Sigmoid Colon Inflammation and Polyps: Key Insights for Patients

Q: Sigmoid Colon Inflammation and Polyps: Key Insights for Patients

Hello： The biopsy results indicate chronic inflammation of the sigmoid colon and lymphoid aggregation at the ileocecal valve (this area is connected to the terminal ileum, where lymphoid tissue is normally more abundant, and there is a low likelihood of malignant transformation).

Ulcerative colitis of the sigmoid colon, grade 3?

Hello, I previously inquired about colonic erosion, and now I have received my health check report with some questions.
I would like to share an excerpt from the report:
Colonoscopy report excerpt: Colitis (Slice A), Colon Polyp (Slice B: approximately 0.5 cm)
Pathology report DIAGNOSIS:
Intestine, large, sigmoid colon, 15 cm from anal verge, endoscopic biopsy, --- chronic inflammation
Intestine, large, ileocecal valve, endoscopic biopsy, --- lymphoid aggregation with severe crush artifact
MICROSCOPIC DESCRIPTION: Microscopically, section A of the colonic mucosa shows edematous stroma and lymphoid infiltration.
There is no specific cryptic change or injuries.
Section B of the colonic mucosa shows lymphoid infiltration in the lamina propria.
The nuclear details are difficult to discern due to severe crush artifact.
There is no evidence of malignancy.

Chronic inflammation (Slice A).
Lymphoid tissue aggregation with severe crush artifact (Slice B) (no malignant findings, but some tissue interpretation difficulties due to crushing).

As for the endoscopic examination record, it states: Several aphthous erosions (Bx A) are noted at the sigmoid colon, 15 cm from the anal verge.
A 0.5 cm YAMADA type 2 polyp (Bx B) is noted at the ileocecal valve.

The health check center staff indicated that there is no need for immediate follow-up, and I should monitor my stool condition, with a follow-up colonoscopy in a year.
They mentioned that the inflammation might be due to diarrhea caused by bowel preparation (I took Fleet), but I am still concerned, so I would like to ask the doctor a few questions:
1.
Could the inflammation be merely a side effect of the bowel preparation?
2.
I recall experiencing diarrhea about two weeks before the health check, but after taking anti-diarrheal medication, I felt better the next day and had no particular issues afterward.
After the health check, I had a bit of diarrhea the next day, but since then, in about a month, I have only had one day of significant diarrhea.
Is it possible for inflammation to have such subtle symptoms?
3.
Can inflammation resolve on its own without medication, or do I need to see a doctor again?
4.
Is intestinal inflammation a common condition like gastric inflammation?
5.
Regarding the polyp, does lymphoid tissue aggregation count as hyperplastic polyp? Is there a possibility of malignancy? The polyp was only biopsied and not removed.
I apologize for the many questions, and I greatly appreciate your responses!

me, 30~39 year old female. Ask Date: 2013/12/16

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: The biopsy results indicate chronic inflammation of the sigmoid colon and lymphoid aggregation at the ileocecal valve (this area is connected to the terminal ileum, where lymphoid tissue is normally more abundant, and there is a low likelihood of malignant transformation).
Regardless of the underlying cause (whether due to bowel cleansing agents or infection), there should not be any significant issues.
When discussing diarrhea, it is important to consider the total volume, frequency, and consistency of the stool (e.g., watery diarrhea); a single occurrence of unformed stool cannot be classified as diarrhea.
Small polyps can generally be completely removed during the biopsy process, unless they are larger polyps, in which case a polypectomy would be necessary.
For any related questions, you may consult the gastroenterologist who performed your examination, as having the colonoscopy images is essential for accurately addressing your concerns.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2013/12/16

More Info

Understanding sigmoid colon inflammation and polyps is crucial for patients, especially when faced with findings from a colonoscopy. Based on your report, it appears that you have chronic inflammation in the sigmoid colon and a small polyp at the ileocecal valve. Let's address your questions one by one.

1. Could the inflammation be a side effect of bowel preparation?
Yes, bowel preparation can sometimes lead to transient changes in the intestinal lining, including inflammation. The use of agents like Fleet can cause irritation and may lead to temporary diarrhea, which can affect the mucosal appearance during a colonoscopy. If the inflammation is mild and correlates with the timing of your bowel prep, it may resolve on its own as your bowel returns to its normal state.

2. Is it normal for inflammation to present with mild symptoms?
Inflammation in the colon can indeed be asymptomatic or present with very mild symptoms. Many patients with chronic inflammation may not experience significant discomfort, especially if the inflammation is not severe. The fact that you had a brief episode of diarrhea prior to the colonoscopy could be related, but it’s also possible that the inflammation is not causing significant symptoms at this time.

3. Will the inflammation resolve on its own, or should I see a doctor?
Many cases of mild chronic inflammation can resolve without specific treatment, particularly if they are related to transient factors like bowel prep or dietary changes. However, if you continue to experience symptoms such as abdominal pain, changes in bowel habits, or if you notice blood in your stool, it would be prudent to follow up with your healthcare provider. They may recommend monitoring your symptoms or possibly initiating treatment if necessary.

4. Is intestinal inflammation common among the general population?
Yes, intestinal inflammation can occur in many individuals and can be due to a variety of causes, including infections, inflammatory bowel disease (IBD), or even dietary factors. While some people may experience it as a chronic condition, others may have isolated incidents that resolve without intervention.

5. Regarding the polyp, is lymphoid aggregation considered a hyperplastic polyp, and is there a risk of malignancy?
Lymphoid aggregates are often benign and can be a normal finding in the colon. They are not typically classified as hyperplastic polyps, which are usually characterized by a different histological appearance. The report indicates no evidence of malignancy, which is reassuring. However, any polyp, regardless of type, should be monitored over time, as some types can have a potential for dysplasia or cancer. Since your polyp was not removed during the colonoscopy, it is essential to follow up as recommended by your healthcare provider, typically with a repeat colonoscopy in a few years, depending on your risk factors and the characteristics of the polyp.

In summary, while your findings indicate some inflammation and a small polyp, the absence of malignancy is a positive sign. It’s essential to maintain regular follow-ups and monitor any changes in your symptoms. If you have ongoing concerns or new symptoms arise, don’t hesitate to consult your healthcare provider for further evaluation and management. Regular screenings and being proactive about your gastrointestinal health are key to preventing complications.

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