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5 replies

what do these results mean?

pouchingtonpouchingtonMember
FINAL DIAGNOSIS

A. POUCH BIOPSY #1:
- MILD CHRONIC INFLAMMATION OF LAMINA PROPRIA ACCOMPANIED BY MINIMAL
VILLOUS ATROPHY WITH NO NEUTROPHILIC INFILTRATES.
- THE HEIDELBERG POUCHITIS ACTIVITY SCORE IS: 2/12.
- NO GRANULOMAS OR DYSPLASIA SEEN.

B. POUCH BIOPSY #2:
- MILD CHRONIC INFLAMMATION OF LAMINA PROPRIA ACCOMPANIED BY MINIMAL
VILLOUS ATROPHY WITH NO NEUTROPHILIC INFILTRATES.
- THE HEIDELBERG POUCHITIS ACTIVITY SCORE IS: 2/12.
- NO GRANULOMAS OR DYSPLASIA SEEN.

C. POUCH BIOPSY #3:
- MODERATE LYMPHOCYTIC INFILTRATES OF LAMINA PROPRIA ACCOMPANIED BY
CONGESTION, PARTIAL VILLOUS ATROPHY AND PATCHY NEUTROPHILIC INFILTRATES ON
THE SUBEPITHELIUM.
- NO ULCERATION SEEN.
- THE HEIDELBERG POUCHITIS ACTIVITY SCORE IS: 5/12.
- NO GRANULOMAS OR DYSPLASIA SEEN.
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J jeaneMember
My biopsies with chronic pouchitis usually read ' mild inflammatory changes w prominent eosinophils in the lamina propria' and the cuff reads ' moderate chronic colitis, mildly active with many lamina propria eosiphinils'

My GI and surgeon have seen active ulcers in my distal pouch. Although it causes me discomfort at times w cramping etc I manage w Canasa and low dose antibiotics.

I am not sure this report is of real concern as many people have active inflammation in their pouch with no symptoms and you have no visible ulcers it appears. Jan may best be able to provide more insight on your results.
Jan DollarJan DollarModerator, RN, retired
ALL pouches have some level of inflammation on the microscopic level, so it is the degree that is important, not the fact that inflammation is present. There is one biopsy of three in this report with more than mild inflammation. It may or may not be significant. All pathology reports need to be taken in consideration of the clinical findings and visual inspection by the physician doing the scope. The most important findings in pathology reports are in regard to dysplasia, neoplasm, or granulomas.

Jan Smiler
Scott FScott FMember
What the results mean depends (IMO) entirely on how you're feeling. You don't have microscopic (pathology) evidence of roaring pouchitis, but you *might* have mild or moderate pouchitis, depending on what your doctor observed and what symptoms you're having.

The Heidelberg scoring system combines clinical symptoms, observations during pouchoscopy, and pathology (how the biopsies look under the microscope). Each can score up to 12 points (more points mean pouchitis is more likely).

Heidelberg Pouchitis Activity Score

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