What is the best medication for strictures?

[Terriernut]

I admit it, I'm not the best on the meds for Crohns. Because I was just diagnosed officially, I'm not that clever with what medication is best for certain manifestations of this crap disease!! :ybatty:

So, my transverse colon feels a mess. The pred has helped but I cant stay on that forever. (unless ya'll want to visit me in prison?) On 6MP, but still a low dose. What helps strictures???

 

[Angrybird]

Hello Terriernut, as far as I am aware there isn't a medication that will get rid of/help with a stricture. Once the bowel has this narrowing medication may only help with the amount of inflammation you have around and inside it. I recently had an op to have my 4cm stricture cut out, this was done via key hole surgery so I only have 3 smallish scars on my belly and through my belly button. They have to come out otherwise I assume they continue to get worse until they cause a complete blockage of the bowel. Leading up to the op I had to have Modulen nutritional drinks - no food - as this was the only thing that could get through the stricture without causing agonising pain.

 

[DustyKat]

Hey Misty,

If the Pred has reduced the inflammation then 6mp is an okay med. Infliximab isn't always recommended as it can heal things too fast and cause even more scarring. I don't know about the other biologics but I imagine they may well have a similar effect. So I guess if the inflammation is controlled you could move to a biologic.

If inflammation has already caused scar tissue then no medication will treat that. Depending on the level of narrowing it can be treated by a restricted diet, if only mild, or stretching the area via scope. But if it is causing major issues you really don't have any choice but to have it operated on by either strictureplasty or resection.

Dusty. xxx

 

[Sybil Vane]

Strictures are permanent scar tissue so there's nothing you can do for those but have surgery. The best thing to do if you're not going to have surgery is to remain on a low residue diet to prevent obstructions. The pred would help the narrowing due to inflammation, but if you have a ring of scar tissue, there's nothing that can remove it but a resection or a stricturoplasty.

I have the type of disease that forms a lot of strictures. The area around the stricture will usually have a lot of inflammation, so any type of regular CD medicine (like the TNF blockers) can help with the inflammation around the area, but that narrow portion is there to stay unless you get it resected or have a surgeon who can perform the stricturoplasty to save the maximum amount of bowel.

 

[Terriernut]

I seem to have the stricture type of crohns disease. It was a stricture that caused the perforated sigmoid colon. Oh and then there was the nice little fistula that went thru my left fallopian tube. Oh that was gorgeous I tell ya! NOT!

I guess that my crohns being left untreated for so long (stupid f'ing drs!) has caused alot of scar tissue. I'm trying to just be liquid diet as much as possible now, because my next GI appt is the 9th of Dec. Which was moved up from the end of January. Does wine count???

Anyway, thank you very much for the responses. I knew that but I though a blooming miracle might have occured while I slept!

 

[Sybil Vane]

I can't imagine how painful the perforated sigmoid colon was, not to mention the fistula. Strictures are the worst. I'm sick of having mine removed, though. I told my GI that I would not have surgery again until something burst. He just shook his head. We both know I'm f**ked.

 

[Sybil Vane]

That makes perfect sense. I had a near-death experience from a planned surgery this summer so I'm a little soured on surgery in general, but you're right. My stomach is just so screwed up after being cut open three times. I have two ventral hernias they don't want to repair because I have so much scar tissue. I've had five and a half years of intensively trying to wrestle this thing into remission and I'm ready to give up. I'm so tired of all of the tests and treatments. I'm a compliant patient and take my medication, but after three surgeries in three years, I'm not going to do that again unless I'm completely and irrevocably obstructed.

I am keeping my fingers crossed for you! Let us know the results of the colonoscopy.

 

[Terriernut]

Oh hon!! I'm so sorry! My tummy is a frippin mess too. I'm wearing maternity trousers because my muscles are gone, I could go on and on.

This disease is horrific. I hate it. I am a positive person generally, but sometimes I just could do something awful.

I remember when I woke up last December. I was checking which side the stoma was on. I knew it was temp when I woke up and wondered why they didnt just take the whole thing then. Its a lost cause to save my colon I think. I just thought, 'you mean I have to go through this AGAIN'??!!! Then I think...well, just maybe they'll come up with something some day soon. Wishful thinking I know, but maybe.......

 

[Sybil Vane]

I've thought about maternity clothes, too. Does it help? I can't stand the pressure of pants against my stomach. I'm still flaring and those stupid hernias hurt when I touch them. I've thought of resorting to maternity clothes, but was afraid my husband would never look at me the same way again. Although, after spending two months with me in the hospital this summer, I'm sure he's lost all illusions.

I agree--this disease is horrific. I used to be really positive and joke around about it, but I think I need a few more months to recover my personality. They must have cut it out with my intestines.

I hope you'll be able to keep your colon, but I understand that there may be no love lost if it has to go!

 

[Misty-Eyed]

Methotrexte. Don't hate me!! That stuff let me go from being too ill to work for two years to getting a job and then getting my degree. It did me well!!