Gone for 2 scopes but no dignosis

[paranoid_]

Hi,

I've had occasional bleeding when passing stools for about 3 years. Initially it would occur for maybe a week every few months but recently it has been occurring more frequently but at a shorter duration (1 - 2 days each time). Blood has always been bright red.

Initially the specialists I went to diagnosed me with piles but when the problem kept re-occuring, I went to look for a new specialist who did a flexible sigmoidoscopy for me.

During the scope, nothing looked out of the ordinary except for a small amount of inflammation at the sigmoid (also no piles). Biopsies were taken but results showed no colitis. I was put on anti-biotics for 2 weeks as my specialist believed that it might be due to an infection instead and scheduled me for a scope as she was slightly concerned with the results of the biopsy. There was still some slight bleeding last Tuesday.

My scope was today and my upper colon was more or less healthy but the doctor took biopsies anyway. Inflammation in the sigmoid was still there and the doctor said it showed no spreading or decrease in size (also very thankful there were no polyps).

I'm slightly worried that they have not been able to diagnose anything (and that the anti-biotics didn't solve the issue). Wondering if you guys have suggestions on tests that I can ask for or suggestions on what I could be suffering from if the results of the biopsy don't point to anything in particular.

Thank you so much in advance!

 

[Scipio]

The problem could be located farther upstream. A colonoscopy doesn't get to see much of the small bowel - only the last few centimeters of the ileal region, depending on the skill of the doctor.

So if the full colonoscopy doesn't turn up anything you may wish to discuss with your GI the possibility of assessing your small bowel via MRI and/or capsule camera endoscopy. The capsule camera was how my Crohn's was finally diagnosed.

 

[Guerrero]

I agree with scipio.
Dont be paranoid but maybe further tests must be done. A non invasive one could be calprotectin on your stools or inflammatory markers in you lr blood, to see if there is inflammation going on and what's the level... but usually if you see a good doctor, must be him to suggest the further tests to be done, and inflammation has already been seen in your sigmoid so i guess they should arrive to a diagnosis soon...

 

[scottsma]

You might have Proctitis, which is what I was first diagnosed with.The symptoms sound the similar. It is inflamation in the rectum. I was prescribed Asacol suppositories,to use twice daily.It did clear the bleeding in about a week,then I used one daily as maintenance.Since then,I've been diagnosed with crohns colitis which is further up the bowel.Maybe suppositories would work for you.But,as suggested,it is up to your doctor to subscribe what he thinks is needed and would work for you.

 

[paranoid_]

You might have Proctitis, which is what I was first diagnosed with.The symptoms sound the similar. It is inflamation in the rectum. I was prescribed Asacol suppositories,to use twice daily.It did clear the bleeding in about a week,then I used one daily as maintenance.Since then,I've been diagnosed with crohns colitis which is further up the bowel.Maybe suppositories would work for you.But,as suggested,it is up to your doctor to subscribe what he thinks is needed and would work for you.

Certainly sounds like it could be this but I'm just concerned why the biopsy did not return any results. According to the doctor, the biopsy showed that the structure of my cells are fine (I can't remember the exact words).

Is there any specific test that needs to be done to diagnose this? I was prescribed Augnentin the first time because it was believed to be a general infection but the inflammation showed no improvement.

 

[paranoid_]

The problem could be located farther upstream. A colonoscopy doesn't get to see much of the small bowel - only the last few centimeters of the ileal region, depending on the skill of the doctor.

So if the full colonoscopy doesn't turn up anything you may wish to discuss with your GI the possibility of assessing your small bowel via MRI and/or capsule camera endoscopy. The capsule camera was how my Crohn's was finally diagnosed.

Would the blood not be bright red if this was the case? Or is this possible as well?

 

[Lady Organic]

bright red blood suggests bleeding in the last part of the colon, rectum or anus. It souonds like it may be coming from this inflammation patch in your sigmoid. Does the blood cover the stools or there are blood drops? You also mention the upper colon is more or less healthy? what did the GI find, more inflammation patches?

I remember a long time ago, about a year after my diagnosis, I had a very unsual presentation in my sigmoid, a patch filled with white dots. My GI at the time was very experienced and specialized specifically in IBD, he didnt know what that was and was confused. He though maybe an infection, maybe a reaction to a treatment... Finally biopsies revealed nothing unusual, healthy colon :yrolleyes:. And a few months later that patch disappeared and never came back.

I understand this situation with clear biopsy is strange. How many biopsies were taken? Personnaly, if this GI doesnt propose anything soon such as another type of treatment as a trial, I would seek a second opinion with another GI and another sigmoidoscopy.

 

[paranoid_]

bright red blood suggests bleeding in the last part of the colon, rectum or anus. It souonds like it may be coming from this inflammation patch in your sigmoid. Does the blood cover the stools or there are blood drops? You also mention the upper colon is more or less healthy? what did the GI find, more inflammation patches?

I am colour blind so I can't be for certain but I don't believe the blood covers the stool. I mostly only notice it when I wipe. Very bright red. Very rarely does the blood drip.

In the full colonoscopy, I was told that the rest of the colon is healthy and the only inflammation present was the same as the one found earlier. Even then she said it wasn't a glaringly obvious inflammation and one she really had to look for.

From the report, all sections in the colon are marked as "normal" except the sigmoid which she marked as "colitis". Something which was put as a possible diagnosis in the first scope.

I understand this situation with clear biopsy is strange. How many biopsies were taken? Personnaly, if this GI doesnt propose anything soon such as another type of treatment as a trial, I would seek a second opinion with another GI and another sigmoidoscopy.

In the first round (flexi sigmod), I believe only 2 were taken from the area where the inflammation was present. In the most recent scope, one was taken from each section of the colon as well as the inflamed area.

I remember a long time ago, about a year after my diagnosis, I had a very unsual presentation in my sigmoid, a patch filled with white dots. My GI at the time was very experienced and specialized specifically in IBD, he didnt know what that was and was confused. He though maybe an infection, maybe a reaction to a treatment... Finally biopsies revealed nothing unusual, healthy colon :yrolleyes:. And a few months later that patch disappeared and never came back.

It really helps to hear this. Curious though...how long were you suffering before it magically cleared up? I've had this issue for about 3 years now.

 

[Lady Organic]

so for both exams the results of the biopsies turn out to be normal? (you also got the results of the biopsies of the second scope, right?) I was asking because if simply one or 2 were taken the first time, mistakes or errors are always a possibility, but if you had 2 sets with same conclusions... THis is indeed quite strange. Do you feel your dr is thinking of trying another medication?

Do you have any other symptoms? like gurgling (gaz passing in your lower left side of the abdomen), cramps before a bowel mouvement? unformed or too soft stools, diarrhea?

In my situation, I remember the patch was not inflammed, it just had a weird and unusal presentation. I am not sure, but I think I was asymptomatic at that time.

 

[paranoid_]

so for both exams the results of the biopsies turn out to be normal? (you also got the results of the biopsies of the second scope, right?) I was asking because if simply one or 2 were taken the first time, mistakes or errors are always a possibility, but if you had 2 sets with same conclusions... THis is indeed quite strange. Do you feel your dr is thinking of trying another medication?

Do you have any other symptoms? like gurgling (gaz passing in your lower left side of the abdomen), cramps before a bowel mouvement? unformed or too soft stools, diarrhea?

In my situation, I remember the patch was not inflammed, it just had a weird and unusal presentation. I am not sure, but I think I was asymptomatic at that time.

Sorry about the late reply. I just got the result from my colonoscopy today.

Right side of colon which was unsampled before shows "focal mild active colitis". I was told not to worry about this as that side of the colon looked healthy (biopsy samples were taken at random for this part) and that this can come and go for many normal patients as a result of diarrhea, infections etc.

For the sigmoid, no change in result - still inflamed but no signs of colitis. She is puzzled as well and has requested for a stool sample as she thinks that it might be due to a specific bacteria or virus that may need a different cure.

I have been put on metronidazole for 10 days followed by some probiotics for 2 weeks to see if my gut health improves before she tries to refer me elsewhere.

As for my popping habits, yes been getting cramps recently before popping sometimes. A lot more diarrhea which usually lasts a week as well. Been going 2 times a day when I'm usually a 1 a day person.