Could this possibly be a mis-diagnosis?

[IDreamInColor]

Tex, you are so knowledgable I would love your input on this. As you all know I have had D for years, and during the past year it slowly got worse. But then one fine day in August the D just went severe and I was in the bathroom too many times to count, it was mostly water I was passing.
Well, after two trips to the ER for starvation/dehydration (wasn't eating because of the consequences, but I learned that not eating didn't make much difference anyway.) Countless doctor visits and test after test, I was told at my last follow up with the GI doctor that I "might" have microscopic colitis. "Might" isn't good enough, I need to know for sure. So I requested a copy of my results and I'd love your opinion.
From what I'm reading of my results it makes it sound like a mild case, or not even developed yet, if that's the case then why am I having all these problems?
Anyway, this was my diagnosis from a colonoscopy and random biopsies of the lower bowels. Here is what is says, word for word...

Diagnosis:
1. Terminal Ileum Biopsy
Ileal Mucosa with presence of ileal villi showing nonspecific chronic inflammation. No evidence of granulomas

2. Random Colon Biopsy
Colonic glands are tubular, focally slightly crowded and surface epithelium and lamina propria show focal mild increase
in lymphocytes, evolving microscopic colitis is possible. Note: Close follow-up for microscopic colitis is suggested.
No granulomas are identified. No glandular dilation or distortion is seen.

Ok, there it is, lots of words I don't understand, this diagnosis makes it sound mild, doesn't it? But I'm having such terrible symptoms.

[tex]

Hi,

Looking at the report, yes, you definitely show the markers of LC, even in your ileum, (which is somewhat common for MC). If the ileitis involved any granulomas, that would indicate possible Crohn's disease. In your case, though, none were found, and no other histological changes are noted, so only MC is indicated.

A "mild" increase in lymphocytic infiltration does not necessarily mean a mild case of MC, (though many GI docs seem to interpret it that way). it is true that a low lymphocyte count implies a relatively mild level of inflammation, but unfortunately, as a group, the members of this board have found that the lymphocyte count has no correlation with the severity of symptoms. Many of the members with "mild" indications on their biopsy reports, have the most severe symptoms.

Also, if you have had D for years, prior to your diagnosis, then obviously your MC, (LC), is not accurately described as "evolving". It may have been evolving for years, with chronic D, but once you reached the secretory D stage, (high-volume, watery D), in August, it had obviously matured. My opinion is that individual patients present with widely varying levels of lymphocytic infiltration, but the numerical lymphocyte count has little correlation with the stage of their disease, or the intensity of the symptoms. IOW, it's like an antibody count. The actual count doesn't matter. All that matters is whether or not the count is above a certain threshold level.

Thanks, I appreciate the kind words.

Tex

[IDreamInColor]

Thank you Tex, that certainly makes alot more sense. I'm slowly putting all this together to try to make sense of it. You have been most helpful.