Colonic Ulceration

[Jandersen20]

Hello,

My son was diagnosed with Crohn’s in July. His symptom before diagnosis was bleeding. He started on Humira and although bleeding has gotten slightly better, he now has increased frequency and urgency. Going about 5 times a day with urgency. Waiting to test blood levels later this week to see if Humira is working.

I called the nurse today to ask a few questions about location of disease. She mentioned he has severe colonic ulceration. Is that another word for UC? Although the GI said it was not definitive Crohn’s or UC. But the pattern of disease in the colon shows up more like Crohn’s. TI is good. Sounds like majority of disease is in colon. I’m confused on “colonic ulceration”. I will clear this up at our next appt.

In the meantime, does anyone have any experience with their child having Colonic ulceration? Could this explain the bleeding? What treatments target this? Would Uceris foam help this while waiting for Humira to kick in? Any other Biologics known to treat this area? I’m just trying to understand all this.

Thank you!
Jamie

 

[Scipio]

I called the nurse today to ask a few questions about location of disease. She mentioned he has severe colonic ulceration. Is that another word for UC? Although the GI said it was not definitive Crohn’s or UC. But the pattern of disease in the colon shows up more like Crohn’s. TI is good. Sounds like majority of disease is in colon. I’m confused on “colonic ulceration”. I will clear this up at our next appt.

No, UC is different from colonic Crohn's.

Inflammatory Bowel Disease (IBD) primarily consists of two main ailments: Ulcerative Colitis (UC) and Crohn's Disease (CD). They are similar diseases, but as its name suggests, UC is confined to the colon (and rectum). Crohn's, by contrast, can occur anywhere from mouth to anus and all points in between, but mostly it is found in either the small bowel, the colon, or both. About 70% of CD is found in either the small bowel or both, and about 30% is confined to just the colon. The colon-only version of Crohn's is sometimes called "Crohn's colitis." But again, Crohn's colitis, even though it often involves a lot of ulcers, is not the same as Ulcerative Colitis. It often takes the microscopic examination of the tissue biopsies collected during colonoscopy to make a certain determination to distinguish CD and UC when they are both located in the colon.

But even with biopsies it can still sometimes be very hard for docs to say for sure whether it's CD or UC. Occasionally you see a patient who says that s/he had UC that later "turned into Crohn's." This is thought to be exceedingly rare if it happens at all. A more likely explanation is that it was Crohn's all along but was at first misdiagnosed as UC. Some GIs sometimes employ a diagnosis of "IBD-Indeterminate" as a sort of catch-all to name the cases where they can't make up their minds betwen UC and CD.

It sounds like the doc suspects that your son has Crohn's colitis. An active case of Crohn's anywhere in the gut could certainly explain the bleeding. Bleeding is very common in CD.

 

[Jandersen20]

No, UC is different from colonic Crohn's.

Inflammatory Bowel Disease (IBD) primarily consists of two main ailments: Ulcerative Colitis (UC) and Crohn's Disease (CD). They are similar diseases, but as its name suggests, UC is confined to the colon (and rectum). Crohn's, by contrast, can occur anywhere from mouth to anus and all points in between, but mostly it is found in either the small bowel, the colon, or both. About 70% of CD is found in either the small bowel or both, and about 30% is confined to just the colon. The colon-only version of Crohn's is sometimes called "Crohn's colitis." But again, Crohn's colitis, even though it often involves a lot of ulcers, is not the same as Ulcerative Colitis. It often takes the microscopic examination of the tissue biopsies collected during colonoscopy to make a certain determination to distinguish CD and UC when they are both located in the colon.

But even with biopsies it can still sometimes be very hard for docs to say for sure whether it's CD or UC. Occasionally you see a patient who says that s/he had UC that later "turned into Crohn's." This is thought to be exceedingly rare if it happens at all. A more likely explanation is that it was Crohn's all along but was at first misdiagnosed as UC. Some GIs sometimes employ a diagnosis of "IBD-Indeterminate" as a sort of catch-all to name the cases where they can't make up their minds betwen UC and CD.

It sounds like the doc suspects that your son has Crohn's colitis. An active case of Crohn's anywhere in the gut could certainly explain the bleeding. Bleeding is very common in CD.

This is helpful. Thank you.