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I have a BCIR and recently had it scoped due to severe cramping, blood, and increased urge to empty. My gastro went over the photos with me and said it's Crohn's.  The biopsies came back "suggesting pouchitis".  But the doctor wrote on there that it looks like Crohn's to him. I, too, believe it's Crohn's since I've had pouchitis several times, and this time the symptoms are different and much worse.

 

My question is this: How much weight should be given to biopsy results vs. what a gastroenterologist of 30 years says? 

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All the diagnosis gives you is a particular set of treatments to try. More important than the "correct" diagnosis is a treatment plan that makes you feel better. Neither biopsy results nor clinical judgement necessarily prove the diagnosis. Just try something in collaboration with your doctor, give it enough time to work (or not), and if it doesn't work, try something else.

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