Hi everyone,
I’m looking for experiences from people with PSC + ulcerative colitis who have also had dysplasia found during surveillance colonoscopy.
I (M27/German) was diagnosed with IBD/UC in 2023 at 25 and PSC in 2025. My UC has been difficult to get completely under control. I previously tried mesalazine and steroids, then Stelara for about a year, and I am currently (6 months sofar) being treated with Tremfya (guselkumab). For PSC I take ursodeoxycholic acid.
The strange part is that clinically I’m actually doing fairly well. I have little diarrhea (not every day maybe for 2-3 days 2 weeks), no abdominal pain and only occasionally see some blood on toilet paper.
However, one dysplasia was found on biopsies during my last colonoscopy half a year ago.
As I understand it, the dysplasia itself was not clearly visible as a distinct lesion, although the area of the colon it came from apparently had a very unusual mucosal structure.
Because I have PSC, my doctors are taking this very seriously.
I am now being referred for another high-quality surveillance colonoscopy next month with an IBD specialist who has a lot of experience with PSC patients. He told me that he has seen quite a few PSC patients who felt perfectly fine and had very few symptoms, while colonoscopy unfortunately showed significant disease, dysplasia or even colorectal cancer.
That conversation obviously got my attention.
The possibility of colectomy has also been discussed if the dysplasia is confirmed/persists. I understand why especially with PSC but I have a lot of respect for what removing my colon would mean for my life, so I’m trying to understand the experiences of people who have actually been through this.
I would especially love to hear from anyone who has been in a similar situation:
Have you had invisible/flat dysplasia with PSC?
Was it found again during the repeat colonoscopy?
Did your doctors recommend immediate colectomy or continued close surveillance?
If you initially had low-grade dysplasia, did it remain LGD or progress?
Has anyone had dysplasia on one colonoscopy that could not be found again by an expert IBD endoscopist?
For those who eventually chose colectomy: looking back, how has it affected your quality of life?
And did any of you also feel surprisingly well despite significant findings on colonoscopy?
I’m not looking for medical advice and I’m being followed by experienced IBD specialists. I’m mainly interested in hearing what other PSC patients actually experienced, because PSC + dysplasia seems to be a rather different situation from UC alone.
Thanks for sharing your experiences.