Confused on pathology report

[Caeryn23]

Biopsy report terms question

I got my flex sig report back.

What do "mild nonspecific reactive changes including edema and congestion of the lamina propria with focal surface hyperplastic features." mean?

The doctor who did the test just said it means swelling and inflammation from constipation. He also said I had proctitis. He wouldn't give me specific info on the terms. He also said just to take Miralax.

Thank you.

 

[DustyKat]

Non specific reactive changes means they don't the cause of the inflammation.

Oedema is the swelling.

Lamina propria is layer that makes up the mucous membrane that lines the bowel.

Hyperplastic features means that there is an abnormal number of normal cells present. You may well expect this to happen when there are changes present as you have.

So essentially you have mild superficial inflammation and oedema of the rectum and anus, this is the area that proctitis affects.

Now that may be as a result of constipation but if you are you also have to investigate as to why you are constipated. Is because of diet or lifestyle or do you have an underlying functional problem that is causing it.

Did they take any biopsies?

Dusty. xxx

 

[Caeryn23]

The biopsy report said: "mild nonspecific reactive changes including edema and congestion of the lamina propria with focal surface hyperplastic features."

Are these seen in IBD? Or, something else?

I try to eat fiber rich foods. I even changed some meds that cause constipation. I don't know what to do.

 

[DustyKat]

It is difficult to say. Certainly inflammation, oedema and congestion would be present in IBD but there would be other pathological changes as well.

Why did you have a flex sig only?

Have you had a colonoscopy done?
If so what were the results and outcome?

I will tag Aussie into this and see if he can provide some insight and direction for you.

Dusty. xxx

 

[Caeryn23]

Thank you for responding. I'm not sure why my GI ordered a flex sig.

Here is my colonoscopy results from 2012.
Scope: descending colon mucosa is "erythematous, hemorrhagic, ulcerated, and to show loss of vascular markings suggestive of stercoral ulcers due to constipation."
Biopsy report: "Descending colon, biopsy: Colonic mucosa with edema and hemorrhage."

I'm confused on my exact diagnosis is. They keep saying its IBS and fecal impaction.

 

[Aussie]

Hi Caeryn and Dusty. Fortunately there is nothing on the biopsies to indicate IBD. Macroscopic changes are interesting though. I would suggest treat the constipation and then repeat the colonoscopy to see if the descending colon changes have resolved.

Best wishes.

 

[Caeryn23]

Thank you for responding.
1. What would cause the changes in the biopsy report?
2. The proctitis I have is not IBD, then?

I was just confused.

 

[Aussie]

Hi Caeryn, the non-specific changes could be due to bowel prep or enema, mild infection, drug effect, etc... Unlikely to be anything serious or sinister.

In regards to the proctitis, this is essentially a generic term meaning inflammation in the rectum. Again, lots of different causes. To diagnose IBD you really want to see architectural distortion of the biopsy specimen.

I assume your GI biopsied the proctitis, do you have these results?

Best wishes.

 

[Caeryn23]

Here is the proctitis report:

My flexible sigmoidoscopy from 2013.
Scope: showed proctitis and fecal impaction/solid stool.
Biopsy report: "mild nonspecific reactive changes including edema and congestion of the lamina propria with focal surface hyperplastic features."

 

[Aussie]

Hi Caeryn, very unlikely your symptoms are driven by IBD. I would suggest looking further into constipatory disorders. The most appropriate next investigation for you would probably be a colonic transit study which will firstly confirm whether you have constipation and then differentiate between slow transit constipation and a defecatory disorder.

Best wishes.

 

[Caeryn23]

I thought someone with IBS would have normal path reports. Are there other forms of IBD that my reports would indicate? What else could cause those path report results?

 

[Aussie]

Hi Caeryn.

Are there other forms of IBD that my reports would indicate? No.

What else would cause those path results? The changes are very non-specific, so lots of things could potentially cause them, ie. bowel prep, mild infection, drug reaction, etc. In regards to the ulcerated area, faecal impaction could cause those changes.

Best wishes.