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I am having the same questions as Willabec posted in WHY? but I think in reverse! I started to have watery diarrhea for only a week or two before I was diagnosed with MC. Looking back on my notes, I started Imodium, but in very small doses, such as 1/2 to 1 tablet every other day. (I've only taken Imodium for maybe less than 2 weeks). The watery diarrhea stopped, replaced by semi soft, semi formed stools, even though the frequency of bm's didn't change much ( 4-5 a day). I took my last imodium (1/2 tab) on Saturday, four days ago. I am still getting fairly formed stools, without the help of Imodium! What is going on? How long does Imodium stay in your system? Should I continue NOT to take Imodium if my stools are not watery? Am I beginning to heal?
Mandy
This is weird...
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Mandy wrote:How long does Imodium stay in your system?
Probably not more than a couple of days, but that's just a guess.It's your choice. Not everyone has secretory D with MC - you're apparently having osmotic D, which is a much milder form.Mandy wrote:Should I continue NOT to take Imodium if my stools are not watery?
Maybe - if you previously had secretory D, and you've changed your diet. Periods of spontaneous remission are also possible, just as with Crohn's disease and UC, but spontaneous remission with MC is not a common occurrence.Mandy wrote:Am I beginning to heal?
Imodium will not bring remission, if that's what you're wondering - it will only slow down the D while you are using it. It does nothing to address the inflammation.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
It depends on the instructions that the GI doc gave the pathologist. IOW, it depends on whether he gave the pathologist specific instructions to rule out a certain disease, (or diseases), or if it was an open-ended analysis. Even if specific instructions were involved, the pathologist would still have surely noted any remarkable observations in his report. The problem is, if the GI doc has his mind made up ahead of time, he or she will often ignore some or all of the findings in the pathologist's report. That has happened to many members here, where the pathology report showed the markers of MC, but the GI doc never mentioned that to the patient, because he or she was unfamiliar with the disease, and considered it equivalent to IBS. 
Sometimes Crohn's presents initially in the jejunum, (only), so it can be missed with a scope, but in most cases, physical evidence of both Crohn's disease and UC, (in the form of visible lesions), can be seen through the colonoscope, so the GI doc can actually visualize it during the exam, (and the pathologist will verify the diagnosis when examining the biopsy slides under the microscope). UC is rarely missed, because it always originates in the distal colon, (IOW, in the rectum, and sigmoid colon).
For LC, the pathologist looks for lymphocytic infiltration, (T cells), and a diagnosis of LC requires a lymphocyte count in excess of 20 lymphocytes per 100 enterocytes. A normal colon usually has about 5 lymphocytes per 100 enterocytes. CC is marked by thickened collagen layers in the lamina propria, and a collagen band thickness in excess of 10 microns is considered diagnostic evidence of CC. Normally, collagen bands do not exceed a thickness of 4 or 5 microns, in a healthy colon.
For mastocytic enterocolitis, the diagnostic threshold is 20 mast cells per 100 enterocytes, but the pathologist almost always has to be specially instructed by the GI doc to rule out ME, because this analysis requires a special stain to make mast cells more easily visable, and most pathology labs don't even keep that stain in stock, so they have to special order it when a GI doctor request it. Even if they have it in stock, they're not likely to use it, unless the instructions from the GI doc requests the mast cell analysis. That's why diagnoses of mastocytic enterocolitis are rare, even though mast cell issues are rather common for people with MC. GI docs continue to make the disease rare, by failing to look for it. Like MC in general, you can't find ME unless you look for it, and you also have to know how to look for it.
Tex
Sometimes Crohn's presents initially in the jejunum, (only), so it can be missed with a scope, but in most cases, physical evidence of both Crohn's disease and UC, (in the form of visible lesions), can be seen through the colonoscope, so the GI doc can actually visualize it during the exam, (and the pathologist will verify the diagnosis when examining the biopsy slides under the microscope). UC is rarely missed, because it always originates in the distal colon, (IOW, in the rectum, and sigmoid colon).
For LC, the pathologist looks for lymphocytic infiltration, (T cells), and a diagnosis of LC requires a lymphocyte count in excess of 20 lymphocytes per 100 enterocytes. A normal colon usually has about 5 lymphocytes per 100 enterocytes. CC is marked by thickened collagen layers in the lamina propria, and a collagen band thickness in excess of 10 microns is considered diagnostic evidence of CC. Normally, collagen bands do not exceed a thickness of 4 or 5 microns, in a healthy colon.
For mastocytic enterocolitis, the diagnostic threshold is 20 mast cells per 100 enterocytes, but the pathologist almost always has to be specially instructed by the GI doc to rule out ME, because this analysis requires a special stain to make mast cells more easily visable, and most pathology labs don't even keep that stain in stock, so they have to special order it when a GI doctor request it. Even if they have it in stock, they're not likely to use it, unless the instructions from the GI doc requests the mast cell analysis. That's why diagnoses of mastocytic enterocolitis are rare, even though mast cell issues are rather common for people with MC. GI docs continue to make the disease rare, by failing to look for it. Like MC in general, you can't find ME unless you look for it, and you also have to know how to look for it.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thank you so much! I remember the GI being especially pleased that MC was found because he had muttered under his breath " you always take biopsies, always! when you do a colonoscopy!" I took that to be that he was talking about other GI's who don't. So I am guessing he didn't see anything out of the ordinary, such as ulcers, etc. to confirm UC. I really, really need to get that pathologist report. Who knows what could be in there that he didn't mention!
Mandy
Mandy
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draperygoddess
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Mandy,
I would definitely encourage you to get a copy of the path report. My GI told me everything was "normal," and weeks later, when I requested a copy of the report, I found out that it wasn't normal at all!
As far as the Immodium goes, I never had secretory D (thankfully), but when I was taking Immodium I would often have 3-4 days of normal-to-constipated days, then the cycle would start over again. I didn't get any long-term results until I changed my diet.
Glad you're having some happy days--hope it continues!
I would definitely encourage you to get a copy of the path report. My GI told me everything was "normal," and weeks later, when I requested a copy of the report, I found out that it wasn't normal at all!
As far as the Immodium goes, I never had secretory D (thankfully), but when I was taking Immodium I would often have 3-4 days of normal-to-constipated days, then the cycle would start over again. I didn't get any long-term results until I changed my diet.
Glad you're having some happy days--hope it continues!
Cynthia
"Can we fix it? YES WE CAN!" -Bob the Builder
"Can we fix it? YES WE CAN!" -Bob the Builder
Since he told you that you have MC, the odds are slim that the path report will contain any significant undisclosed information. It's when you're told that there's nothing wrong with you, that you need to see that report.Mandy wrote:Who knows what could be in there that he didn't mention!
If you want to see what he recorded during the colonoscopy exam, (which would include any indications of Crohn's, UC, etc.), you would have to request a copy of the endoscopy report, (from the colonoscopy exam).
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.