Mucosal Atrophy - still waiting for results

[Avdx]

Hello,

I had my very first colonoscopy last week. I have mucosal atrophy in the terminal ileum only, everything else seems fine. Does this mean 'serious' inflammation and maybe villous atrophy, and is this a common finding in IBD? Interestingly, my doc said it's not Crohn's. But as far as I know UC doesn't affect terminal ileum only. What else could it be theoretically? Or maybe there's a chance for it to be Crohn's? On the paper he wrote ileitis terminalis as well so I'm a bit confused.

Thank you

 

[Scipio]

"Ileitis terminalis" just means inflammation of the terminal ileum, and it provides no information as to what is causing the inflammation. Inflammation from UC usually starts at the rectum and progresses upstream in a continuous fashion until it stops at the colon/small bowel border. There is sometimes a little spillover of UC inflammation into terminal ileum - the so-called inflammation "backwash." But that wouldn't be present unless there was also substantial inflammation in the adjacent large bowel.

The location of the inflammation in the terminal ileum makes it suspicious for Crohn's, but perhaps your doc just isn't seeing the type of damage normally seen in Crohn's. Villous atrophy is more typically associated with celiac disease, but it can occasionally occur with Crohn's. Is your doc testing you for celiac?

 

[Avdx]

I don't know yet if I have villous atrophy (sorry for the 'noob' question, but if I have mucosal atrophy, that doesn't necessarily mean I have villous atrophy aswell, right?), I was tested for Celiac which came out negative. I have some allergies aswell, I was thinking about that maybe my soy allergy could cause things like that, but the location of the atrophy is looking too 'special' to me.

 

[Scipio]

The term "mucosal atrophy" by itself often refers to the stomach more than the small bowel. I assumed the term was characterized by villous atrophy when applied to the small bowel, since that's where the villi are, but I am no expert.

You should take these questions up with your doctor at your next appointment. Ask why it's not Crohn's, given its location, and if not then what is it? When is your follow-up appointment?

 

[Avdx]

Around one month from now. So until then I won't know anything for sure...

 

[Avdx]

Hello! An update:

I received my results. It's a bit hard to understand everything, because I still couldn't speak with my doc. I have partial villi atrophy with mild inflammation and the mucosa "smoothed". The strange thing is that I am gluten free for like 2 years now (I was thinking about that I might have NCGS), for like 90% I'm eating gluten free (I don't take that seriously like someone who has Celiac, since my docs said it's not that, but I went gluten free because of my symptoms to gluten).

Could IBD cause something like that?

- I had D vitamin deficiency
- Selective IgM deficiency showed 2 times on blood test (once at age 12 second time last year)
- Every year I have: eosinophilia, lower amount of thrombocytes
- One time I also had folate deficiency which was resolved after I took supplments for it

At age 14 (I'm now 30) I have developed spider nevi on chest, upper back, shoulders and upper arms. I'm pretty sure it's from some kind of liver disease. And I think it's because of the findings in the small intestine.