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Junco
New Member


Date Joined Jan 2008
Total Posts : 5
   Posted 3/3/2008 5:58 PM (GMT -7)   

Hello all. I have been reading the boards for a long time and find you all to be very insightful. It is a comfort to be able to come to others who may understand what I am going through.

 

I have not been officially diagnosed with Crohns although it was my impression I was from my previous GI visit in December. My blood work and biopsies do not show Crohns but colonoscopy shows inflammation around the area of the cecum. CT shows bowel wall thickening and abnormal mucosal surface at the terminal ilium. (no blood in stool, just lots of pain, nausea and vomiting) I have been on mesalamine since June.

 

Pains tapered off but have been getting worse the last few months so... I had an appointment with my GI today. I also wanted to let him know about my fatigue and joint pains. And here is where I'm confused. The first thing my GI says to me is he wants to do a resection, to cut out the inflamed area, BUT he's not convinced it's Crohns. He says that it would of showed up in CT and blood work.

 

I asked about doing a camera pill and he preferred to do a colonoscopy, so that is scheduled. I would like to see more of what is going on before agreeing to surgery.

I guess I'm just curious to hear anyone’s thoughts about this. I would definitely get a second opinion before surgery.

Sorry this is such a long post.. just confused about what to think.

Thanks!

 


belleenstein
Veteran Member


Date Joined Feb 2007
Total Posts : 1010
   Posted 3/4/2008 5:37 AM (GMT -7)   
Is your GI also the surgeon? I wouldn't want a GI who is also a surgeon. GI should be focussed on the medical management of a disease like crohn's. If all you have tried is 5ASA to control your symptoms I don't think you have given medical management an opportunity to work yet. And if he doesn't think you have crohn's even more reason not to operate. What does he think you have that invasive surgery provides the answer for?

You need a second opinion, from an internist specializing in gastroenterology, or a lot more clarification from your surgeon. What are you expecting the surgery to accomplish? etc. I mean it sounds like he wants to do surgery to diagnose you.. I would rather treat as though you have crohn's and start bringing out some of the more powerful drugs, don't cut it out to find out.
Belleenstein:

30+ years living with Crohn's.


MikeB
Veteran Member


Date Joined Mar 2006
Total Posts : 1169
   Posted 3/4/2008 5:52 AM (GMT -7)   
There are some good reasons to do a resection in Crohns disease, including obstruction and fistulas, but this does not sound like one of those good reasons. The disease almost always returns in adjacent areas after resection, so the surgery won't "cure" it. Surgery should be the option of last resort after medical treatment and only when the area to be resected is so badly damaged as to be beyond medical therapy, or when an obstructive or infectious crisis prompts the surgery.

Junco
New Member


Date Joined Jan 2008
Total Posts : 5
   Posted 3/4/2008 3:29 PM (GMT -7)   
Thanks for the replies.
My GI's thinking is that if he gets rid of the inflammation, I wouldn't have to be on meds my whole life (his words not mine). What he thinks the inflammation is from, if not IBD, I have no idea. I was just taken by surprise and didn't ask all the questions I needed to.
Now I'm really wondering what other reason there would be for inflammation in the colon? Colonoscopy biopsy showed no cancer and I was on a long dose of Flagyl before the 5ASA's.
Definitely going to be looking for a GI with more knowledge of IBD, I just don't feel comfortable anymore.
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