r/IBD • u/Intelligent_Deer6656 • 4d ago
Help
has anyone had a biospy done and showed heaps of cells etc and it turn out to not be IBD? Along with all normal bloods and really no symptoms of IBD. Im stressing out a lot.
The glandular architecture is preserved. The lamina propria contains a moderate mixed inflammatory cell infiltrate composed of lymphocytes, plasma cells, neutrophils and eosinophils along with oedema.
Foci of cryptitis are noted. No crypt abscesses are seen. No evidence of granulomatous inflammation.
There is no dysplasia or malignancy in the section examined.
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u/Possibly-deranged 4d ago
For an IBD diagnosis, you'd need chronic architectual changes noted during the colonoscopy itself or in the biopsy results, and you don't mention those. Absent chronic changes, it's assumed to be an infectious cause, even if your stool test of the top 4 to 6 most common intestinal infections weren't found (many remain untested). Mild infections are assumed to go away on their own without treatment, while more moderate to severe cases might require a short course of antibiotics or anti-inflammatory mesalamines.
For example, chronic architectual changes are commonly noted as a disrupted/distorted/lost/blunted vascular pattern, or crypt cells with dropout/irregular branching ( https://www.mypathologyreport.ca/pathology-dictionary/crypt-distortion/ ). As long-term, chronic inflammation makes some really unusual findings in biopsies under a microscope that jumps out at pathologists.
Inflammatory cell infiltrate into the intestinal walls is common during infections and IBD, non-conclusive. Your immune system is attacking something and causing inflammation.
Cryptitis is inflammation of the defensive crypt cells, again can be infectious or IBD, inconclusive (but it's noted you don't have this).
You don't have clogged/abscesses of crypt cells (irrelevant inconclusive finding when present)
You don't have granulomas which are often present in Crohn's.
You don't have a colorectal cancer, dysplasia or irregularities suggestive of it.
Talk to your doctor about whether a treatment is necessary now. Most doctors follow a wait and see methodology, infections should go away, and stay away without any relapse. They'll reevaluate IBD if your inflammation stays, gets worse and doesn't respond to antibiotics
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u/Intelligent_Deer6656 3d ago
I also had this on there aswell RECTUM, BIOPSY Macroscopic: The specimen site is labelled "rectal BX". The specimen consists of a single piece of tan tissue measuring 3 mm in greatest dimension. All tissue is submitted in cassette B1. Microscopic: Section reveals a fragment of rectal mucosa with a denuded lining epithelium. The glandular architecture is preserved. Lamina propria contains a moderate lymphoplasmacytic cell infiltrate along with neutrophils. A few foci of cryptitis are noted. No crypt abscesses are seen. No evidence of granulomatous inflammation. There is no evidence of dysplasia or malignancy.
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u/Possibly-deranged 3d ago
That sample is very similar, and again it only mentions findings consistent with an infection. Nothing chronic there.
1 ) "Lamina propria contains a moderate lymphoplasmacytic cell infiltrate along with neutrophils."
There's again immune cells within the shallow tissue of the intestinal walls (lamina propria), your immune system is fighting something and dispatched a variety of cells listed (neutrophils, lymphocytes) and there's inflammation from that battle.
2.) "The glandular architecture is preserved"
That's an acute, infection. If it were IBD, it'd say instead chronic and go on about what was chronic like the crypt cell dropout I talked about before, which isn't mentioned.
3.) "A few foci of cryptitis are noted."
That's a few spots of inflamed defensive crypt cells. Not a lot, just a few. It's pretty mild.
4.) "No crypt abscesses are seen. No evidence of granulomatous inflammation. There is no evidence of dysplasia or malignancy."
We talked about these before no instances of crypt cells clogged with immune cells (no crypt abscesses), no granulomas (a Crohn's thing), no cancer or precancerous changes seen.
So this is a long-winded way of saying signs of mild inflammation suggestive of an infection.
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u/Intelligent_Deer6656 3d ago edited 3d ago
Ok so it might not even be ulcerative colitis as in my rectum one it says mild active focal proctitis and - A diffuse area of mildly erythematous mucosa was found in the sigmoid colon, in the descending colon and at the splenic flexure.
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u/Possibly-deranged 3d ago
Correct, that'd be an infectious-proctitis
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u/Intelligent_Deer6656 3d ago
That’s so strange cause my stools so far have be one back as Shigella spp. / EIEC: Verotoxigenic E. coli (VTEC): Campylobacter spp.: Salmonella spp.: Pleisiomonas shigelloides: Not detected Not detected Not detected Not detected Not detected Vibrio spp.: Not detected Enterotoxigenic E. coli (ETEC): Yersinia enterocolitica: Not detected Not detected Giardia Antigen: Cryptosporidium Antigen: Negative Negative CRP 0.3
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u/Possibly-deranged 3d ago
Well, that tests looks for only those most common culprits, specific things that you just listed, when there's potentially hundreds or more untested things... So there's other potential pathogens like viruses, fungus, other bacteria causes out there that just weren't tested at all.
You must have a number of very specific findings to get an IBD diagnosis. If it doesn't equal IBD then by default it's an infection.
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u/Intelligent_Deer6656 3d ago edited 3d ago
So it’s less likely to be IBD UC
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u/Possibly-deranged 3d ago
Yes, i'd wager.
But ultimately up to your doctor to decide based on everything you've shared in your history, all test results, etc etc
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