Is there nothing else to be done for stricturing?

[Irene3]

I read here somewhere, that one of you had the small bowel where there was stricturing, ballooned or something???

I'm sooooooooooo disappointed after my GI appointment yesterday. I'd been jotting down different medications, that I researched, to try. Iv dot a lot of distention and I had a couple of obstructive symptoms, so I thought, get a ct, and make sureits not an abscess, and if all good, give humira a try if he says no to everything else.
He basically said, because I only had a 5mm gap, with ulcering two years ago, and Iv got these symptoms, he said his almost certain I need another resection. MRI first, then I guess he'll refere me to a surgeon.

Is there nothing else that can be done for stricturing???

 

[DustyKat]

Unfortunately not all stricturing is able to be dealt with via balloon dilatation. The risk of doing this procedure if you have active inflammation is the structure of the bowel wall is already weakened and therefore you risk perforation. That is the same reason many GI's will not push through an inflamed area during a colonoscopy.

Stricturing is scar tissue, as a result it is inflexible and does not respond to treatment like normal tissue does. Once it has built up enough to cause problems, like obstruction, then the only way to treat is to physically alter or remove it. Sometimes during surgery they are able to perform what is called a strictureplasty. This procedure allows them to cut along the scar tissue lengthways and hopefully it will release enough to allow a decent diameter of bowel to remain for food to pass through. It can be done in conjunction with a resection, allowing less bowel to be resected.

Either way though it sounds like you will require some sort of surgery.

Dusty. xxx

 

[Irene3]

Thank you. Iv had over 70cm so far rescected, and where the bowels were rejoined, is where the crohns came back. But I was starting lots of vitamins, and wanting to diet, (scd) and thought with humira if nothing else, surely it will settle. So I guess I just have to wait for the MRI results and go ahead with it. I was supposed to have that bit recsected last year, but tried a candida diet, thinking that it might settle. Ended up in hospital with clitis, though it's always been crohns only before. Now crohns is affecting the rectum too, and I worry how much will be recsected if I have surgery.

Guess I was hoping there is something, if not medication, that can be done to the bowel, rather then just getting more recsected. It's just disappointing

 

[DanHerefordshire]

ballon dilation is actually very sucsesfull the only problem is the location of the stricture its possible to get the inflamation gone with iv steroids very fast and then carry out the procedure... but as the scopes/ballon can only reach the first and last part of the gi tract this is where the problem comes

odviously theres meds and liquid diets to do if your stricture is still only 5mm and out of reach of the scopes/baloon or thereabouts you never know

 

[Irene3]

Thank you, it's not out of reach because it's 50+ small bowel, and 20+ large bowel was recsected, so the scope can easily reach that bit where it was rejoined after the temporary illeostpmy. I'll ask my GI when I go for my MRI results. I hope he will say IRS worth a try. My inflammation markers are fine, because I'm still on a reasonably high dose of prednisone, and 5mm was fine for eating, so I'll see what he says. Thanks again.

 

[DanHerefordshire]

yep its well worth asking i had a stricture in my colon ballon dilated 4 years ago and its still fine i had one in my dudoneum done twice in four years and thats ok to
serious complications are very rare 1 in 30000 some people go over ten years without surgery with a baloon dilation

 

[Irene3]

I will be for sure. I'm only 29, and I worry about having more recsected already. I don't want to let it become an emergency situation, as when my bowel perforated, my GI said that it had to be 70cm recsected, because all the bowels stick together, around the abscesses and perforation.
At the same time, I still only want resection if it's absolutely necssesary, so you've given me a bit of hope that it may not be. Just have to be patient to go see him in 2 weeks, and not get my hopes too high. Then I just hope long term he'll let me trial antiinflamitories rather then imunesuppresants, and I could do the scd then.
Thanks again

 

[MCPayne]

I read here somewhere, that one of you had the small bowel where there was stricturing, ballooned or something???

Irene

That may have been me. I posted a question about a possible stricture that I had in September of 2011 when I had a colonoscopy. It was smooth narrowing in the colon, down near the rectum. The GI fellow (it's at a teaching hospital / clinic) was wondering if he could balloon dilate it, which they were going to discuss at their next panel discussion. However, my most recent scope, which was Thursday, the narrowing was gone. A different fellow thought that the narrowing was just inflammation at the time, which has subsided.

I actually was worried that I may need to have surgery to have that removed, but turns out I don't, as it resolved itself. They talked about using a pediatric endoscope to try to get passed the narrowing this most recent procedure, which they did use, but the fellow though that he could have passed through the colon with a regular adult endoscope (I'm 28 years old).

 

[Irene3]

Hello, nice to kind of meet you Iv read so many threads in the last couple weeks, that it may have been for all I know.
That's wonderful that it resolved for you, I'm praying that there's no need for another recsection, but because of constant distention when I eat, and needing endone day to day, otherwise only resting helps with the discomfort and at times pain, so I'm not sure if this area can 'settle' on it's own. It's been a long time since there was 5mm left for food to pass through, and my GI believes there may only be a pin hole opening left. Even if I just have lots of sustagen through the day, by night time I'm extremely distended and in discomfort. I'm trying to eat a little more (low residue for now), and cut back on milk, though GI dosnt think it aggravates my bowels, my last stay in hospital going back on low residue, lots of milk, I actually felt worse. I didn't take anything for pain before going in, and I was taking 4+ endone coming out of hosp. Though I must say my back gets really sore on high dose cortico steroids. My inflammation markets are back to normal, (still high dose of Pred, yuk), but it's still happening.
I so hope he will agree to try dilation.
Thanks for added hope though, never know, it could settle. I'm glad yours did. Their those bits of good news we hang out for with this disease I think. Xo