@CTBarrister posted:I met with my gastroenterologist today and we went over the EBD photographs which can be recapped as follows:
(1) the J Pouch looks really good;
(2) the J pouch inlet is inflamed with ulcerations and strictured;
(3) there is additional inflammation well above the J pouch inlet in the neoterminal ileum.
He is ordering 2 things right now: (1) Remicade level blood test; (2) he is putting me on Entocort to see if that will bring down the inflammation at the inlet and in the ileum.
He can't say whether or not the inflammation, which is all north of the J pouch, is due to backsplash stool. Some of the inflammation seems to be well above the inlet. So while backsplash stool is one possibility, the "morphing of a new inflammatory bowel disease process", which was first observed 15 years after the J pouch was surgically created, may also be what's going on. He declined to place a label on it (such as Crohn's), instead calling it "Crohn's like", because he understands that such labels are totally irrelevant to treatment determinations and also possibly incorrect. He is simply dealing with it as bowel inflammation that needs to be treated.
I am going to see him again 2 weeks after the next EBD which is set for October 6.
The past few years I have had 2 small ulcers at the top of the pouch(inlet), Shen saw them right before he left Cleveland , and put me on Tindamax. 2 years later I had my scope with my new surgeon Dr Dietz and he noticed them still there. He stated sometimes the pouch just has some small ulcers, and that he did not think it had a Crohns appearance at all. He didn't even put me on any meds since I wasn't having any symptoms.