I think you chose wisely.
An intestinal obstruction that is caused by a stricture can also lead to perforation of the bowel. The bowel must increase the strength of its contractions to push the intestinal contents through a narrowing in the bowel. The contracting segment of the intestine above the stricture, therefore, may experience an increased pressure.
This pressure sometimes weakens the bowel wall in that area, thereby causing the intestines to become abnormally wide (dilated). If the pressure becomes too high, the bowel wall may then rupture (perforate). This perforation can result in a severe infection of the abdominal cavity (peritonitis), abscesses (collections of infection and pus), and fistulas (tubular passageways originating from the bowel wall and connecting to other organs or the skin). Strictures of the small bowel also can lead to bacterial overgrowth, which is yet another intestinal complication of IBD.
My hubbies first surgery was caused by a stricture and perforation.
Take care of you.
hmmm...very interesting reading all of this.
I was experiencing bloating/gas and occassional pain and saw my GI. He sent me for a SBFT and found out I had developed strictures in my terminal illieum. My crohns has been localized to about 12 inches there since diagnosed in 1995 and has not spread but has now developed the strictures.
Note: I was hositalized in June for a partial blockage. I was admitted and got through that issue with antibiotics, iv steriods and entocort once I got home.
Anyway, my GI told me that at this point the entocort nor the Remicade is going to help THIS issue (strictures) and that the only option I had if my symptoms were to get any worse was surgery. (He continued that w/strictures you are at higher risk of developing partial blockages.) He said he wanted to prolong surgery as long as possible. He asked me how I was feeling and I told him I was feeling pretty good at the time. He said to just let him know if things started to get more difficult for me, and if so, he would have to schedule me for surgery.
It has been since right after Thanksgiving that I had the test and so far I still feel pretty good. I have been watching my diet very carefully and continue to take my methotrexate and remicade.
After reading about what skitt wrote about possible preforation, peritonitis and possible bacterial overgrowth, I wonder too if I am just prolonging the inevitable and just putting myself at a higher risk of other complications.
I too thought it was a good question to ask, how long have people gotten through with holding off on surgery? I mean since my GI (whose opinion I respect) has told me he would like to hold out for surgery, as long as possible. But now I wondering if I'm doing the right thing?
Anymore comments out there? Maybe it's time to schedule an appt. w/my GI and talk about these possible issues.
Post Edited (sukay) : 12/26/2007 7:25:08 AM (GMT-7)
My daughter was diagnosed with a stricture in March 2006. She is doing fine now on Entocort and plans to avoid surgery as long as she possibly can.
For people whose quality of life is low because meds are not working and natural remedies are exhausted, it probably makes sense to consider surgery. It might also make sense to consider sugery if side effects of meds are too toxic.
Our reasons for taking a pass on surgery: first and foremost, meds and diet are working with no side effects. Some others: surgery tends to lead to more surgery; crohn's symptoms can show up within months, days, hours or even immediately after surgery; clinical trials have shown patients with resection are less likely to respond to some of the meds being trialed; and any surgery can cause complications.
The following link will take you to a pretty good discussion about surgery for Crohn's:
The following link mentions perforation is rare in Crohn's Disease:
The following link corroborates perforation is rare: "Spontaneous free perforation is an uncommon event in the natural history of Crohn's disease. It occurred in 21 of 1415 patients (1.5%) admitted with Crohn's disease to The Mount Sinai Hospital between 1960 and 1983. The mean duration from onset of Crohn's disease to occurrence of perforation was 3.3 years. Ten patients had small bowel perforation, ten patients had large bowel perforation, and one patient had simultaneous perforation of both ileum and cecum. The incidence of perforation in disease segments of small bowel was 1.0% (jejunum 6.0%, ileum 0.7%), and in the colon, 1.3%. Besides the 21 patients with spontaneous free perforation, an additional nine patients had spontaneous free rupture of an abscess into the peritoneal cavity. The mean duration from onset of Crohn's disease to rupture of abscess was 8.5 years. All 30 patients had surgery within 24 hours of perforation or rupture. All 21 patients with spontaneous free perforations survived, as did all but one of the nine patients with perforated abscess. The cornerstone of the treatment of ileocolonic lesions perforating into the general peritoneal cavity is proximal diversion with delayed reconstruction of intestinal continuity whenever possible. With perforation of the small bowel, primary reanastomosis is possible in selected patients."