Nonspecific inflammation

In early 2016 I was diagnosed with diverticular disease following a colonoscopy (I had had mild/moderate stomach pain for several months which came and went).

In July 2017 I some moderate bleeding in the stool and was given another colonoscopy. This time they found 1. small haemorrhoids 2. Non-specific inflammation in the sigmoid colon (acute and chronic inflammatory cells) and 3. Mild active inflammation in the rectum.

I was told at the time by the consultant that there was no direct evidence of IBD and that I should take a faecal calprotectin test in about 6-7 months. That test came back as normal (11mcg/g) and the consultant said no action was required. The whole consultation lasted for, literally, 5 minutes, during which time he said that I could “put this behind me” . I was shocked however when I saw the letter he sent to my doctor. In it, he wrote “he described a minor flare-up of bowel problems (in February this year there was some fairly mildish stomach pain which my GP had attributed to diverticular disease and which I told the consultant about) “WHICH WE CAN NO LONGER ATTRIBUTE TO DIVERTICULAR DISEASE GIVEN THE ENDOSCOPIC FINDINGS.” But what does this mean? My GP had attributed the minor flare up to diverticular disease whereas the consultant seems to directly contradict this view. Does this mean I am still a candidate for IBD which has yet to manifest itself more directly? At the moment I have no symptoms.

Apologies for sounding so dramatic, but this came as a nasty shock this evening - I thought I was out of the woods on this (particularly given the 5 minute consultation) but it now appears that this may not be so. I am aware this is a rather complicated car, but does anyone have any opinions? I am 63 and have no family history of IBD.

[Valbaty54]

Hello, I was diagnosed with Ulcerative Colitis three years ago aged 61 and had no family history. UC does start with rectal inflammation and works its way up through the sigmoid colon, so I would guess your consultant is hinting it's a possibility but very mild at the moment. Your Calprotectin is normal (mine is 1100!). If symptoms return perhaps they will give you more info.

Val

[Hidden in reply to Valbaty54]

Thanks for your reply. I just find that this is like a sword of Damocles- you never know if/when it’s going to land on your head. I don’t really know if I have IBD or not.

[Hidden in reply to Valbaty54]

If you don’t mind my asking, is the condition manageable or has it caused you significant problems? I was told that if you got it in later life it was usually less serious.

[Valbaty54 in reply to Hidden]

For me it has caused significant problems, I'm afraid! I don't respond to many of the medications which they use, so at the moment I'm reasonably ok on Infliximab infusions, azathioprine and rectal steroid foam. Surgery has been on the table but on hold for now. However, everyone is different, and if you are diagnosed, it could be much less of a problem. Let's hope your inflammation doesn't flare up again!

[Hidden in reply to Valbaty54]

Thanks! But I still feel I am living next to a volcano. I’m going to ring the consultant on Monday for more info.

[willow24 Administrator]

Gastroenterologists are the specialists, GP's do not have the specialist knowledge or expertise as they do not focus on 1 particular area or system of the body.

your faecal calprotectin is fantastic, and doesnt even suggest IBS.

As people age, pressure within the colon causes bulging sacs of tissue that push out from the colon walls. These sacs are most common near the end of the colon called the sigmoid colon, just above the rectum. This condition is called diverticulosis, which may have few or no symptoms. If a diverticulum becomes infected or inflamed, it is called diverticulitis. this is what Im assuming caused your flare.

There has been research into the correlation of Crohns and diverticulitis, as Crohn's disease and diverticulitis share clinical and radiologic features but usually differ in histopathy. There is an idea that the pathology of Crohn's disease may be a secondary reaction to diverticulitis. and that the presence of Crohn's disease in association with diverticulosis predisposes to the development of diverticulitis.

An article from Gloucester Royal Hospital makes for interesting reading gut.bmj.com/content/gutjnl/...

[Hidden in reply to willow24]

Thanks for your reply and the interesting article- I did not know there was a link between the two.