Updated: Dec 10, 2020
So what are Indeterminate Colitis (IC), Ulcerative Colitis (UC) and Crohns Disease (CD)? and how do I know which I have?
Indeterminate colitis (IC) originally referred to those 10–15% of cases of inflammatory bowel disease (IBD) in which there was difficulty distinguishing between ulcerative colitis (UC) and Crohn's disease (CD) in the colectomy specimen.
(UC) Ulcerative Colitis is a condition that causes inflammation and ulceration of the inner lining of the rectum and colon (the large bowel). In UC, ulcers develop on the surface of the lining and these may bleed and produce mucus.
(CD) Crohn’s Disease is a condition that causes inflammation of the digestive system or gut. Crohn’s can affect any part of the gut, though the most common area affected is the end of the ileum (the last part of the small intestine), or the colon.
How do I know what I have?
The truth is, No one knows 100%, However, my colon specimen has been researched and diagnosed by a top scientist at Gloucester University, Dr Shepherd, it is thought that I suffer indeterminate colitis, although they cannot rule out completely, that what is thought to be more Ulcerative colitis now, will not present as Crohns disease in the future.
I suffered predominantly in the colon and rectal area presenting with ulcers, inflammation and bleeding, however, my Ileum is thought to of been affected historically during flare ups.
At present (December 2020) my specimen was reassessed following severe pouchitis and cuffitis, by Professor Hart at St Marks Hospital (Bowel Disease and Cancer Specialist Foundation). I have since had a total proctectomy so now live with a permanent ileostomy stoma and full removal and closure of the rectum - affectionally known as a 'Barbie Butt' .
I hav e been through a failed Jpouch which was removed in February 2020 and have shaed my full journey in my blog.
The official word on IC
Wiley Online Library - Indeterminate colitis: definition, diagnosis, implications and a plea for nosological sanity
In 1978, Price introduced the concept of indeterminate colitis to describe cases in which colonic resections had been undertaken for chronic inflammatory bowel disease (CIBD), but a definitive diagnosis of either of the classical types of CIBD, ulcerative colitis and Crohn's disease, was not possible. This was especially apposite in cases of acute fulminant disease of the colorectum. More recently, the term indeterminate colitis has been applied to biopsy material, when it has not been possible to differentiate between ulcerative colitis and Crohn's disease. In our opinion, and in those of other workers in this field, the term should be restricted to that originally suggested by Price. This then provides a relatively well‐defined group of patients in whom the implications and management of the disease are becoming much clearer. Cases where there are only biopsies with CIBD, but equivocal features for ulcerative colitis and Crohn's disease, should be termed ‘CIBD, unclassified’, ‘equivocal/non‐specific CIBD’ or IBD unclassified (IBDU), in line with recent recommendations. When the diagnosis is correctly restricted to colectomy specimens, there is now good evidence that the majority of cases will behave like ulcerative colitis. Furthermore, the diagnosis should not be a contraindication to subsequent pouch surgery. When the latter is undertaken, surgeons and patients can expect an increased complication rate, compared with classical ulcerative colitis, especially of pelvic sepsis, but most patients fare well. Only very occasional patients, around 10%, will eventually be shown to have Crohn's disease. This review describes the pathology of cases appropriately classified as indeterminate colitis and the implications of that diagnosis. It also highlights recent advances in its pathological features, clinical management and its immunological and genetic associations.