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Biopsy report suggesting inflammation of the colon, probable ulcerative colitis? - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Digestion and Bowels
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
User :   Diagnosis: benign colonic mucosa with increased eosinophils and some neutrophils in the lamina propria. No amoeba observe
Doctor :   Hi
User :   pls interpret
User :   hello dr
User :   what can this biopsy report means
Doctor :   Hstologically, colon has 4 layers in it
User :   ok
Doctor :   The first 2 layers (from the inside) is referred to as lamina propria.
Doctor :   According to the reports here, there is an increase in the neutrophils and eosinophil blood cells.
Doctor :   we find such instances when there inflammation of the gut
Doctor :   and most probable reason for such inflammation is infection, a parasitic infection.
Doctor :   This is not the diagnosis, but just the inference of the biopsy report.
Doctor :   Do you follow?
User :   can this be seen in ulcerative colitis?
User :   what does inference means?
Doctor :   Inference means, what the biopsy is revealing.
Doctor :   It is suggesting that there is an inflammation present.
Doctor :   It could be an acute inflammation which are seen in conditions such as colitis.
User :   so with that kind of report can that indicate ulcerative colitis
Doctor :   Ulcerative colitis is a chronic condition.
Doctor :   apart from the presence of neutrophils in the lamina propria, usually surface changes (on the innner most layer referred to as epithelium) are noticed.
User :   a colonoscopy was done but the dr. said that they did not reach the upper portion of the colon because it still was dirty, still full of stool so the tissue sample was just taken from the lower portion
Doctor :   Some amount of neutrophils can be seen in the lower part of the colon especially if they were close to rectum.
Doctor :   The changes just indicate inflammatory changes secondary to bacteria or parasites.
User :   in your opinion dr. what may be the disease?
Doctor :   The changes are more suggestive of an acute changes and not ideally chronic condition such as ulcerative colitis.
Doctor :   Can you brief me about your symptoms and the reason why colonoscopy and biopsy was performed?
User :   abdominal pain sharp and sudden for quite some time now
User :   dark stool, before like last year dark stoll with fresh blood
User :   all bowel movements is with mucus
User :   I had athritis in my fingers
User :   everyday extreme fatigue (literally)
Doctor :   Ok
User :   i have chest pains like my chest is being steped on
User :   last year fever for more thatn a week that even i was already hospitalized and was given antibiotics thru IV fever doesnt go down
Doctor :   May i know your age and gender?
Doctor :   Apart from the colonscopy, have you had any other tests done?
User :   female 28
User :   my mom is filipino chinese and my father is puertorican
User :   yes blood test
Doctor :   and were the result of blood test normal?
User :   ESR 26mm/hr
User :   CRP positive
Doctor :   Ok
Doctor :   Let me brief you.
User :   C3 190.24
Doctor :   ESR is definitely above normal, but not alarmingly high.
Doctor :   These tests are not specific to diagnose a condition.
Doctor :   presence of mucous in stools is a concerning problem
Doctor :   and can be seen in both acute condition such as colitis
Doctor :   as well as in chronic inflammatory condition
Doctor :   such as ulcerative colitis.
Doctor :   The biopsy report is more suggestive of an acute colitis rather than ulcerative colitis.
User :   in 2007 in a KUB xray they saw segmented ileus in the right lumbar region
User :   what is acute colitis?
Doctor :   Colitis is a medical name given when there is inflammation of the lower gut- the colons.
Doctor :   This inflammation could be result of an acute condition such as acute infection, acute changes secondary to allergies and so on.
User :   what are the risks, and treatment for this
Doctor :   Similar changes when it occurs gradually over a long period, it is referred to as inflammatory bowel disease (Ulcerative colitis/chron's disease)
Doctor :   Before we step on to the next level, where treatment is decided, if your doctors who
Doctor :   have examined you are suspecting a chronic condtion
Doctor :   he/she may advice you a repeat of the tests after proper bowel preparation.
User :   so correct me if im wrong dr. so if acute colitis is not treated early for a long period of time complication is ulcerative colitis
Doctor :   Acute colitis are usually caused by bacterial infection which usually has 2 results
Doctor :   1. It gets cured spontaneously
Doctor :   2. Results in complications.
Doctor :   Thus rarely acute colitis progress to chronic ones unless
Doctor :   the cause for acute inflammation is an auto immune mediated or allergen mediated.
User :   dr. bloating and tenderness are also my symptoms i forgot to tell you
Doctor :   Abdominal symptoms are found in multiple conditions and diagnosis cannot be confirmed based on the symptoms alone.
User :   yes afcoarse
Doctor :   A diagnosis can be obtained only after a proper physical examination and off course by the colonscopy.
Doctor :   Colonscopy and biopsy that you have currently
Doctor :   probably are not very helpful here to rule out ulcerative colitis or other chronic condition.
User :   what other test can be done to really find what is wrong
Doctor :   You may need a repeat of the tests, which is done after proper bowel preparation
Doctor :   so that the higher colon can be visualised and sampled for biopsy.
User :   thats what i said also
Doctor :   I agree with you here, that you may need to get a repeat of the biopsy to rule out ulcerative colitis.
Doctor :   The biopsy report that you have here
Doctor :   is not very conclusive, it only indicates that there is an inflammation secondary to parasitic infection
Doctor :   If your repeat biopsy also has similar reports
User :   yes you are correct dr
Doctor :   than you need not concern.
Doctor :   It can be corrected/treated.
Doctor :   Do you have any other query?
User :   ok thank you very much you were very helpful
Doctor :   Thanks for consulting me. Bye for now.
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