Strictures can be from scar tissue or inflammation. If yours is due to inflammation, then immune modulators such as 6MP or Immuran may help; humira or remicade may help; prednisone may help. If yours is due to scar tissue, then once it becomes too much to live with or at whatever other point you decide, then surgery could be performed.
I can't imagine how awful a perforation must be and hope to never have one. I've had two resection surgeries for stricture in the small intestine and have also experienced an easing up of strictures with medicine. Before beginning humira last June, I had a few strictures, weight loss, fatigue, etc. Since taking humira, I'm eating popcorn, crisp vegetables, brown rices--foods that were impossible to pass through stricture previously.
I mentioned in another post that adhesions can form following surgery. Adhesions may or may not become painful, too.