Crohns-Sanity

Please login or register.

Login with username, password and session length
Advanced search  

News:

WELCOME ALL MEMBERS AND VISITORS!

Happy Birthday to all the September Crohnies! 

Visit us on your Smart Phone using TapaTalk or try the new version for Tablets!     

We have a Member Map available on the Forum.  Add your location within your Profile Page.

Check out the DOWNLOADS tab for great music at our main web page, www.crohns-sanity.org.

Pages: [1]   Go Down

Author Topic: Living with a stricture......  (Read 9756 times)

Annie

  • Guest
Living with a stricture......
« on: March 04, 2008, 08:10:23 PM »

Are there people who live with strictures for a long period of time? I have a 5-7cm. stricture in my sigmoid colon but am not experiencing any symptoms other than a kink which I used to call it on my left side at times. Others have referred to it as a pinching. Before being diagnosed with Crohns 8 months ago I would occasionally vomit during a bowel movement but have not done this since. I was on Prednisone for 3 months which I felt definately eased the bowel movements and made the stools larger in diameter. I was scoped again after a month and the GI said the Prednisone had not done enough and recommended surgery or Remicade. Met with a surgeon in December and she felt I wasn't needing surgery yet and referred me to another GI. Have had my third colonoscopy and have a follow-up appointment with him March 18th. Was one day away from having a Remicade infusion before I saw the new GI. Both options seem pretty drastic as I have no symptoms and have not been on any medication for 5 months. I have been told by all of the above that other medications won't work being that it is a stricture.  As much as I hated the side effects of Prednisone I thought I read somewhere that a guy took 60 mg. for 7-10 days when he was flaring and that helped for some time. I am very careful of what I eat and how much I eat at one time. So I guess my question is "can it look bad on the inside but not give you any problems for a long time?"  At first I worried it might perforate but have read about people who have such a narrowing that they can only drink fluids? When do you decide surgery is necessary?
Logged

Pagan

  • Poopinator
  • Super Pooper
  • *****
  • Offline Offline
  • Posts: 1106
Re: Living with a stricture......
« Reply #1 on: March 04, 2008, 08:26:12 PM »

 
7 cm is small. If you aren't having problems, feeling okay, no pain, fevers, etc... then its up to you as to what meds or surgery options to take. It is possible to live with a stricture, as long as you can control it with diet and meds when necessary. It may be possible to have dilation to open the stricture.

I lived with my stricture for about 4 years, (1989-1993) before going for surgery. I was taking 140 mg of pred a day along with painkillers. (Before pentasa, remicade and humira) I was very sick and in a lot of pain by that point. There is the danger of perforation with a stricture. Some of us here have had that happen. Myself included. Not a pleasant experience.
 
You will need to stay in touch with your GI's, monitor your stricture and general health. None of us want surgery, but sometimes it is the best option.
Logged
Hold your breath sunshine

drizzle

  • Super Pooper
  • *****
  • Offline Offline
  • Posts: 3356
Re: Living with a stricture......
« Reply #2 on: March 05, 2008, 07:54:59 AM »

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.

Good luck.

drizzle
Logged
Fistulizing Crohn's since 1986
Interstitial Lung Disease since 2007
2 fistula surgeries
2 small bowel resections
mom to two wonderful kiddos
wife to a pretty good guy

Annie

  • Guest
Re: Living with a stricture......
« Reply #3 on: March 05, 2008, 09:47:40 AM »

Thanks for the info. I think I needed someone to reaffirm that the ultimate decsion is mine. Certainly listen to my doctors but don't think I need to panic.

I haven't been able to eat popcorn for years, before I knew I had Crohns or a stricture. Did ask about Immuran which my first GI said would not work for me but don't know about Humira. Had wondered before if I had surgery to remove the stricture, then could I maybe use a "lesser" drug such as Asacol or whatever?
Logged

rebelsgirl

  • Poopastrator
  • Super Pooper
  • *****
  • Offline Offline
  • Posts: 10214
  • RIP Rebel
    • Crohn's Sanity Support
Re: Living with a stricture......
« Reply #4 on: March 05, 2008, 10:59:02 AM »

Annie, right now I am being bother by a stricture or narrowing. Mine I believe is caused by scar tissue as it's at the anastomosis (reconnection site) Since I can feel food passing thru there and it's some what painful.

If your narrowing is caused by inflammation it should be able to be gotten under control with medication. With scar tissue, you will usually have to have some kind of surgery to help things.

So it depends on what is causing the narrowing or stricture whether you would need surgery or medication to help it. Have they told you which was causing it?

I will know for sure after my ct scan what is going on and whether it's inflammation or scar tissue, I hope..
Logged
"If you want to make God laugh, tell Him your plans."
"I did the best I could. When I knew better, I did better.Maya Angelou
DX-Crohn's 1988
DX-Breast Cancer  2008
Forum Founded 1998

Sir Joey The Great!

  • Super Pooper
  • *****
  • Offline Offline
  • Posts: 1216
  • Protecting the Castle for My Princess Donna!
Re: Living with a stricture......
« Reply #5 on: March 06, 2008, 11:18:50 AM »

Annie, you say your stricture is in the sigmoud right????

If it is you should talk to your Dr about having a dilation done for the strictured area.  I have had this done several times already and it has helped tremendously.  I am not sure of all your particulars but if most of your problem is in the sigmoud this may be a procedure to look into.  It would at least give you some time to get things in order before your surgeery if you decide to do so.

My surgery is necessary.  I put it off for years and now know it is the only way to fix what is wrong. 

I come from the school of thinking that surgery is the absolute last resort.

Just my opinion.  Good luck with your decision.
Logged
Resistance is Futile.
You will be assimilated into the Church of Weedeons. 
All hale the High Priestess Donna! Hommmmmmmmm Cough! Cough!

Lord and High Priest Joe.

Annie

  • Guest
Re: Living with a stricture......
« Reply #6 on: May 08, 2008, 07:19:01 PM »

Had an appointment with colorectal surgeon yesterday. He did a sigmoidoscopy and found the colon to be completely normal to the stricture, then the stricture which is about 5-7cm., then colon normal past stricture. He did not go much further. There is inflamation present in the stricture.
So options are surgery, but don't think we are near that stage. Dilation, but he would not perform this while inflammation is present.  Medication, which my GI said he would like me to go on Imuran if I did not have surgery in the next few months. Or do nothing, but closely monitor the situation.  So I feel like I have been cleaned out, poked and prodded and have enough medical opinions for awhile. Will do some research on Imuran and make appointment with GI. Even though medication may not completely remove stricture if it has scar tissue, it will hopefully improve somewhat. Throughout I have felt real good without usual symptoms of Crohn's and stricture manageable with eating habits and diet.
Logged

kimS

  • Super Pooper
  • *****
  • Offline Offline
  • Posts: 1266
  • Joel and Kidd Kraddick at Disney World
Re: Living with a stricture......
« Reply #7 on: May 09, 2008, 06:51:22 AM »

Annie - I'm sure you are so sick of all that poking by now. 

I would agree with the others that if you're not having any symptoms, why have surgery.  Just be very careful.  If you start having any symptoms that worry you at all, contact your doctor.

I don't really understand why the doctor would put you on Imuran if your stricture is from scar tissue, unless he's hoping to prevent future inflammation. 

My son was on Imuran (azathioprine) for 2 1/2 years and didn't have any bad side effects that we're aware of.  It does suppress you immune system so we were careful about making sure we all washed our hands and tried not to let him come into contact with anyone who was or had been sick recently. 

I understand that Remicade and Humira are not good to use if you're dealing with scar tissue because of the rapid healing that takes place which can made things worse, so check this out carefully before you agree to either of these meds.

Take care,
KimS
Logged
Mom to Joel
diagnosed with CD in 2005
when he was 9.
Resection in March 2006.
Osteopenia in 2009
Been through all the Crohn's meds.
Currently on:
Humira, mtx, entocort
zofran, prevacid, folic acid

http://www.caringbridge.org/visit/joelsage

drizzle

  • Super Pooper
  • *****
  • Offline Offline
  • Posts: 3356
Re: Living with a stricture......
« Reply #8 on: May 09, 2008, 08:06:48 AM »

I'd want to start meds soon to reduce the present inflammation.  It's good news that the endoscope could pass through the strictured area and see beyond it.  Should you need surgery in the future, you'll have less removed if you can reduce the inflammation now.

I used 6MP (which is similar to Immuran) for 15 years and would rather be on that than on prednisone. 

Good luck and continue to let us know what's happening with you.

drizzle 
Logged
Fistulizing Crohn's since 1986
Interstitial Lung Disease since 2007
2 fistula surgeries
2 small bowel resections
mom to two wonderful kiddos
wife to a pretty good guy

Dee

  • Super Pooper
  • *****
  • Offline Offline
  • Posts: 1248
  • Poster Child for Legume-Induced Diarrhea
Re: Living with a stricture......
« Reply #9 on: May 20, 2008, 05:37:02 PM »

Annie - update?  Dee
Logged
Up Sh!ts Creek Without a Paddle!

Annie

  • Guest
Re: Living with a stricture......
« Reply #10 on: May 21, 2008, 12:14:05 AM »

Left a message to make appointment with GI. Recording said I should hear back in two days, its now been 12 days. I will e-mail the nurse clinician if I don't hear soon. I would like to read the surgeon's report although he did say he was surprised at what he saw during the sigmoidoscopy. I think he was referring to the fact that the stricture is bad but that's all. You think you have all your questions answered at the time, then the next day things aren't quite as clear. I think I will go on some medication to try reduce the inflammation but not sure about Imuran. I do have a prescription for Salofalk from my previous GI which I only took for a week in December. (Probably posted previously that I was told it would not work on my stricture but prescibed because it was my health insurance's criteria to have tried other drugs before approving Remicade.) (I did not take Remicade for a few reasons, main one being I do not have usual symptoms of Crohn's.)  Now I could e-mail and ask if Salofalk would be at all effective in reducing inflammation since I could start taking it now and not wait to see GI and make a two hour drive. Although that is not a problem as I get to see my only grandchild at the same time.

Not against surgery if I thought  they could just cut the bad part out and then not be on any medication and not have any complications but know this may not be realistic? Would like to try dilation if possible? Do all doctors give you the worst case scenario of the options? Surgeon said that if you had a leak as a result of resection, then you really have problems and could end up with a stoma. If there is inflammation present during dilation then the intestine could 'crack' and more problems. Seemed like a strange word to use in referring to your colon?

 As you can see, still confused but a lot of that comes with feeling so well? Not complaining.
Logged

rebelsgirl

  • Poopastrator
  • Super Pooper
  • *****
  • Offline Offline
  • Posts: 10214
  • RIP Rebel
    • Crohn's Sanity Support
Re: Living with a stricture......
« Reply #11 on: May 21, 2008, 03:55:55 PM »

Annie, they probably do give you the worst case scenerio just to make you aware of complications that could occur. I've never heard of the intestines cracking during a dilation but Joey might be able to help you more with that term.

I have had a resection, and it does not guarantee that you won't have to take medications afterwards, but I would assume if they know what they're doing during a resection, you're not going to get a leak unless it's done wrong.

I hope you're able to get some answers and start feeling better soon.
Logged
"If you want to make God laugh, tell Him your plans."
"I did the best I could. When I knew better, I did better.Maya Angelou
DX-Crohn's 1988
DX-Breast Cancer  2008
Forum Founded 1998

Dee

  • Super Pooper
  • *****
  • Offline Offline
  • Posts: 1248
  • Poster Child for Legume-Induced Diarrhea
Re: Living with a stricture......
« Reply #12 on: May 21, 2008, 07:25:15 PM »

Annie,   My GI once referred to my intestines as dried out leather and cracked. He said I could have perforated big time and he felt lucky he got thru the scope.  So I have heard cracked before as in the inflammation and infection is so bad.  Dee
Logged
Up Sh!ts Creek Without a Paddle!

Sir Joey The Great!

  • Super Pooper
  • *****
  • Offline Offline
  • Posts: 1216
  • Protecting the Castle for My Princess Donna!
Re: Living with a stricture......
« Reply #13 on: May 23, 2008, 10:37:36 AM »

Hey Annie,

What your Dr meant by Crack is.  The area of your stricture actually becomes quite stiff or tough.  And trying to stretch it can cause a tear in the wall or what would appear to be a crack.  It is the inflammation that causes the toughness.  My stricture is a bit different as it is from surgery and mostly scar tissue.  But I have heard others have dilations for your type of stricture.  I believe Princess Donna had this done.

Your stricture isn't very large in length but that doesn't matter if it is very swollen.  Right now it is acting like a cork on a champagne bottle.  And the pressure is what you are feeling.  Like stopping a leaky Dam with a finger. 

Usually GI's are more keen on doing dilations then surgeons.  So I would talk to your GI and tell him your dilemna.  Don't leave anything out.  Tell them everything.  Or they won't be able to help you the way you should be.

Good luck.
Logged
Resistance is Futile.
You will be assimilated into the Church of Weedeons. 
All hale the High Priestess Donna! Hommmmmmmmm Cough! Cough!

Lord and High Priest Joe.
Pages: [1]   Go Up