Need help with biopsy report

[omar]

hi everyone , i just had a colonoscopy done and they took biopsies from my ileum. the reason for the colonoscopy was blood in stool and no other symptoms.
the results of the lower GI endoscopy report were ( internal piles grade 1 , mild ileitis and promiment lymphoid follicles of the ileum).

the result of the ileum biopsies was
Microscopic:
sections show ileal tissue with villous crypt ratio of 2:1 with significant villous shortening.no crypt hyperplasia is noted.foci of acute cryptitis and crypt abscess.the chronic inflammatory infiltrate in the lamina propria is moderately increased.promiment payer's patches are seen. surface ulceration and neutrophilic infiltration in the surface layer is seen.no granulomas seen.no dysplasia seen. no evidence of maligency.

Diagnosis:
acute on top of chronic ileitis (highly suggesting crohn's disease)

my GI asked for fecal calprotectin and it came back 478. and he put me on 2 grams on pentasa daily.
what do you guys think, is it really crohn's would appreciate some help.

 

[Saratay05]

Omar: sorry to hear your colonoscopy had poor results. I am not particularly good with deciphering cytology results. I just know that my most recent ( I am already diagnosed with crohns) also showed chronic ileitis.
Have you had a Ct Enterography or a capsule Enterography to confirm crohns? Also there is another blood test called Saccharomyces Cerevisaiae that tests for presence of two antibodies that if both are present are highly specific for crohns.
Good luck. I hope you can get some answers from your doctor.

 

[Smokeyjameson]

Sounds very Crohn's to me. The inflammation and ulceration as well as it's location in the ileum.

 

[Axelfl3333]

Have you seen your doctor yet to discuss your results?i,m the same as you I like it explained properly to me,try to steer away from dr google to translate your results it,ll only make you more worried than you already are.good luck all the best.

 

[Patricia56]

Sounds like a pathology report for someone with Crohn's. Damage to the crypts is a hallmark of CD.

I am surprised they put you on pentasa. A recent large study found it to be no more effective than placebo and it's mostly active in the colon - not the ileum where you have inflammation.

I would expect the doctor may offer you budesonide (topical steroid) to help calm the inflammation in the small bowel and then a maintenance medication like azathioprine to treat the Crohn's.

 

[omar]

Sounds like a pathology report for someone with Crohn's. Damage to the crypts is a hallmark of CD.

I am surprised they put you on pentasa. A recent large study found it to be no more effective than placebo and it's mostly active in the colon - not the ileum where you have inflammation.

I would expect the doctor may offer you budesonide (topical steroid) to help calm the inflammation in the small bowel and then a maintenance medication like azathioprine to treat the Crohn's.

he said pentasa is all i need at the moment because i have no symptoms.should i get a second opinion?

 

[Patricia56]

Yes.

Was any other testing done like an MRE?

 

[If*]

No, why when the pathology is pretty clear??
Not EVERYONE needs to be on a stronger med, sounds like your Dr. is doing their best.