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Scarring, strictures and CT scans

Hubby just got back from the new GI. I think this GI is the one. This is the second tine he's been to the doc. Anyway, the doc looked thru old CT scans from past GIs and seen scar tissue in there. He wasnt sure where so he has a colonoscopy schedueled for next Friday to see the exact location, severity, ect. This is exciting for us because finally we have a doc that is going to do something. My husband asked why didnt the old docs see the scarring (the particular CT was done in 08) and the GI said cause normally its hard to see scar tissue in strictures on CT when they are in certain places. He said the same about strictures & obstructions.
So now Im confused. The hospital ER that did the CT that showed the scarring said the CT would show it and that it was clear except for some inflammation. I dont understand this. There is no telling how long he has went with this scar tissue. Is it true what the GI said? I though barium CTs showed everything.

Oh & the doc said its either.going to be treated by stretching (my guess ballon.dialation) or resection. Ive read about the resection surgery. But is the balloon dialation sounds a lot like what my dad had done to his heart valve. It was painful. Is this going to be painful or effective in the long term? Thanks!


Unfortunately it's very hard for them to know for sure if its inflammation or scar tissue. Honestly from my experience they are guessing and I have been told its been inflammation when it's scar and the reverse. That's why it's always best to exhaust medications as an option unless you have an obstruction and if that doesn't work resection is the only option.

Balloon dilation won't be painful at all, it's done through a colonoscopy and he will be asleep. It can be very effective but only if its inflammation. It may require multiple dilutions but sometimes one is enough to hold you over for a while.
Well, I'm not one to stick up for Docs usually, but have you ever seen a CT scan with barium? There are so many loops of small intestines packed into such a relatively small space, that even experts that read them every day can either get it wrong or miss something. And there may be nothing they did wrong, the intestines are just rolled up in there so nobody could see it all or catch a small narrowing or stricture.

This is one of the reasons that bowel disease is so hard to diagnose. For my last small bowel follow through, my GI Doc saw something the radiologist didn't, but neither saw the 5 inch stricture in there.

We just have to keep hanging in there as patients, and keep trying. Don't give up on that new test because of the old one. Things change positions in there, and maybe next time they will get to see things better.

Good luck!
Thanks noguts. Im hoping that the dilation is all they have to do. When he was first dx he got on google and read horror stories about resection and hes very anxious. I have a good friend from HS that has had a small bowel resection and her colon removed from CD so shes been trying to alleviate his fears about surgeries.

Thanks Nurse. I dont think it was the ER docs fault cause he was just a ER doc. I guess it takes a specialist in that area to differentiate inflammation from scarring. I guess we need to not just take the a ER docs assesment as the only one. Ive seen a CT and it is definatly confusing. Hubby did the one where he drank the barium. Out of curiosity, would a barium enema CT be better as far as looking at the small bowel? Would it show any abnormalities better?
There are limitations to every test unfortunately. A Colonoscopy can only see the large bowel and MAYBE a few inches into the small bowel. That's if the valve is open enough or there's no scarring at the terminal ileum,

An endoscopy (upper scope) can only go down so far. Usually just past the stomach for a few inches into the duodenum. There is a special scope that can now go up to the gall bladder.

The pill cam is pretty cool and a good test. You swallow that and it takes pictures as it goes through. There is a danger of it getting stuck, so they have "test" cams to do first.

Barium enemas I believe only go as far as a regular enema which is the large intestine. The barium small bowel follow through is a pretty good test. You drink it and take regular X-Rays as the barium moves through, but again, those loops of bowel are very convoluted. They saw the "narrowing" at the terminal ileum for mine, but not the huge stricture and you cant' tell if it's scar tissue or inflammation, or both as in my case.

Sorry to go on and on. I wish you luck. Hang in there and insist on continuing to look. Don't be satisfied until something is definite. :hug:
I had a stricture stretched at my colonoscopy on Tuesday. It’s Thursday evening and I am weak and no appetite. The area is sore but worse are gas pains in stomach and abdomen. The dr had not planned for this but the stricture was narrowed to size of a pin hole. Had to “blow” me up full of air to get balloon through with esophogeal tube. Question: how long did recovery take?