I can’t answer your question about the photos, but your doctor should have biopsied any suspicious areas observed during the examination. I would ask his office to give you a copy of the procedure report and the pathology report (if biopsies were taken).

The dots you point out look like small ulcerations to me. The white patches in the other images are ulcerations too. The other lesions that you call bulbous are what my doc refers to as cobblestoning. It is common in Crohn's, but can occur in UC too. If you do a Google search you'll find similar images. 

Jan

@Billv i  would ask the doctor but hes referring me to a GI doctor anyway so ill get the answers then, i just figured i could get a head start and see what im looking at from the community.

@jan I'm hoping i do not have Crohns.....that would be a huge blow, what do they typically do for this cobblestoning? i vaguely recall the surgeon saying this could be why its hard to empty at times.

and what are ulcerations exactly?

Sorry for the delayed response. Our cable was chewed through by squirrels!

Ulcerations are just inflammatory erosions in the mucosa. Cobblestoning is inflammatory also. There isn't different treatments for different inflammatory lesions, at least not as far as I know. Just poucitis treatment. Antibiotics and/or IBD treatments. 

To me, it does not matter whether it is UC, Crohn's or some new form of IBD. You just deal with it and accept things as they are.

Jan

I work in IT so i know the havoc that squirrels and other rodents create. damn cute furry destructive creatures!

I just received the follow up letter from the surgery and apparently they took a biopsy even though he didnt mention anything about that in the recordings we took after the scope, (we record because i never remember anything we talk about" 

I'm actually about to email them now to find out where we are at with the referral to a GI Doc. 

one more question if you dont mind, they said mild pouchitis yet i have been on cipro and flagyl now for close to 8 months or a year, i was on xifaxin at the same time about 2 months ago, is there anything else that will work since this regime isnt wanting to? wonder if i can get Hydrocortisone suppositories for that "cobblestoning" 

I have biopsies done every time I am scoped. All lesions are generally biopsied. It would be a big surprise to me if they were not. It is the only way to find dysplasia. You cannot diagnose it based only on visual inspection.

I am one with persistent pouchitis with ulcerations despite long term use of antibiotics. It is why I am on Imuran and Remicade.

Jan

Adding hydrocortisone suppositories and/or Entocort (pills) were somewhat helpful for me to add to the antibiotics, but they don't like you on the suppositories forever due to risk of thinning, and Entocort is also not generally used as a maintenance drug (Altho they have been trailing it as a maintenance drug). When I was unable to wean all the way off the Entocort w/o symptoms returning, I started Immuran. Rotating antibiotics AND taking Immuran have kept me in check for 2.5 years so far. Adding a Biologic would be the next step after that.

JJA posted:

Adding hydrocortisone suppositories and/or Entocort (pills) were somewhat helpful for me to add to the antibiotics, but they don't like you on the suppositories forever due to risk of thinning, and Entocort is also not generally used as a maintenance drug (Altho they have been trailing it as a maintenance drug). When I was unable to wean all the way off the Entocort w/o symptoms returning, I started Immuran. Rotating antibiotics AND taking Immuran have kept me in check for 2.5 years so far. Adding a Biologic would be the next step after that.

I'm on Enbrel currently for arthritis, i used to be on Humira when i had a colon but it became inneffective after awhile, maybe it will help with this small area, I had adverse reactions to remicade so thats out of the question. 

Enbrel is not effective for IBD, that is why it is not approved for it. There are other biologics that are effective for both IBD and arthritis besides Remicade and Humira. There is also Simponi and Cimzia. Cimzia has an assistance program that pays for your deductible and copay up to $11,000 a year which did not require a financial need statement. That was real nice!

Jan

Wow! Seeing that you guys have to pay that much money for medicine in the US, I consider myself blessed. My state insurance covers all biologics here, no deductible or co-pay needed.  And even if I had to pay the  full price for, let's say Humira, a box of two doses (two syringes or pens) would not cost me more than $350. Lucky me

I have good insurance with a low copay (for now), but the monthly cost before benefit for most biologics in my area (California) is $2000-$6000. I guess this is one of the reasons that there is a large movement to work better prescription price deals for Americans.

What is weird is the fact that I have been on Remicade for about 3 months now and have yet to recieve a bill for those infusions. I knew there was no copay for the infusion itself, but I thought I'd be billed for the medication.

Jan