Would you elect to have surgery if you were me?

[rdsoxfan]

would you elect to have surgery if you were me?

About 2 years ago, I had a period of several months where I had flares every 4-6 weeks. A flare for me is mainly blockage (and not due to eating rough food but totally random). I was put on Humira and that worked for about a year until this past spring. A month ago I had a colonoscopy and upper bowel x-rays. Both showed significant strictures and narrowing of the ileum. He couldn't get the scope into the small intestines at all. I just had a bad blockage Monday- lasts about a day or so. My DR said I could have surgery if I wanted to or I could take Humira weekly instead of biweekly.

He's leaving this decision up to me which is annoying since he's the freaking DR who spent half his life in medical school.

I'm in straight commission sales so flares equal lost time from work which equals no $$$. The surgery would seem to eliminate the flares from occurring allowing me to work regularly. I've also read a lot on here about people having emergency surgeries from blockages and being proactive here would take care of that potential problem. But at the same time, I haven't had a surgery in the 10 years I've had Crohn's and I'm okay not having it if the meds could do more "healing" and opening up the restricted area. I'm 31 and other than being in the fetal position in pain for a day every couple of weeks when I have a flare, my Crohn's isn't that "big" of a deal.

Would you be proactive and get it done now or would you be reactive and wait till it gets worse and stays blocked after a flare up?

Blessings and appreciate the feedback!

 

[muppet]

It's an incredibly personal decision and you're the expert on your lifestyle and the likely impact. I know that's not the answer you're looking for.

I've had my Crohn's 28 years and I've avoided surgery all this time, but I'm therapeutic on Lialda and while I do have fistulae, I've never been told I have a bad stricture. My doc can get into my ileum when doing a scope. So, I'm probably not the one to get advice from anyway.

I'd say that if the strictures are likely to cause you larger problems in the end, surgery might be a good idea. That said, I've heard of strictures returning not long after surgery. I'd ask your GI for the odds on that, or ask a colorectal surgeon better still.

Good luck with your decision. It's a tough one.

 

[tiloah]

I feel like doctors wait too long before considering surgery. Are your strictures mainly scar tissue or inflammation? That could be a big factor in your decision.

Whatever you choose I hope it works well for you.

 

[Jennifer]

Ya scar tissue or inflammation would make the decision for me as well. Also it could be both so then I'd want to know how bad the scar tissue is so if the inflammation were reduced to nothing through meds, would it make much of a difference? Scar tissue cannot be healed and only stretched, cut up and re-sewn or removed but remember that some people have issues soon after surgery due to many issues be it not all bad portions were removed, improper maintenance meds etc. Get all the information you can about all options and go from there. I've never taken Humira but I don't believe its instant. I have had a resection and was in remission for 12 years after. Hope whatever you decide works out for the best.

 

[rdsoxfan]

Yeah, I don't know if it's scar tissue or inflammation. My DR doesn't give me much time to answer questions or explain things very well. I'm requesting a referral to a different DR in the city who sees more patients and is actively involved in cutting edge research.

 

[Jennifer]

A second opinion is always a good thing. Here's hoping they can help you and that you're able to see them soon.

 

[Grant]

I was told by my specialist nurse that if its scarring then no treatment of a drug will cure it. Balloon dilation during a Colonoscopy would be my 1st choice. And of course the reason they are reluctant to perform surgery is that it generally leads to more.
A stricture due to inflammation is a different matter entirely & I hope the weekly Humira sorts it for you, definitely better than surgery.
Rgds
Grant