Questions about Strictureplasty

[Bamafan94]

Hi!
I've had Crohn's Disease for almost 15 years. It's located at the end of my small intestine. In that time, I've had 3 flare-ups. I learned a few months ago that I now have scar tissue there that has caused a narrowing. My GI said the narrowing is not severe right now, but he put me on a low residue diet, and told me it was time to start thinking about surgery.
He said that I would need a bowel resection, but I've been researching the surgery and found something called Strictureplasty.
It sounds much less invasive, and I was wondering if anyone here has had that done. I'd much rather have something like that than having to be cut open. :/
I'd been doing well on the low residue diet until last week. I don't know if I ate something that I shouldn't have, or what happened, but I'm tired of living in limbo. If I can get better by having surgery, I'd rather get it over with. But if this Strictureplasty is an option, I'd like to know that too.
I'd appreciate anyone's advice if you have experience with the Strictureplasty.
Thanks!


Current Meds:
Imuran
Lialda
Remicade
Prenatal Vitamin (For extra vitamins)
Prayer

 

[nogutsnoglory]

I have had strictureplasty done. When you say you don't want to be cut open what do you mean? For a strictureplasty they still need to cut you open (most likely laparoscopic) and then slice the stricture in half to give you more of an opening but they won't resect it.

It's definitely worth discussing with the surgeon but if your intestine is severely scarred it may not be an option.

 

[Carrie]

It depends how much of your bowel is affected. If it's more than two or three inches, it has to be resected.

My last surgery was a strictureplasty (I'd had two prior resections), and am pleased with the results so far, and the recovery seemed much smoother (but that could be down to changes in surgery in 10 years and the UK vs. the US). The only concern I have about mine is that it helps, but doesnt get rid of the scar tissue--it could continue to scar and still require resection in the future.

I'd say it is worth inquiring about it as an option.

 

[Bamafan94]

Thank you both for the advice.
My Crohn's takes up 8 to 10 inches in my small intestine, but I don't know how much of that is scarred. I'll ask my doctor, but it's probably more than 3 inches which is why he only mentioned resectioning to me and not the Strictureplasty.
When I said I didn't want to be cut open, I meant that I don't want the large incision that is sometimes required to do a resection. I haven't talked to a surgeon yet, so I don't know if I'm a candidate for lapriscopic surgery or not. If it comes down to surgery, I HOPE it can be done laprisocically. From what I've read, sometimes it requires a fairly long incision to do the resection, and needless to say, I'd like to avoid that at any cost.
I'm also concerned about more scarring. I mean, the more surgery you have, the more scar tissue you have. But I'm also worried that if I do nothing, and my Crohn's flares up again, this scar tissue that I already have will swell up because of inflammation and cause a blockage.
This is all very frustrating and confusing. I really hate Crohn's!! I wouldn't wish it on anyone!
Thank you both for the advice though. I appreciate it.

 

[nogutsnoglory]

These are difficult decisions unfortunately. I have been in your shoes many times.

Most surgeries can be done laparoscopically these days but you will need to give consent for open surgery too just in case they need to during the procedure.

 

[Bamafan94]

Well, I talked to my doctor today and it turns out I'm not a candidate for Strictureplasty. My small intestine is actually attached to my colon in one area. He's referring me to a colorectal surgeon to let her answer my questions.
He says the narrowing caused by the scar tissue isn't bad, but that whole area of my bowels isn't working correctly because of it. I'm still having diarrhea, and having to be careful about what I eat or I'll end up with the pain and bloating.
So I'm going to talk to a surgeon and get an idea of what kind of surgery I'd have to have. I've been very blessed in the 15 years that I've had this disease. Up to this point, I've only had one minor surgery to correct a fistula. I've never faced anything like this.
Once again, I appreciate your help and advice.
I wish you both good luck and good health!