Pathology/Endoscopic Biopsy of Colon
My 18 year old Son had a colonoscopy because of a sudden onset of chronic diarrhea and a lot of blood in his stool. I don't actually understand all the results.
1.(Colon, Cecum at 70 CM) Fragments of cecal mucosa showing moderate crypt destruction colitis with cryptitis, crypt abscess formation,lymphoid aggregates and active ulceration.
2. (Colon, Ascending at 60 cm) Fragment of colonic mucosa showing moderate crypt destruction colitis with cryptitis, crypt abscess formation, lymphoid aggregates and active ulceration.
3. (Colon, Ascending at 50 CM) Insufficient material for evaluation
4. (Colon, Ascending at 40 CM) Moderate chronic colitis with cryptitis and lymphoid aggregates
5. (Colon, at 30 CM) Fragments of colonic mucosa showing moderate crypt destruction colitis with cryptitis, crypt abscess formation, and lymphoid aggregates
The other one at 20 cm says the same as 30CM. They all say No evidence of Granulomata, dysplasia, or malignancy identified.
What does this mean for my son. They have him on steroids, and Asacol. He has currently stopped bleeding and the diarrhea has slowed down. But he lost a a lot of weight in the month in a half before treatment. Will he be on medication forever. Will this get worse?
The GI Doc is wonderful to my son but his approach seems too laid back, my son lost 24 pounds in 6 weeks. He is still so pale. He thinks he is doing better because he isn't bleeding, after he started the steroids, and his bowel movement are down to 10 a day Vs. 20+ a day.
Various biopsies taken at different levels of the large intestine (colon) show the following features:
1) Crypt destruction/cryptitis/crypt abscess: The inner lining of intestine is thrown into folds forming tubular structures called crypts. These are lined by epithelial cells. As per the report there is destruction of these crypts, inflammation (cryptitis) and abscess formation (destruction of tissue with collection of inflammatory cells) is observed..
2) Active ulceration: There is denudation of the surface epithelium lining of intestine causing ulceration...leading to bleeding and diarrhea as the absorptive surface (epithelial cells) are destroyed.
3) Lymphoid aggregates: Collection lymphocytes - chronic inflammatory cells.
All of these point to Inflammatory Bowel Disease (IBD) a group of disorders with a spectrum of disease ranging form mild inflammation - colitis or severs disease like Ulcerative Colitis or Crohn's disease.
It is considered to be an auto-immune disease. The treatment is usually to control the symptoms and prevent relapse. Dietary modifications are also recommended.
There is always a chance of recurrence, the goal of treatment is prevent a relapse.
The GI doctor will be able to provide more information as a specific diagnosis is made.
I wish your son good health.