Crohn's Disease Forum » General IBD Discussion » Help - Understanding biopsy results! Is this Crohn's?

05-20-2017, 07:50 PM   #1
Join Date: May 2017
Location: Murrieta, California
Help - Understanding biopsy results! Is this Crohn's?

Well, new here.. hate to have to say I'm possibly here to join along.

Quick explanation of events - this may be a long post and I'm sorry!

March 29th, literally out of no where as I was taking a shower after work I started having abdominal cramping, you know, the kind where you know you're going to have to hit the toilet. I had the feeling of it REALLY wanting to come out, not necessarily urgency but if I had to describe it, kind of the feeling how vomit wants out of your system and all the muscles in your body contract to make sure it does! This wasn't explosive, nor even watery diarrhea, but it was 'loose' in the sense that it was not one piece, but a bunch of little pieces with clear cut edges. Felt a lot better, but still had some upset stomach/cramping as I'm sure we have all felt from time to time (even before being diagnosed!).

Ever since that night, my stools have been odd ever since. Most of the time it has been in little bits, and about 2-3 weeks into it I started having noticeable mucus in my stools. No blood.

I have also had some bad acid reflux, at least I think that is what this was.. food felt like it was up to my throat, and I had some weird bubble feeling in my throat for weeks. I've also lost some weight, but it's hard to really say if it was all because of this or not. I have a very physical job and this lined up perfectly with when my business' season began (as I always seem to lose some weight at the start of the season, although never payed this much attention to it). I also wasn't eating as much as I was trying to keep it bland, and then I came down with the flu for 2-3 days that my son, and most of my family contracted as well. So I didn't eat for a few days, followed by definite light eating afterwards. This mixed with the anxiety of what is going on, has meant less eating as well, and with the same physical work load.

On May 3rd, I had my colonoscopy - and here are the results:



Pathy erythema, friability, erosions and ulceration were noted in the ileo-cecal valve. Multiple cold forceps biopsies were performed for histology in the terminal ileum, cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum. This was done to assess the extent and severity of disease, and to reult out dysplasia.

Normal mucosa was noted in the whole colon and terminal ileum. Biopsies were obtained from normal mucosa to evaluate for/exclude microscopic colitis. Multiple cold forceps biopsies were performed for histology in the terminal ileum. Eval for microscopic ileitis.

Medium grade 2 internal hemorrhoids were noted.


A. Terminal Ileum-Biopsy:
-Mild Acute Ileitis

B. Whole Colon-Biopsy:
-Moderate Focal Active Colitis

C. Ileo Cecal Valve-Biopsy:
-Abundant fibrinopurulent exudate consistent with ulceration.
-Diagnostic tissue not identified.

Microscopic Description:

A: The villous architecture is intact. The lamina propia contains benign intramucosal lymphoid aggregates. There is mild inflammation characterized by the presence of a mildly increased number of neutrophils within the lamina propria. There is no evidence of granuloma formation or atypia.

B: The crypt architecture is intact. The surface is straight. There is mild-to-moderate acute inflammation characterized by the presence of multiple crypts involved by neutrophils and an increased number of neutrophils within the lamina propia. Intraepithelial lymphocytes are not increased. Granulomas are not present. Rare pigmented macrophages suggestive of mild melanosis coli are also noted within the lamina propia. There is no evidence of atypia. There is no significant thickening of the sub-basement membrane layer.

C: No diagnostic tissue is otherwise identified.


So, is this really how Crohn's starts, completely out of the blue?! BM frequency really hasn't changed much, although the times are different and some days have some increase. I must also mention I have had times of undigested food in stools, as well as some times of steatorrhea.

I thank you for all your time, I am a nervous wreck about all of this and what this means. My GI hasn't given me a diagnosis, but has mentioned IBD and even infection as still a possibility. Although stool tests and bloods were normal.
05-20-2017, 08:57 PM   #2
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ronroush7's Avatar
Join Date: Oct 2013
Location: vienna, Virginia

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I have heard the word ileitis referred to as Crohns.
Diagnosed in 1990. On Humira, Imuran, Gabapentin, Colestipol, Synthroid, Lialda. Resection in April of 2010. Allergic to Remicade, Penicillin, Flagyl, Doxycycline. Thyroid issues and psoriasis and neuropathy and mild cerebral palsy. Mild arthritis in my lower back.
05-20-2017, 09:19 PM   #3
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Jabee's Avatar
Join Date: Oct 2016
Location: Massachusetts

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Basically, they found significant ulcerations (inflammation) in your ileocecal valve as well as some mild inflammation in your terminal ileum. The biopsies die not show crohn's, but only @30% of crohn's patients have diagnostically significant biopsies. You could have a crohn's but you could also have an infection.
05-21-2017, 04:50 PM   #4
Join Date: May 2017
Location: Murrieta, California
Is this how Crohn's usually roars its head, out of no where like this? Would the inflammation show as acute like this, or would/does it usually show as chronic?

I appreciate any other insight figuring out what this means, as being in limbo is beyond horrible.

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