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A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
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Experience:  Board Certified NP, MS, RN. Private practice & hospitalist
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when is a biopsy necessary during a colonoscopy I had one

Resolved Question:

when is a biopsy necessary during a colonoscopy? I had one because my Ct scan revealed mild wall thickening of sigmoid colon, non-distended loops, and pericolonic stranding. But during colonoscopy no biopsy was taken. I had no polyps no IBD and no diverticulitis or cancer. I do have the h. pylori stomach infection. Could that have caused inflammation? I ran no fever no vomiting or diarrhea just a lot of constipation. FOBT and stool guaiac were negative for blood. DO I need upper endoscopy now? What part of intestine does h. pylori affect? I took triple therapy for 2 weeks.
Submitted: 6 years ago.
Category: Health
Expert:  A. Schuyler, NP replied 6 years ago.

Hello,

 

Welcome to Just Answer and thanks for your question. H. pylori affects the stomach and is usually eradicated with triple therapy along with several weeks of acid suppression to allow the stomach and lower esophagus to heal. Biopsies during colonoscopy are taken when polyps or anything suspicious is seen during the colonoscopy. Interior samples of the colon may be taken if there are abnormalities seen. It appears that the things seen on your CT scan were not internal to the colon. You cannot take biopsies through the lumen of the bowel to evaluate wall thickness, etc.

 

Customer: replied 6 years ago.
Could you please clarify what you mean by things seen on Ct were not internal to colon-were they external and is this cause for concern? What does wall thickness really mean? I always thought it meant a cancer or obstruction. So do I have anything to worry about?
Expert:  A. Schuyler, NP replied 6 years ago.

Think of the colon as a garden hose. Water going through the hose is internal to the hose. The air surrounding it is external to the hose. If you cut a hole in the hose (take a biopsy) through the hose wall, the hose leaks water into the exterior (your abdomen) setting up the possibility fo peritonitis. Therefore, you can't take a biopsy through the wall of the colon.

 

What the CT found was that the hose was thicker than the average garden hose. One cause of wall thickening is chronic constipation. Pericolonic stranding is a result of inflammation causing swellling of the adjacent fat around the colon. This is often seen in different types of colitis (inflammation of the colon). Wall thickness doesn't necessarily have anything to do with cancer. It is often seen when there has been obstruction, as in constipation. At this point they have seen no cancer, no IBD, but you do have signs that you've had bowel inflammation. Now they need to find out what has been causing it.

 

Customer: replied 6 years ago.
Would I have to undergo another colonoscopy to find out what caused the inflammation. I am not constipated anymore, but I did test positive for h. pylori Could that have caused the inflammation? Also, the doctor told me I did not have colitis because I had no blood in my stool and FOBT and stool guaiacs were negative for blood. So what could be possible causes of inflammation?
Expert:  A. Schuyler, NP replied 6 years ago.
Having been constipated with bacteria confined in one place in the colon would have been enough to have caused inflammation. It's possible that it had healed by the time you had the conoloscopy. H. pylori is known for causing problems in the stomach, but I suppose there is always the possibility it could have been one of the bacteria responsible for inflammation lower in the digestive tract. Colitis just means inflammation of the colon. Bleeding is not required, although it is most common.
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 14936
Experience: Board Certified NP, MS, RN. Private practice & hospitalist
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A. Schuyler, NP
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