Treating Strictures with Remicade?

[spiceman]

Hi all, Am curious if anybody has had some succsess in treating their strictures with Remicade? Its been 3 years since my Resection and now im getting very painful blockages/vommiting again. Since October its happened 6 times, stayed in hospital twice for pain relief. Ct scan has showed a stricture at the resection site.

Next wednesday im starting Remicade to see if it helps with my constant bloating and blockages. The GI said I should know after the first day if its going to help and will try 2 infusions before handing me over to the surgical team. I'm so hoping its inflammation and not scar tissue. Can't believe im at this point so soon again after having this Crohns for 20 years.

 

[Manzyb]

I was going to ask you if the stricture is form inflammation or scar tissue. I think that if it is from inflammation, Remicade will really help you. (it did a lot for me). I was told that with the strictures that I had this last time around were all scar tissue and that nothing would fix it. I hope it is the inflammation for you! Well.. i wish you didn't have it at all... but you know what I mean!

 

[Angrybird]

Fingers crossed the stricture is down to inflammation (how bad is it that we hope for things like this!!!) and not scarring as the Remi should then be able to hit this hard and get it sorted. This is the problem with surgery, once you have it you are more likely to have these problems quicker than you did before. My doc has given me a rough window of 5 years before surgery is needed again. I have taken this has a personal challenge on how much further past this I can get! I hope things go well on Wednesday and let us know how you get on.

 

[shamrock15]

I am now closing in on 6 years since my last surgery, remicade for almost 4 years now I think. Certainly the small bowel where I used to have my problems has been extremely well behaved (had a total of 6 surgeries for it previously). Remicade has done a lot of good for me.

 

[spiceman]

Hi Manzyb. On the Ct scan the doctors think it looks like infammation so yes I'm really hoping Remicade is going to help. How quick did you notice improvement when first starting Remicade and how did you confirm in the end your stricture was scar tissue? Thank you so much.

Hello Angrybird. I also had a lleocecal resection and was told the average person may need a second surgery 10 years later. I'm amazed to be back to square 1 so soon but I don't suppose being without medication for 2.5 years has helped! I've now been on 125mg of 6mp for 6 months but i think its a little to late to help.

Thank you both for your reply's

 

[spiceman]

Hi Shamrock15, Sorry to hear that you've had so many surgeries and I sure do hope I don't go through the same. Were your surgeries because of strictures and if so were they where the small bowl join the colon?
Thank you for all your help.

 

[shamrock15]

4 of the 6 were due to a combination of strictures and obstructions. In total, I think there were 6 resections and over 15 strictureplasties. I was a real mess, and symptoms were becoming more frequent and steroid resistant. My terminal ileum was the first to go! Throughout everything, I have had involvement from the throat to the rectum. Currently almost symptom free.

 

[spiceman]

4 of the 6 were due to a combination of strictures and obstructions. In total, I think there were 6 resections and over 15 strictureplasties. I was a real mess, and symptoms were becoming more frequent and steroid resistant. My terminal ileum was the first to go! Throughout everything, I have had involvement from the throat to the rectum. Currently almost symptom free.

Did you suffer from bloating at all? I'm not sure if my bloating is just active inflammation or a stricture causing it but it just seems so strange how it appeared a month after surgery.

I'm pleased to hear you say that your almost symptom free, that is good news. With all the surgery did you need to have a Stoma?
Thanks

 

[shamrock15]

Did I have bloating? Between being pale as a ghost and how big my belly got, I am glad Captain Ahab wasn't around. Yes, a lot of bloating due to gas and it was very frequently difficult to pass - it led to retention in the bowel. What I found in mine was that it started to return just after I began eating food again. Depending on you meds, your bowel flora is probably all out of whack. I needed to try really strong probiotics, and that worked for a while. Sometimes antibiotics worked, but it wasn't a guarantee. Many of our meds can upset that balance, and the occasional beer, carbonated soda (probably due more to the acid content) and just about any food can affect it. Maybe start a food journal to see if you can correlate the bloating to your diet.

I briefly had a stoma - my 4th surgery failed when sutures tore. My surgeon believed that an excessive length of time on pred had weakened the bowel. As a result of this, surgery 5 was to set up a temporary stoma and let the bowel heal, then it was reversed after approximately 4.5 months. I had a lot of problems with gas immediately after that one, and that is when I made the link to bacteria in the bowel.

 

[spiceman]

Did I have bloating? Between being pale as a ghost and how big my belly got, I am glad Captain Ahab wasn't around. Yes, a lot of bloating due to gas and it was very frequently difficult to pass - it led to retention in the bowel. What I found in mine was that it started to return just after I began eating food again. Depending on you meds, your bowel flora is probably all out of whack. I needed to try really strong probiotics, and that worked for a while. Sometimes antibiotics worked, but it wasn't a guarantee. Many of our meds can upset that balance, and the occasional beer, carbonated soda (probably due more to the acid content) and just about any food can affect it. Maybe start a food journal to see if you can correlate the bloating to your diet.

I briefly had a stoma - my 4th surgery failed when sutures tore. My surgeon believed that an excessive length of time on pred had weakened the bowel. As a result of this, surgery 5 was to set up a temporary stoma and let the bowel heal, then it was reversed after approximately 4.5 months. I had a lot of problems with gas immediately after that one, and that is when I made the link to bacteria in the bowel.

Thats very interesting and thank you for sharing with me. I've often wondered about bacteria overgrowth being the problem but my bloating don't seem to go by passing wind.... I feel like one strange case. Ive tried VSL 3 for 1 month but that doesn't seem to help. Never tried antibiotics so maybe that be worth a shot if the remicade don't sort it out. Its pleased me that after hearing all what you've gone through your still going to the toilet the normal way, that sure gives me hope for the future. The GI has labled my Crohns as Stricturing Crohns.
Thank you so much for your time.

 

[shamrock15]

You're most welcome. Hope it helps a little. I do think the Remicade should help out as long as there isn't much scarring. I have had the same surgeon for all of my surgeries, and the strictures actually healed up enough that they are no longer visible even to him. You are on remicade now (or shortly), and I haven't had a stricture form since I have started (or at least one big enough for me to know about). Keep us updated!

 

[Wildanimalpark]

How are you doing after Remicade for a year with strictures? I am concerned about Remicade and stricturing Crohn's. Dr. Lashner, Cleveland Clinic, wrote a response on this subject in October 2010.

My daughter has had two surgeries and her GI wishes to give her a sixth Remicade treatment to keep inflamation at bay but we have not seen any inflamation in several years. We started the Remicade in hopes of reducing the stricture if it was inflamation. It had no effect on the stricture and she had the stricture removed. We continued Remicade as she still had vomiting and stomach pain, again it has no effect on her present symptoms.

Hope your remission has continued.