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What Does Severe Inflammation Of Colon Indicate?

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Posted on Mon, 2 Feb 2015
Question: Colonoscopy found severe inflammation in patches from a little way up from rectum right through to as far as they got which was at the top of colon, before it turns and goes down towards the small intestine (hope i've explained that well enough) They had to stop the procedure at that point as the bowel started to bleed and it became impossible to see anymore. Endoscopy at same time showed mucous, and red markings to the top of the stomach.
Was told they suspected either an IBD (UC) or Allergic Colitis (EGID) Was kept in hospital as it was so severe.
Results were rushed through and next day was told all biopsies were clear , No ulcerative colitis at all, and nothing to suggest allergic colitis. (one more test result was a fecal calprotectin level of 600+)
So discharged after 1 week, with all food removed and on an Elemental Diet (amino acid formula only)
Returned for repeat scopes.. upper & lower GI tract again, 9 weeks later. This time, there was NO inflammation , all that was reported to me was loss of vascular markings in rectum, and also red markings in stomach ??
So introduced food back into diet, 1 thing at a time, and not long after.. she was showing same symptoms, although a lot less severe than before...
9 months on and she is back to the ill child she was... she has stopped eating, extreme constipation, lethargic, pain in tummy, screaming through the night etc etc etc
Huge story I know... I am sorry !!!... So basically my question to you is, does it sound like IBD to you?
Everything i read points towards Crohns (not UC like suggested) and I have now read so many medical reports suggesting that Elemental diet in a child with IBD can induce a clinical remission in as little as 8 weeks and in fact just 2 weeks in some ...
So can Crohns be missed in Biopsies ?
As you can probably tell, I am at a loss here with no support (or next to none anyway) from the local medics who seemed baffled, and then just seemed to give up..
doctor
Answered by Dr. Deepak Kishore Kaltari (1 hour later)
Brief Answer:
Crohn disease could be missed based on sampling error

Detailed Answer:
Hi
Welcome to Healthcaremagic
Greetings of the day
Dear Ms

Chronic Idiopathic Constipation can also present with severe inflammation of colon. Regression of appearance of inflammation on repeat colonoscopy suggest chronic constipation as the possible cause of symptoms especially in view of negative biopsy.

Crohn disease can be still missed in biopsy depending on sampling error.

I would suggest you the following

1 Ensure adequate intake of water : 1 cup of water 1 hour before meals and 1 cup of water 1 hour after every meals will ensure adequate intake of water

2. High fiber diet : 2 servings of vegetable salad and 2 servings of fruits especially citrus fruit will ensure adequate intake of water

3. Retention Enema with normal saline and glycerine will definitely help with constipation


Do get back to me if you need any further assistance, will be glad to assist you.

Take care

Best regards
Dr Deepak Kaltari
Consultant Pediatric Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepak Kishore Kaltari (12 hours later)
Thanks for reply.

For the inflammation to have been caused by chronic constipation, then wouldn't the constipation have to had improved somewhat in the 9 weeks between the 1st and 2nd scopes?
As it never..

She drinks more than the recommended daily amount, which the hospital told me as they monitored fluid charts for 4 consecutive days.

As she was placed on an Elemental Diet (amino acid formula)after they found the inflammation I also can't give the foods you've suggested...
She had worked her way back to having 10 safe foods, but totally stopped eating due to how she is feeling just now.

She has had quite a few enemas now, and they have proven inafective each time, as she always has the build up at the top end... as seen on x-rays..
doctor
Answered by Dr. Deepak Kishore Kaltari (2 hours later)
Brief Answer:
Additional information required

Detailed Answer:
Dear Ms

The inflammation associated with colitis could have possibly resolved with bowel preparation done as previously procedure preparation for colonoscopy.

It would be very helpful if you provide me with the following

1. X ray images

2. Colonoscopy report and pictures

3. Ultrasound abdomen report


Awaiting your response


Take care

Best regards
Dr Deepak
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepak Kishore Kaltari (33 hours later)
Hellom,

I don't have copies of test results but I have called them today and asked for copies...
I can forward these to you as soon as I receive them.

The only test you have mentioned there that hasn't been before is an ultrasound... do you think this could be useful to her?

I am just very concerned at the high levels of medication she needs each day to try and have a bowel movement :(

Thanks
XXXXXX
doctor
Answered by Dr. Deepak Kishore Kaltari (8 hours later)
Brief Answer:
Ultrasound will be helpful

Detailed Answer:
Dear Ms

Will be waiting for the reports. Ultrasound will definitely be helpful. I would suggest you to kindly discuss it with treating Physician.

Take care

Best regards
Dr Deepak
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Deepak Kishore Kaltari

General Surgeon

Practicing since :2002

Answered : 3195 Questions

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What Does Severe Inflammation Of Colon Indicate?

Brief Answer: Crohn disease could be missed based on sampling error Detailed Answer: Hi Welcome to Healthcaremagic Greetings of the day Dear Ms Chronic Idiopathic Constipation can also present with severe inflammation of colon. Regression of appearance of inflammation on repeat colonoscopy suggest chronic constipation as the possible cause of symptoms especially in view of negative biopsy. Crohn disease can be still missed in biopsy depending on sampling error. I would suggest you the following 1 Ensure adequate intake of water : 1 cup of water 1 hour before meals and 1 cup of water 1 hour after every meals will ensure adequate intake of water 2. High fiber diet : 2 servings of vegetable salad and 2 servings of fruits especially citrus fruit will ensure adequate intake of water 3. Retention Enema with normal saline and glycerine will definitely help with constipation Do get back to me if you need any further assistance, will be glad to assist you. Take care Best regards Dr Deepak Kaltari Consultant Pediatric Surgeon