Diagnosed with both crohns and UC?

[Pharmacist]

I was diagnosed with crohns when I was 17 with a colonoscopy and other classic symptoms (arthritis, canker sores, stomach pain, fever, etc). I have been blessed not to be sick for over 15 years until now. This time, my symptoms are much different. Mostly I just have bloody diarrhea. I had a sigmoidoscopy done today and the Dr. said it's ulcerative colitis. Can this be? Can I have both or the diagnosis has changed?

 

[DJW]

That's odd. I've read that you can't have both.

 

[Lisa]

Often times Crohn's is diagnosed as UC - that was my case for years as my involvement was mainly in the large intestine. It was only after many years and additional doctors visits, test, etc that the diagnosis was changed to Crohn's Colitis...which may be what you have. There is specific testing that can give you a better idea - were any biopsies taken with a sig scope? That only looks at a small part of the intestine.

 

[Pharmacist]

Often times Crohn's is diagnosed as UC - that was my case for years as my involvement was mainly in the large intestine. It was only after many years and additional doctors visits, test, etc that the diagnosis was changed to Crohn's Colitis...which may be what you have. There is specific testing that can give you a better idea - were any biopsies taken with a sig scope? That only looks at a small part of the intestine.

Yes. They took biopsies so hopefully that will help. Crohns colitis would make more sense.

 

[pb]

It is rare to have both UC and CD but it is possible, about 2% of IBD patients do in fact have both UC and CD....that said, many GI's don't seem to have a clue when it comes to detecting the specific pattern of inflammation that comes with CD and differs from UC, with CD the inflammation is patchy, with UC it isn't, with CD the inflammation can go through the many layers of the intestinal lining, with UC it stays on the surface of the lining only.

I also have crohn's colitis which is CD affecting the colon, there are 5 sub-types of crohn's disease (an easy google search) since CD can affect the entire GI tract from mouth to anus, UC is limited to the colon/rectum, the rectum is commonly where UC starts to do it's dirty work, but that's not written in stone anymore than CD always starting in the small intestines as it can pop up anywhere when you first become sick.

Chances are it's crohn's colitis that you're dealing with and don't have both, but I just wanted to clarify a few things since many get confused by their docs, probably cuz their docs are often confused too lol!

 

[chata]

My delightful first GI doc diagnosed CD & UC five years ago. He finally retired at 80 (looked 65), and my new guy says: Nope. We don't think that way anymore. You have Crohn's colitis. Your skip lesions tell the tale.

It sounds like autism spectrum disorders to me. They reclassify as they learn more about various illnesses, and for a while, different usages abound depending on where and when they trained.

 

[JjelmJ]

in the UK they give it the medical term "indeterminate colitis". Basically a way of saying they are not sure if it is one or the other, as there are symptoms of both. They then monitor over time and hope to see it manifest more clearly into one type or the other. This is what I was diagnosed with 4 years ago and still have no definite "label" to stick on it. Mostly due to the incompetence and lack of urgency from my hospital. I am now 16 months into a "flare up", meaning ive been bleeding, had diarrhear, mucuos, ulcers, all the other lovely symptoms and now possible fistulas yet still havent had an mri or a colonoscopy since 2011!
Recent theories are suggesting that it is maybe an illness in its own right - like a standalone 3rd type of IBD by the way ☺

 

[pb]

in the UK they give it the medical term "indeterminate colitis". Basically a way of saying they are not sure if it is one or the other, as there are symptoms of both. They then monitor over time and hope to see it manifest more clearly into one type or the other.

They do as well in North America, but indeterminate colitis is different from having both UC and CD which sadly it's estimated that 2% of the IBD population has both UC and CD confirmed....indeterminate is when they're not sure which type of IBD a patient has but it's clear they do have one.

 

[Pharmacist]

Interesting about the 2%. I'm still waiting on the biopsy results and because they only did a sigmoidoscopy there's no way for them to know if other parts are currently inflamed although based on my symptoms (bright red bloody diarrhea, no stomach pain) seems unlikely that other parts are involved. Also I started oral mesalamine (Rafassal) and the bleeding and diarrhea are significantly improved after just a week. I know mesalamine is often not so effective for crohns but what about crohns colitis? Thanks

 

[Lisa]

Mesalamine did work for me a million years ago - I was on and off it for years before it lost effect.