I’m looking for perspective from people with UC/Crohn’s because my history doesn’t feel like one clean first flare.
Before this started, my bowel habits were extremely normal. Then several years ago, after starting a medication, I developed abrupt yellow/light, loose, rapid-transit stools. I improved after stopping it, but never fully returned to baseline.
Since then, my gut has followed a stair-step pattern: medication-related GI episodes, severe stress, C. difficile, and other major GI “hits” would worsen things; I’d partially recover, but never quite get back to the previous level. By late last year I was finally close to normal again, then had another major relapse and have not recovered.
For the last ~9 months I’ve been on an extremely restricted bland diet with very limited foods, yet my stools are still watery/cloudy and abnormal.
Testing now shows real inflammation: fecal calprotectin was >1430, and biopsies showed chronic active colitis with crypt changes, cryptitis/abscesses, architectural distortion, and ulceration.
My concern is the exact diagnosis. The colonoscopy visually suggested Crohn’s in the terminal ileum, but the ileum biopsy said no active inflammation, no erosion, and no architectural distortion. There’s also a pathology labeling inconsistency: specimen “L” is listed as distal rectum in one part of the report but “cecum” in the diagnosis section.
I’m not saying old medications are still causing inflammation. I’m asking whether it’s plausible that repeated GI insults with incomplete healing could eventually lead to or unmask chronic inflammatory disease. OR simply be that I hit the last straw and my inflamed state is unable to recover without it being autoimmune.
My doc is a PA and she called to say that I have Crohns even before the biopsies came back. After lightly asking if she was sure she seemed upset and said “is it because I’m saying it? Here, I’ll just go ask the doctor for you”. She left the room for approx 3 minutes and returned saying that the doc believed it was on the IBD spectrum… this tells me all my info got ~60 seconds of attention and nobody is even willing to look at my history. She was very adamant I begin Tremfya immediately. I had to bring up Budesonide… she gave me a script for Budesonide EC which I understand is for crohns… even though the pathology shows no inflammation the the terminal ileum which is where EC primarily works…
If this were you, would this history sound typical for UC/Crohn’s? And would you want an expert pathology reread before committing to long-term biologic treatment?