Inflammation Detected During Colonoscopy: Causes and Concerns

Colonoscopy revealed colitis?

Hello, I recently experienced symptoms similar to irritable bowel syndrome, but to be cautious, I underwent a fecal occult blood test, which returned negative.
Additionally, after a colonoscopy, the results were mostly normal, but a small area of inflammation was found.
Could this be a case of general inflammation that might resolve on its own? Or is it typically indicative of chronic enteritis or cancer? Can the biopsy determine this? Thank you.

Boris, 40~49 year old female. Ask Date: 2021/08/16

Dr. Chen Jiaming reply Surgery

Since you have undergone a colonoscopy, the physician who performed the examination was a specialist (gastroenterologist or colorectal surgeon).
At that time, the physician's clinical judgment and management represented expert opinion.
They determined that most of the findings were normal, with only a small area showing inflammation (symptoms similar to irritable bowel syndrome indicate increased intestinal motility, which can cause wear on the intestinal wall and result in an inflammatory state).
There is generally no need for concern, and there are no suspicious lesions for cancer; therefore, the physician did not perform a biopsy at that moment (and you cannot request one, as it may not be possible to locate the same area during a repeat colonoscopy).
It is advisable for you to focus on discussing medication, diet, and the actual subsequent performance of your intestines with your consulting physician.

Reply Date: 2021/08/16

More Info

Understanding inflammation detected during a colonoscopy can be a complex issue, as it encompasses a range of potential causes and implications for your health. Based on your description, it seems that your colonoscopy revealed a small area of inflammation, which can indeed be indicative of various conditions, from benign to more serious.

Causes of Inflammation
1. Acute vs. Chronic Inflammation: Inflammation in the colon can be acute, often resulting from infections, dietary irritants, or recent changes in bowel habits. Chronic inflammation, on the other hand, may be associated with conditions like inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis. Chronic inflammation can also arise from long-standing irritants, such as chronic infections or autoimmune responses.

2. Infectious Causes: Sometimes, infections can lead to inflammation in the colon. Bacterial infections, such as those caused by Clostridium difficile, can result in significant inflammation and symptoms like diarrhea and abdominal pain. However, your negative stool test for occult blood and the absence of other infectious markers suggest that an acute infection is less likely.

3. Dietary Factors: Certain foods can irritate the gastrointestinal tract, leading to localized inflammation. This is particularly true if there has been a recent change in diet or if you have food intolerances.

4. Irritable Bowel Syndrome (IBS): Given your history of symptoms resembling IBS, it is possible that the inflammation is related to functional gastrointestinal disorders. IBS can sometimes present with inflammation-like symptoms, although it is not characterized by inflammation in the same way as IBD.

5. Polyps or Neoplasia: While the presence of inflammation can be benign, it is essential to rule out the possibility of polyps or neoplastic changes, including cancer. The biopsy results from your colonoscopy will provide critical information regarding the nature of the inflammation.

Biopsy and Diagnosis
The biopsy taken during your colonoscopy is a crucial step in determining the cause of the inflammation. Pathological examination of the tissue can reveal:
- Chronic Inflammation: This may suggest conditions like IBD or chronic infections.

- Granulomas: These are specific types of inflammation that can indicate Crohn's disease.

- Dysplasia or Malignancy: The presence of abnormal cells can indicate precancerous changes or cancer.

Self-Healing and Treatment
In many cases, mild inflammation can resolve on its own, especially if it is due to transient factors such as dietary irritants or minor infections. However, if the inflammation is chronic or associated with conditions like IBD, it may require medical management, including anti-inflammatory medications, dietary changes, or other therapies.

When to Seek Further Evaluation
If you experience persistent symptoms such as abdominal pain, changes in bowel habits, or any new symptoms like weight loss or fever, it is essential to follow up with your healthcare provider. They may recommend additional tests or treatments based on your symptoms and biopsy results.

Conclusion
In summary, the inflammation detected during your colonoscopy could be due to various factors, including benign causes that may resolve on their own or more serious conditions requiring treatment. The biopsy results will be instrumental in guiding your next steps. It is always advisable to maintain open communication with your healthcare provider to address any concerns and ensure appropriate follow-up care.

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