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Dr.M.D.Mazumdar, MD
Dr.M.D.Mazumdar, MD, Doctor (MD)
Category: Health
Satisfied Customers: 8688
Experience:  Twenty years experience in active private practice
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I was diagnosed with colon low-grade dysplasia. What ...

Resolved Question:

I was diagnosed with colon low-grade dysplasia. What is the chance of avoiding colon removal surgery?
Submitted: 8 years ago.
Category: Health
Expert:  Dr.M.D.Mazumdar, MD replied 8 years ago.

Hello,

When were you diagnosed? how large is the area of dysplasia? Where in the colon is it?

Customer: replied 8 years ago.
Reply toCustomer MD's Post: I was diagnosed about three weeks ago.
Here is some info from the pathology report.
Random Rectum biopsy:
Uninflamed colonic mucosa with low grade dysplasia
Comment:
One fragment of colonic mucosa and a minute portion os a second fragment of colonic mucosa contain low grade dysplastic epithelium.
There was a polyp removed from the rectum area.

My doctor is getting second opinion to see if it is related to the polyp. In mean time he prescribed Pentasa. He did mention about possibility of total colon removal.

Thanks,
Mark
Expert:  Dr.M.D.Mazumdar, MD replied 8 years ago.

Hello,

Dysplasia in the colon is divided into low grade and high grade dysplasias. While all high grade dysplasias need to undergo total removal of the colon, low grade dysplasia has some criterias for this surgery.

-There must be long term ulcerative colitis or other inflammatory bowel disease - usually more than 8 years.

- If the dysplasia affect more than 50% of the colon.

- If it is a flat type of dysplasia (was yours on the polyp or in another part of the colon?)

- If the ulcerative colitis has not responded to the maximum possible medical treatment

Since, in your case, the dysplasia was diagnosed from only a small biopsy specimen from the rectum. I believe that you will need a more detailed colonoscopy and further biopsies from other sites higher up in the colon to decide on the course of the treatment.

But, I am afraid many gastroenterologists do suggest that total removal of the colon is the only treatment of colon dysplasia, whether high grade or low grade, since the chances of developing full-blown cancer is very high.

To know more about the treatmnet procedures of low grade colon dysplasia, please see:

- http://www.thedoctorslounge.net/oncology/forums/backup/topic-4285.html

- http://www.aafp.org/afp/20050201/practice.html please scroll down to 'Cancer Surveillance'.

I hope this helps.

Customer: replied 8 years ago.
Reply toCustomer MD's Post: I had chronic loose stools in the past (about 12 years ago). It could be that I had colitis but it was never confirmed. Condition was cured by taking rowasa and pentasa.
Doctor is not sure if dysplasia was a part of the polyp. He is getting second opinion from the Mayo Clinic.
Expert:  Dr.M.D.Mazumdar, MD replied 8 years ago.

Hello,

Chronic loose stools, especially if accompanied by cramps and bloating can be a part of colitis. But since it was a long time ago and you were cured by medicines, I do not believe that that could be a cause of the dysplasia now.

Rectal polyps often cause an inflammatory reaction around them which can lead to dysplasia. This may clear up spontaneously after removing the polyp. If this is the case, then you may not need removal of the colon.

If the dysplasia is not related to the polyp and occupies a large area of the colon (which can only be diagnosed by further colonoscopies), then surgical treatment may be necessary.

But in your case, I think that your symptoms are quite hopeful that you may not need a removal of the colon, especially the facts that you have not had continuous inflammatory bowel disease for a long time, the fact that the colitis was cured by medicines and the fact that there is a chance that the dysplasia could be due to the rectal polyp.

I hope this helps.

Customer: replied 8 years ago.
Reply toCustomer MD's Post: As doctor prescribed pentasa again, would it prevent from condition to worsen or perhaps cure it?
What about taking suplements such as flax oil, shredded coconut, folic acid?
Expert:  Dr.M.D.Mazumdar, MD replied 8 years ago.

Hello,

I believe you should continue to take the Pentasa - it should be helpful for you. But the other supplements should be avoided until a definitive diagnosis has been made.

I hope this helps.

Customer: replied 8 years ago.
Reply toCustomer MD's Post:
How helpful Pentasa will be, can it stop dyspasia?
Another question: Would mid internal non-bleeding hemorrhoids be correlated to my dysplasia condition?
And one more question:
I am taking UVB light course for skin psoriasis.
Would it make dysplasia condition worse?
Expert:  Dr.M.D.Mazumdar, MD replied 8 years ago.

Hello,

Peantasa is a drug used in the treatment of Ulcerative Colitis todecrease the inflammation associated with the condition. But Pentasa cannot prevent or stop dysplasia once it has already occured.

Non-bleeding hemorrhoids are not related to your dysplasia. It can occur independently.

UVB light for psoraisis will have no effect on the dysplasia.

I hope this helps.

Let me know if you need more input. If not, please click on the green"Accept" button on this page. A positive rating and adding a bonus will be warmly appreciated.

 

Customer: replied 8 years ago.
Reply toCustomer MD's Post: If pentasa would not help hy I need to take it?
Expert:  Dr.M.D.Mazumdar, MD replied 8 years ago.

Hello,

Penatas would decrease any inflammation of the colon and prevent further dysplasia. Which is why your doctor prescribed it.

But it would not stop what you already have.

I hope this helps.

Customer: replied 8 years ago.
Reply toCustomer MD's Post: Is there any non-surgical treatment at all to treat low grade dyspasia?
Expert:  Dr.M.D.Mazumdar, MD replied 8 years ago.

Hello,

No, I am afraid that there are no non-surgical treatment.

I hope this helps.

 

 

Customer: replied 8 years ago.
Reply toCustomer MD's Post: How about Endoscopic Mucosal Resection?
Expert:  Dr.M.D.Mazumdar, MD replied 8 years ago.

Endoscopic Mucosal Resection is a surgical procedure.

Customer: replied 8 years ago.
Reply toCustomer MD's Post: Sorry, I ment anything else but removing colon
Expert:  Dr.M.D.Mazumdar, MD replied 8 years ago.

If the diagnosis is established as low grade dysplasia occupying a wide area of the colon, then I am afraid there is no other option than removing the colon. If the dysplasia is lcocalised, then the part of the colon affected must be removed.

Please accept this answer to continue this discussion.

Dr.M.D.Mazumdar, MD, Doctor (MD)
Category: Health
Satisfied Customers: 8688
Experience: Twenty years experience in active private practice
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Dr.M.D.Mazumdar, MD
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Twenty years experience in active private practice