question on pouchoscopy biopsy results

No, I think you are reading something into this that just is not there. The comment at the end states that only the top mucosa layer (superficial) was presented for biopsy. He is just saying that he cannot comment on what is potentially going on in the deeper layers.

The fact that you only have active inflammation/ulceration at the anal transition zone (ATZ) is a good thing. Not good, in respect that you have it, but the location. Inflammation in the ATZ cannot be used to make a diagnosis of Crohn's, because it is a common site of post op inflammation. So that means that your pouchitis is likely just regular pouchitis (not Crohn's, because it responds well to antibiotics).

However, the ATZ inflammation could be due to ischemia (nothing on the pathology reports supports or rules it out), or it could be due to the stricture, leading to straining, fecal stasis, etc., and causing your symptoms.

The finding of the the thrombosed vein on MRI could very well be a red herring. This is because when you are looking for sources of ischemia, you are looking for arterial problems, not venous. Arteries supply the blood to an organ, and veins drain the blood. You can lose a vein and be OK, since there are collaterals, and over time new ones grow. But, during the acute stage of venous thrombosis, there can be congestion and swelling, until the collaterals grow. I would tend to think that yours is old news from the time of surgery, and not acute. But you should get clarification from your doctors.

It is easy to get worked up over abnormalities found in tests, but it is the doctors' job to make sense of it all and make clinical correllations. If everyone on the street were examined as closely as most of us, they would also find abnormalities, which may or may not be significant. I know you have other issues to be concerned with as well, so it all gets just a little overwhelming, I'm sure. Hope this helps a little.

Jan

Just when I think I cannot get through the day, I have been given hope. Thank you Jan for taking the time to respond. You have helped ease my anxiety over this issue. Have a blessed Thanksgiving.


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But I'll bet you'd like some sort of clue as to why you're still not doing as well as you'd like. I'm so sorry you're not experiencing a perfect pouch. Hopefully the your GI and CC will have some real answers for you.

kathy

Thanks Kathy. My pouch function is pretty good to be honest. Not sure if that will change when trying to get off cipro. The stricture and cuffitis are giving me most of my headaches.