Stricture confirmed - have to wait until Thursday for more info!!!

[Meredith17]

I had an upper GI with small bowel follow through today. My doc's nurse just called me and said that there is a "noticable stricture of the descending duodenum". She said the report she was looking at did not have diameter or length listed. However, my doctor noted in my endoscopy report from last week that he estimated the stricture to be "5-6 mm in diameter". Also, my blood tests, endoscopy biopsy, etc. all showed inflammation to be "minimal", and he did say after my endoscopy that the strictures look to be from scarring.

The nurse said that the doctor wants to meet with me to discuss treatment. His next available appointment is Thursday.

So, some questions. Please help by sharing your experiences, advice, knowledge.

- Should I assume it's not extremely serious since he's not rushing me in immediately?
- I was expecting a phone call from a nurse saying that the doc wants to put me on prednisone or something for inflammation (even though my inflammation is minimal). Could he be thinking of treatment other than meds since I didn't just get a meds phone call but an appointment phone call?

 

[Meredith17]

Also, how do I stay sane until Thursday????

 

[Clash]

If the structure is solely determined to be scar tissue then there is no med that can treat that. As far as the inflammation, he probably has a med treatment plan but it would be hard to guess which med he may default to.

Some GIs use the bottom up approach moving up as each med fails. So bottom of the pyramid is 5ASAs these workfor some for mild CD(although they are approved for UC and Cochrane studies show no benefit of efficacy over placebo), next level would be imunosuppressants like imuran/6mp or methotrexate, and top level being biologics like remicade or humira.

Steroids like prednisone or the newer entocort work to dampen the inflammation and give the above maintenance meds time to build to therapeutic levels.

Some GIs subscribe to top down approach starting with bilogics in hopes of preventing the disease from progressing to stricturing or fistulizing CD. There are studies that show biologics can improve the risks of future surgeries if started soon after dx.

Good luck on the appt!

 

[DEmberton]

Don't jump to conclusions but I was in a similar position and what my consultant said to me was that they could try to treat it with drugs, but in his experience once things had reached that stage drugs were unlikely to work and surgery was the best option.

If they do that, then they may want to give you something long term to stop any future inflammation. This is where I am: still med free nearly a year after surgery, but will be having a scope soon to see if there's any sign of inflammation coming back.

You're lucky that they're only making you wait to Thursday. I had to wait 2 months.:thumbdown: