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Stricture in the terminal ileum surgery question

Hi everyone,
Well after an exciting week in the hospital for an obstruction in my terminal ileum last week, my GI has concluded that I have a "cold" stricture that needs removing. He is looking at having 10-14 cm of my small intestine removed. This was decided late today, so I have not met the surgeon yet. Has anyone had this type of surgery(mine will be in Toronto, Canada).

How long before they perform surgery based on a decision?

How long will I be in the hospital approximately?

How long will I need to recover afterward? (I am a Childcare teacher and my job often requires me to lift 40+ lbs)

Thanks for any advice you can give me!
 

nogutsnoglory

Moderator
Sorry for your bad news. What's a "cold" stricture? Meaning scar tissue and not inflammation?

I had this type of surgery and was operated on in a matter of days due to the pseudo emergency status of my partial but serious obstruction. I was in the hospital for 5 days and was forbidden to lift over 10 pounds for 6-8 weeks. This was also the timeframe given for recuperation from surgery. The length of your stay depends on whether you have laparoscopic or open surgery and if there are any complications. You definitely to plan to be off of work and not do any lifting.
 
My GI said a "cold stricture" is when there is no inflammation present. They refer to them as "hot" when there is inflamation present at the stricture sight. My stricture is next to my lumen, and causing swelling. He feels that if I don't remove it, I will have repeated bowel obstructions.
 
Crohns Gal.

Just had a stricture removed last month. They thought it was your size, but it ended up around 5 inches long. Also had other things like adhesions and inflammation, so had 18 inches removed.

It's taken me almost 6 weeks to feel pretty OK. Working about 3/4 time now. Done with pain pills. Still have D every day and bleeding every day, so still have active Crohns unfortunately. No "cold" stricture for me haha...

I wish you the best. If it's an open incision, you can count on around 4 to 6 weeks healing.
 

DJW

Forum Monitor
Hi, I've had quite a few of these surgeries.
Usually 7-10 days in hospital to get the bowel
working again. About 8 weeks no lifting. Don't
be discouraged if your not 100% after 8 weeks.
It takes time to heal and we're all different.
Hope all goes well.
 

DustyKat

Super Moderator
I will copy Sarah and Matt's hospital stays, they have had the same surgery you will be having:

Sarah:
had a right hemicolectomy 5 years ago and has been in remission since that time. Her surgery was an emergency, she was undiagnosed, and so was performed as an open procedure. This is an outline of her post op recovery...

Surgery day - She was in theatre for approx 4 hours. When she returned to recovery she had oxygen, two IV's, two drains, an NG tube and an IDC (urinary catheter). She was in ICU overnight. She asked to go back to the ward the next morning. I think the surgeon wanted her to stay another day but she couldn't get out fast enough! Oxygen therapy ceased.

Day 1 post op - Moved to the ward and spent the day on bedrest. IDC removed. NG tube on free drainage and morphine IV remained on PCA (patient controlled analgesia).

Day 2 post op - No change with drains and tubes. Physiotherapy commenced. Up out of bed and gentle ambulation commenced twice a day. Although Roo refused to use a pan so started walking to the toilet that day.
Started eating ice chips.

Day 3 post op - One IV removed and condensed IV morphine and fluids into one. NG tube removed. Increasing mobilisation. Ice chips.

Day 4 - Bowels open. Commenced on clear fluids. Mobilising.

Day 5 - Tolerated fluids from previous day and throughout this day so commenced on light diet at tea time. Both drains removed and IV removed. Oral analgesia and antibiotics commenced.

Day 6 - Discharged home.

I don't know if being paediatric made a difference but each day she was visted by the surgical team twice, the physiotherapist twice, the pain management team once and the dietician once.

Sarah was in very poor condition prior to surgery so I felt that she didn't truly recover for a number of months. I would say she was running on about 80% for the first few months and reached full recovery after about 6 months. She returned to school 3 weeks after the operation and has now been in remission for 5 1/2 years.

Matt:
had a right hemicolectomy in April. It was planned surgery that was required due to an existing fistula and abscess. He had a pigtail drain in for 3 months prior to surgery.

Surgery day - He was in theatre for about 4 hours and recovery for 2 hours. When he arrived back on the ward he had one IV that consisted of the PCA (patient controlled analgaesia) and other IV fluids for hydration and IV medication. He also had one wound drain, a urinary catheter and oxygen.

Day 1 post op - No change with IV's or tubes and drains. Started mobilising and about an hour sitting in the chair.

Day 2 post op - Still no change with the tubes and lines. Commenced on clear fluids and continued with gentle mobilisation.

Day 3 post op - Urinary catheter removed, still on clear fluids, mobilising well.

Day 4 post op - PCA removed and started on oral analgaesia, remains on clear fluids, started farting, only one IV now left.

Day 5 post op - Last IV removed, commenced on free fluids, bowels open.

Day 6 post op - Commenced of light diet.

Day 7 post op - Commenced on full diet, drain out.

Day 8 post op - Discharged!

Matt had no issues post op and I feel that the start of week 4 post op was the real turn around in his recovery. It was at this point that he really started to move freely and shades of his old self started to appear. His recovery has been much quicker than Sarah's. He returned to school 3 weeks after surgery, was allowed to drive short distances after 3 weeks and long distances after 6 weeks but he was driving longer distances at 5 weeks. Started soccer training at about 5 weeks as well. He is also in remission.

The life savers in hospital for them were...TV, mobile phone, iPod, laptop with DVD's, ear plugs, comfortable loose fitting pyjamas/clothes, footwear that is easy to slip on an off, like slippers, magazines/books and short visits from friends when they were up to it.

They have both been on maintenance meds (Imuran) following surgery.
My two had open surgery due to complications so if you are having laparoscopic recovery is normally a little quicker.

As a general rule you are not allowed to lift for 8 weeks following abdominal surgery but I am not sure if there is a reduction in that time if you don't have open surgery.

Sarah was emergency surgery but Matt had planned surgery. If you have planned surgery it will depend on your individual circumstances and what health system you are dealing with.

With Matt it was three months because we were waiting for his inflammation to go from acute to chronic.

In Australia if I was in your circumstance and went public I would have to wait to hear from the hospital with a date and how quickly it is done also depends on what the surgeon recommends. This can vary though, depending on individual circumstances. The surgeon should be able to give some idea of his/her waiting list. We went public with Matt, although it was planned surgery for him he had to have the op within a timeframe due to complications and the surgeon set the date in his rooms 4 weeks out from surgery.

If you go private then you decide when you want it done.

Dusty. xxx
 
I hope you have better luck then I did at getting a date. It took me from the end of May till today to get my appt. I will not have my surgery till Aug 30. I wish you luck.
 
Thanks everyone! I just want to be prepared, and to prepare my husband and kids for the reality of this surgery. I have been very lucky that my Crohn's really didn't in the whole scheme of things complicate my life much. This stricture removal is the first real hiccup I've experienced. I appreciate your stories and I'm feeling much more confident about the whole situation!

:dusty: THANKS! :dusty:
 
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