I am very confused: New Crohn's Diagnosis

[Kate123]

I am confused. Did anyone else have inflammatory polyps in their sigmoid colon when first diagnosed, but no other biopsy/microscopic or visual colonoscopy indications?

History:
Blood upon wiping for years. In more recent months, I saw, occasionally, blood in stools. I had a colonoscopy 9 years ago that showed internal hemorrhoids; I had that colonoscopy because of blood. I had another colonoscopy scheduled in March 2019 to recheck the situation, which I and my GP assumed was hemorrhoids.

Blood tests in April 2019 showed anemia. For background: I have a uterine fibroid which causes occasionally heavy periods. (sorry for the TMI) I have been anemic in the past, but it was not caught in any blood tests in the last three years.

End of December 2018: woke up and thought I had the stomach flu. Diarrhea, fever of 101, exhaustion/ dehydration. The acute episode lasted a few days and stopped. I lost 12 pounds. I am pre-asthmatic, and at the same time, came down with a spasmodic caught. Was given codeine cough medicine. Took a lot of anti-diarrheal meds. Bowls did not normalize and were still loose, but I was not having frequent bowl movements. Abdomen felt swollen and sore. GP sent me to a X-Ray and ultrasound, which showed my colon was partially blocked, back to the small intestine. GP told me to take Restorelax or Clear Lax. Within 3 days, I felt normal again. I was hungry, my bowls normalized.

March 2019: Colonoscopy showed inflammatory pseudo polyps in my sigmoid colon. All the rest of the colonoscopy looks clear. Took 8 biopsies, which, on analysis, are pieces of inflammatory polyp. Biopsies reveal no other information.

Bloods: CRP: Normal. ASCA: Normal. CBC: no inflammation. All bloods normal but for anemia.
Fecal Cal test: 144.
Contrast CT: normal.

Has anyone else presented with inflammatory polyps in the colon, and no other visuals on colonoscopy? Does anyone know if inflammatory polyps are typical of early Crohn's disease?

Thank you all very much. I am shocked by the diagnosis, as I was expecting to be told I had internal hemorrhoids.

 

[David]

Welcome to the community. I understand your confusion and it's always worthwhile getting a 2nd opinion if you're not comfortable with your diagnosis.

Pseudo polyps can result from chronic inflammation associated with IBD but they can result from other disease as well. You may want to give this a read.

 

[Kate123]

thank you very much! I'm getting the impression my IBD is a odd presentation.

At the colonoscopy, the surgeon took one look at the colon and thought it was Crohn's. Wrote that in the colonoscopy report. He put in a rush referral to the gastroenterologist. Gastro specialist looked at the pictures and the anemia, and was very confident it was Crohn's. But we don't yet have microscopic confirmation from biopsy, which only confirmed inflammatory pseudo polyp. A upper and lower endoscope is scheduled.

The way it presented in Jan/Feb match a lot of people's first flair. Didn't have the colonoscopy until mid March. (I used a steroid inhaler for my asthma during the flair symptoms; perhaps it contributed to the flair calming down.)

I haven't noticed many people talking about inflammatory polyps as the only visual at colonoscopy. Looks like it's Crohn's colitis, unless the gastro and surgeon made a wrong assumption. (I was going to write diagnosis, but it's not clear if I've been diagnosed or not. First meeting, gastro told me I had Crohn's. I said, "are you sure?" He said, "yes." Meeting this week, asked him about the lack of microscopic evidence, and he said suspected Crohn's. He is confident the biopsies taken in the scheduled endoscope will confirm Crohn's.

I have been prescribed Mezavant. Present symptoms: the occasional loose stool, mild pain in lower abdomen after eating, mild swelling, occasional blood in stools. Anemia.

Does any know: Do other people with Crohn's colitis commonly get inflammatory polyps seen on colonoscopy? Or is there something odd about my presentation? I have wondered if it's a common symptom of early Crohn's manifestation.

I guess I'm kind of in shock by the tentative diagnosis & scared I'll relapse. The pain in Jan was intense, and in Feb I had a difficult time eating. Thank you all for your responses to this and my other posts.

 

[Honey]

Hi there, and welcome
I hope you start to feel better soon. Crohn's is difficult to diagnose, no set symptoms for everyone! So try not to worry and hopefully you will get a diagnosis soon. I was treated for Diverticulitis for years until my symptoms became more intense and tests pointed to Crohn's.

 

[Kate123]

Thank you! It's been a really confusing time. I hope the next endoscope gives some clarity.