Should I have surgery?

[BoFin1]

My name is Linda and I am 46 years-old. I was diagnosed with Crohns 11 years ago. I have never had any type of surgery. My symptoms have been
managed well with Azathioprine and Humira. I have had a stricture for a long time in the ileum. The recent colonoscopy showed the stricture was only 2mm wide. My GI doctor is concerned about me getting an obstruction or abcess, and she suggests that I have a ileocecectomy.
I am worried too, but I feel good now so I am hesitant to do surgery.
What should I do? Has anyone else had a 2mm stricture, and what did you decide to do? Next month I am scheduled for a new type of MRI called
an MRE and it should give us more information.

 

[Grant]

Hi Linda, many of us have stricture problems. My one was measured @ 4-5mm back in June. I'm having mine balloon dilated to widen it. I would suggest you ask about that 1st TBH. Surgery should be IMO last resort only because of the problems with scarring & adhesions.
Good luck & hope things improve for you soon.
Rgds
Grant

 

[tiloah]

While I disagree that surgery should only be used "as a last resort," it does sound to me like that may be jumping the gun in your case. If you don't have any symptoms that are interfering with your quality of life and your disease process is under good control with your medication regimen, I don't see any reason to jump in to having surgery. Maybe get a second opinion? Or ask about the dilation?

If you do end up having surgery, I would just like to say that it's probably not as bad as you think and the recovery isn't terrible. Good luck with whatever you choose.

 

[SarahAnne]

2 mm seems very narrow to me, but if you aren't having any issues with eating (like vomiting or severe pain when everything gets to that area) and you are managing the disease well otherwise then surgery does seem a few leaps away. I received balloon dilations on my stricture for 3 years in a row, it really helped open the area up the first 2 times. I would at least discuss that option with the GI first. Good luck!

 

[BoFin1]

thank you

Thanks to everyone who replied. I will ask about the balloon procedure.
It really is amazing that despite the stricture, I don't have symptoms.
I can eat whatever I want, even popcorn and nuts (in small amounts). However, I think that I will cut out the popcorn and nuts and be more careful
now that I know my doctor is considering surgery.

 

[BoFin1]

One more thing. The doctor said I have a lot of scar tissue; I wonder if this is the reason
she is recommending surgery and did not mention the balloon procedure.
I am excited about this MRE because I don't need to drink anything!
This is suppose to show more than a CT .

 

[tiloah]

Usually when a person has a lot of inflammation they try to avoid surgery, because that will respond to medications. Scar tissue will not respond to medications.

 

[SarahAnne]

Diesanduhr is right; scar tissue is the reason the balloon dilations stopped working on my stricture, and the reason I'm having surgery next month. If you are 2 mm be careful what you eat with things like popcorn and nuts, it is very easy to get an obstruction when you are that narrow!

 

[archie]

Hi I had the same dilemma last year as I also had a long stricture the eventually did perforate due to an abscess. They treated it with meds but was advised I would need surgery at sone stage. A couple of months later I felt better and had a routine review with the surgeon. He still recommended ( very strongly) that I needed a resection due to risk of another perforation. I asked him about the stricturoplasty but he said the damaged part was too long for this so it gad to be a resection.

Anyway I ended up having an iliocecal resection with no probs and feel good since I'm glad a listened to my surgeon in the end!!! Good luck with your decision but don't be Put off by surgery, it is better to have Planned surgery when your feeling good rather than emergency surgery due to a complication.