So, I went for my one year checkup....j-pouch looks good. The doc found some polyps in a small portion of the near the anal/rectum area where the ulcerative colitis still exists. Evidently, the j-pouch surgery didn't remove the entire colon?! He gave me a prescription for cortofoam for one month, then return in 6 months for a follow-up and possible biopsies for dysplasia. Last time I heard the word dysplasia caused me to have the j-pouch. Anyone else experience this and how concerned should I be?
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There's usually a little bit (1-2 cm) of rectum left (the "cuff") that the pouch getss attached to. It can develop UC-like symptoms (called "cuffitis"). And yes, it can develop dysplasia. But the overall risk of cancer is much, much lower than when the entire colon is at risk. In UC each cell of the colon has a small (elevated) risk of turning cancerous; the surgery removed almosst all of those cells. The small amount left should be biopsied peridically.
I am surprised that your doctor did not biopsy the polyps he found during your examination. My GI found a polyp in the same area that had become malignant over a short period of time and it was successfully removed. In my opinion, a more aggressive approach involving removal of these polyps with biopsies should be done ASAP to catch any problems in their early stages and to put you at ease.
Bill
Bill
He said that he couldn't get a good biopsy with the current inflammation....
Maybe after a month of cortifoam treatment he can get better biopsies. I honestly have never heard of this. I have had cuff inflammation on and off for almost four years and my GI always manages to perform biopsies.
Are you having any symptoms? Couldn't he have at least biopsied the polyp?
Are you having any symptoms? Couldn't he have at least biopsied the polyp?
They were probably inflammatory polyps. Pretty common and not likely to be dysplastic. It is difficult to determine true dysplasia when there is a lot of inflammation, as there is inflammatory dysplasia that looks similar to precancerous dysplasia. It is safe to wait and biopsy later.
Jan
Jan