain), weight loss & Rosacea. A stool test was basically clear apart from a possible Proteus infection and low n-butyrate.

Sorry for the long story but what I was wondering if anyone knows if my biopsy sounds normal? And would the thickening seen on CT scan indicate MC? I don’t have a new gastro doc appointment until 16th April so I can’t ask until then. Your opinions would be appreciated as I am going nuts trying to solve my problem and driving my husband mad with all the “could be’s”!!
Thanks a lot

 

[Beach]

Hi Crocusgirl - I don't have much to add to your biopsy question, just wanted to wish you luck, mention I have MC myself and follow a similar egg/chicken, gluten free diet. I've done well eating this way along with taking a few supplements such as vitamin D, magnesium, fish oil, etc. My condition has all but gone into remission it seems, thankfully!

David also has MC and is more technically versed. I imagine he will be around at some point and might be able to give you a hand with your question. Hope you find relief soon!

 

[crocusgirl]

Hi beach. Thanks for support, it seems that alot of food avoidance helps as i've been reading. It has helped me to "improve" the D but not the pain!

 

[David]

Hi crocusgirl and welcome. I'm so sorry to hear of your struggles, you poor thing

Have they not done a colonoscopy on you yet? With thickening of the sigmoid evident on a CT, if they haven't, I think that's definitely the next step that needs to be taken.

 

[crocusgirl]

Hi David, thanks for reply and welcome.

No I haven't had a colonoscopy yet but I think that will follow sometime after April 16th (things move very slow in UK with the NHS!). I did have a sigmoidoscopy because of the thickening but the doctor that did it said things looked normal and that was it. It was a struggle to get him to do a biopsy as he told me that if things looked "visually" normal he wouldn't take one!! I think I upset him by asking for a biopsy and suggesting they look for MC! My current Gastro is putting me in for a SeHCAT scan as he thinks it might be primary bile acid malabsorption but this is his speciality. I'm not sure as I have of late been more "C" than "D"! I'm thinking of doing a Calprotectin stool test as this is about the only test left and it hasn't been offered by any of the Gastro doctors I've seen yet.
Do you think the biopsy sounded normal?

 

[David]

I wouldn't say the biopsy was normal but it didn't suggest anything specific to me either.

I think a fecal calprotectin would be an excellent idea. I also think a colonoscopy is a good idea based upon your symptoms and the thickening.

I'd also research [wiki]small intestine bacterial overgrowth[/wiki] considering your symptoms and the rosacea. However, I really think a colonoscopy with biopsies is warranted.

 

[crocusgirl]

I would agree with biopsy not sounding normal, this is a question I will ask my Gastro at next appointment. I have ordered the fecal calprotectin and will do that to see if I can eliminate MC, Crohn’s which should save time at my next appointment with my Gastro although after my initial meeting I get the feeling he is a fan of diagnosis by colonoscopy so even if the F.C. test is negative I don’t think he will definitely rule anything out!

Thanks for the suggestion of SIBO, yes I have research it. Normally you have low B12 with this and mine’s always been very elevated! My “hit list” goes as follows:-
MC
P.B.A.M
SIBO

Thanks for your opinion and advice. As you can imagine I have a lot of questions to ask my Gastro on April 16th so will post back here after then. Unfortunately, things move so slow in England with doctors and I am lucky that perseverance is getting me somewhere as my age being below 60 puts me in IBS-D catergory straight away!

Many thanks