Inflammation vs. Thickening?

[annak87]

I'm sure this is basic crohn's knowledge but I'm just a little confused. I've, thankfully, only really had perianal fistula/abscess problems in the past with crohns. Which I mean are more than enough but I have never really dealt with the stomach issues most have. Welllll that was until a few months ago. I started having more trips to the bathroom which are unpleasant to say the least and also some major sounds coming from my guts after eating and last but not least, pretty intense pain to the right of my bellybutton. So, my colorectal surgeon ordered a ct scan about a month ago and I just saw him last week. This is where I got a little confused. He said, and showed me, where my ileum has inflammation/thickening. He used these terms interchangeably and I didn't know if they mean the same thing or if it's both/what would the difference between the two be?

I haven't had a scope in almost 2 years so the first thing he said was I need to get one set up. I see him and my GI at the end of March, so I'll probably set up a scope then, talk options, and also try to figure out this seton mess I've been dealing with. The only crohns med I'm currently on is Remicade every 7 weeks. So I don't know if something else would be added to deal with the inflammation/thickening or what.

Any answers/advice would be greatly appreciate everyone!

 

[katiesue1506]

Inflammation causes thickening. Inflammation is a swelling of the bowel walls, which in turn makes the walls thicker. This can be seen on a CT scan.

Consequently, thickening is also the same as narrowing, because it causes the path in the walls to become narrower. The only thing you have to be careful with is that narrowing isn't always due to inflammation, sometimes scar tissue can cause narrowing.

Therefore,

Inflammation always equals thickening, and inflammation always equals narrowing, but narrowing is not always inflammation/thickening because it could be scar tissue.

I hope I've helped... maybe ha.

 

[Grumbletum]

Ah, thank you, I was wondering about that too as I've been told I have narrowing/thickening in the small bowel.
Can I ask another couple of questions? If you are inflamed, is that what is known as a 'flare'? I would imagine that if you have narrowing it's the cause of pain, but if foods etc are worsening symptoms, does that mean it is likely you are in a flare?

 

[Rebecca85]

Inflammation equals a flare. Food can make pain worse because it irritates the walls of the intestines. Like if you scratch at eczema or dry skin it gets really sore. Scratching didn't cause it in the first place, but if you've got it it makes things worse. Also if you are significantly narrowed, indigested bits of food can get stuck.

 

[annak87]

Thanks for the answers! I think I have my head wrapped around the similarities and differences now. I guess this might be a tougher question but I'll give it a shot. I've never been on a steroid but isn't that what is usually prescribed to battle inflammation? But, aren't those with fistulas/abscesses supposed to avoid steroids? I'm sure I'm not the first to deal with both, so what would they do in this situation?

Also, the food thing really makes sense. I have celiac as well so I do a gluten-free diet but other foods I have been able to tolerate until recently. It's very strange for me to have to cut other things out but I guess it's just something I'll have to get used to.

 

[Rebecca85]

Steroids are prescribed to get inflammation under control quickly. But immune suppressants and biologics will also bring inflammation under control, but it takes a little more time for the drugs to build up in the body. I am not sure about patients with fistulas and abcesses having to avoid steroids, but I believe Remicade (or another biologic) is generally believed to be the best thing for treating them.