Strictures, Ulceration & Treatment

[Sunshine333]

I have recently experienced a partial bowel obstruction. I am trying to find out the difference between inflammation and ulceration. I understand when Crohn's flares up, it causes inflammation. Are ulcers formed as a result of inflammation ? My recent colonoscopy shows ulceration in my small bowel, but there is no abdominal pain caused by ulceration except obstruction from strictures. Also my blood test shows my RBC, WBC and CRP levels are normal. I think ulceration will cause strictures in the small bowel and that's the reason we need medication like biologic treatment to get them under control. My understanding is Crohn's is less active when IBD patients are older like over 55,however, their strictures start to increase or build up due to previous surgeries and new ulceration. We probably think this is like a period of remission. Do other IBD patients have this experience and are they on moderate or strong medication like Imuran or Humira to get ulceration under control ?

 

[DJW]

Hi.
Some good questions.
I'm 48 and was put on Remicade last September. I started imuran a year before that hoping it would be enough. I have had many long had battles with Crohn's.
After 20 years of remission (lots of instructions) it came back.
I honestly don't know if Crohn's is less active as we age. Personally I have my doubts but I know more as I reach 55.

 

[Sunshine333]

Hi DJW,

The information about Crohn's is less active when we age is based on a few doctors and my personally experience. I had Crohn's when I was in my late 20's when the disease was most active and lasted for 25 years, then the disease began to slow down and strictures started to build up in the past 10 years. However, I noticed people started to have Crohn's at a earlier age like their teens now. The other interesting thing is most Asians do not have Crohn's and GI doctors were much surprised that I had this disease in the early 80's. However, I noticed new immigrants from Asian countries living in north America today can also get Crohn's. This leads me to believe that at least one of the causes of Crohn's is environmentally related. Since the real cause is unknown, medication is used simply to treat the symptoms, of this disease but they do have their side effects. Therefore, I believe medical research should focus on not only treatment, but also finding the cause or the root of the disease. In the mean time, through medical treatment, medication, support group and Forum, IBD patients learn how to cope and deal with Crohn's.

 

[DJW]

I agree.
When I was first diagnosed one of the signs I saw was "the pain is real". Doctors know this wasn't psychosomatic.
Things are moving forward, which is good, but more understanding is needed so treatments can continue to improve.

One thing I have noticed is the increase in constant fatigue with no known cause. I've had lots of tests done...everything looks good. Another area my GI was sorry to inform me more research is required.