Question on strictures?

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songstress
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Date Joined Jul 2005
Total Posts : 393
   Posted 11/11/2008 6:48 PM (GMT -7)   
So it was brought up today that my symptoms are that of a stricture possibly. My CT came back really good but because I am not using the bathroom and having so much pain he is thinking of doing a small bowel followthru.
 
Anybody have any experience with strictures or symptoms? Im curious to know if this could be cause of all my pain.

** Songstress.....Would you mind taking out the quote in your sig it is a link to a site......

...Thanks for your co operation..I dont know if you knew that or not

...You can email me if you would like....LYN

Post Edited By Moderator (Howlyncat) : 11/16/2008 6:28:56 PM (GMT-7)


ivy6
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Date Joined Sep 2005
Total Posts : 10404
   Posted 11/11/2008 11:27 PM (GMT -7)   
I have one, but (thank heavens) it isn't giving me many problems yet. I've been advised to keep peeling all hard-skinned fruits and veggies and avoid things like large nuts, that could cause a blockage but, other than that, have had no problems yet.

This isn't a proper answer to your questions, songstress, but I'm giving you half an answer so your thread can be bumped to the top of the forum :-). I know lots of people here have had nasty problems with strictures, so I'm sure you'll get an answer soon.

ivy.
Co-Moderator Crohn's Forum.


athensgirl
Regular Member


Date Joined Apr 2007
Total Posts : 254
   Posted 11/12/2008 12:50 AM (GMT -7)   

I have a stricture too, have had it for many years, and as ivy6 it doesn't really cause me a lot of trouble.  The only thing I have to watch though is to peel all the fruits and veggies, I don't eat nuts, green salad etc, because they tend to cause blockages if they are stuck in the stricture.  Sometimes when I eat something forbitten, I have pain near my belly button, because the food tries to pass through the stricture, but nothing major.

I know people who have been living with strictures for years.

Christina

 

 


gachrons
Veteran Member


Date Joined Mar 2007
Total Posts : 4527
   Posted 11/12/2008 5:58 AM (GMT -7)   
Hi Strictures can be bothersome as it can cause blockages. The bowel doesn't have the easy emptying of not having one .Hope your test goes good for you. lol gail
Hallarious woman over 50 ,CD ,IBS 27 years--resection,fistula's,obstructions,hemmies,and still alive.lol gail


3peppers
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Date Joined Nov 2008
Total Posts : 8
   Posted 11/12/2008 8:25 AM (GMT -7)   

I have had many strictures... I grow scar tissue like other people grow crab grass.  It's true that strictures often don't show up well on CT scans, and an Upper GI Small Bowel Follow Thru has always been the most reliable test for me-but that's my body, so it may not be true for you.  Whatever you do, don't, I repeat DO NOT, swallow the "little" GI camera if you suspect a stricture.  It's not that little, and getting it back out can be a real drag. 

Some things I experience when a stricture is becoming a problem for me are gurgling coming from a specific area of the bowel after eating, excessive belching, and changed bowel habits, and of course pain in that specific area.  I can usually point right at it.  It is best to watch what you eat, staying away from fibrous raw veggies, etc., but my experience has been that if the stricture narrows to 5cm or less there's nothing you can eat and you'd need to go liquid to avoid hospitalizations.  Don't ask how I know.  I just do.  (It is kind of nice when all the ER docs and nurses at the local hospital know you so well they don't even have to ask what's wrong before ordering your meds and whisking you away to your favorite room. :-) )


songstress
Regular Member


Date Joined Jul 2005
Total Posts : 393
   Posted 11/14/2008 3:06 PM (GMT -7)   

okay so I have been swamped and havent been able to get to a computer...thx for all the helpful replies....I think I relate to the last one. My bowels have been very very and I mean VERY...loud lately/thats why at first I suspected an obstruction until I finally started having some movement. Everytime I eat I get the umbilicus / belly button pain and very loud bowel sounds near that area. I actually feel bubbles and contents trying to move through the area.

but if you think a change of diet would help, I will probably try that first. He also suggested miralax for 2 weeks to try and see if that can make me go without all the pain (the other morning the pain had me puking nonstop because it was so excruciating..He thinks if the pain keeps up to go ahead with the smallbowel followthru.  ugh...last time I had one it took 6 hrs to do because the barium wouldnt move through me easily blush

hopefully this one will be better...cross your fingers smurf

 


Anyone can give up, it's the easiest thing in the world to do. But to hold it together when everyone else would understand if you fell apart, that's true strength

Dx'd w/Crohn's colitis in May05--spread to ileum & small intestine as of April08. Currently on Humira every 2wks, Pentasa, Entocort, Phenergan, Lomotil, Celexa, Lortab, Ambien, and new this week Zoloft.


spiceman
Regular Member


Date Joined Aug 2008
Total Posts : 51
   Posted 11/14/2008 4:06 PM (GMT -7)   

Hi.

I've had many bouts with problems regarding my stricture before which has left me in acute pain for around 5 hours or so then finally its passed. I'd say its happened about 10-15 times , all started when I was around 20 and now im 36. The last 2 times ive gone to the hospital for help, in future this is what I will do.

My most recent was in March 08 which for some reason I've never felt the same afterwards. Now I have constant loud noises and feel very distended and uncomfortable. I've tried Pred and Imuran ( high doses ) to no avail. In the next 2 weeks I will also be having a small bowel enema to see if my stricture has closed more.

 


nawlinscate
Veteran Member


Date Joined Jan 2007
Total Posts : 656
   Posted 11/14/2008 4:22 PM (GMT -7)   

Several years ago, I had a GI series with small bowel followthrough that showed that a 12" section of my small intestine was very narrow. My doctor put me on 6MP and a low fiber/low residue diet. Even though the symptoms continued, another followthrough two years later showed that the narrowing had disappeared--which meant that the stricture had been caused by inflammation and not yet by scar tissue. So I was lucky, at least that time.

Although you have to drink lots of barium for the small bowel followthrough, I really recommend the test, since it will show you clearly what's going on in your ileum. And the barium seems to improve a little every year--it used to be an incredible ordeal to try to drink the stuff; now it's just kind of yucky, but not hideous.

My thoughts are with you. I wish you much good luck.

 


3peppers
New Member


Date Joined Nov 2008
Total Posts : 8
   Posted 11/14/2008 4:26 PM (GMT -7)   
songstress,
 
It makes me cringe to read about how much pain you're in, it's the worst pain in the world (I think - and I had back labor with my son).  I'm shocked at the Miralax suggestion, doesn't seem to make sense.  The vomiting is actually not due to the pain, although it is horrible, but since your body can't get the contents of your small bowel/stomach to go out one way, the ensuing spasms makes it go out the other.  You have all the signs of a partial bowel obstruction - it's partial because the food eventually makes its way through and the symptoms clear up.  I've been hospitalized approx. 15 times in the last 16 years with partial obstructions, and suffered through a few short term ones at home.  One word of caution:  I stayed home too long with my first major obstruction (I thought it was the flu) and ended up with peritonitis.  Very scary.  My rule of thumb since then is that I go to the emergency room if/when I begin vomiting.  They can take a quick xray to see if there's an obstruction, you wouldn't think it would show up, but often it does.  My doc usually has me do a hospital stay for complete bowel rest and steroids.  It can be tedious, but the risk of peritonitis is not worth it.
 
If it's a scar tissue/stricture problem, and the "episodes" become more frequent and you're looking at surgery, the Mayo has perfected an awesome laparoscopy - strictureplasty procedure that is minimally invasive and leaves more of your small bowel intact.  If it's not scar tissue but inflamation instead, hopefully one of the new medications out there will help you (but it looks like you're on so much already).  But they take several weeks to kick in, so I really do recommend that you watch what you eat until you find out what's really going on - you want a low residue diet.  If you do end up eating things like fruits, veggies and fiber, try to space it out.  For example, don't have a salad and then a bowl of bean soup in one meal.  Chew well, and don't eat too much at one time - give food a chance to move through without a lot of pressure coming along behind it.  I drink a protein drink every day, and at times have been able to push surgery out another six months by being careful.
 
Good luck, I hope you can get the answers and help you need soon.

songstress
Regular Member


Date Joined Jul 2005
Total Posts : 393
   Posted 11/14/2008 5:49 PM (GMT -7)   
spiceman---I think thats kinda what happened too is that it was obstructed or like 3peppers said/partial obstruction and then when it passes i finally get relief.

I just dont get how a CT can show my inflammation clearing up due to the Humira but my pain is worse than 6 mths ago....has to be what 3peppers is saying

I was told Miralax would maybe help my bowels start working if a stricture was not the problem. Honestly Im so scared to take anything anymore. Pain pills dont work and stop you up. Bentyl slows it down. Lomotil stops it. I think you all are right, that you kinda have to take matters into your own hands and avoid gassy, hard to digest food until you find the cause.

Thanks though, when I finally do get the results I will be posting so everyone can benefit from the findings lol!!

Anyone can give up, it's the easiest thing in the world to do. But to hold it together when everyone else would understand if you fell apart, that's true strength

Dx'd w/Crohn's colitis in May05--spread to ileum & small intestine as of April08. Currently on Humira every 2wks, Pentasa, Entocort, Phenergan, Lomotil, Celexa, Lortab, Ambien, and new this week Zoloft.


BeeSting
Regular Member


Date Joined Nov 2008
Total Posts : 392
   Posted 11/14/2008 6:09 PM (GMT -7)   
Had the same problem as 3 peppers, painful cramps and vomiting after eating vegetables or fruits. Even bananas are dangerous. Had partial obstructions with so much pain that my body was shaking and got so cold that I had to put a lot of cloths on before I went to bed. I asked my GP what to do, and he couldn't answer. I brought up the same question to my GI, but he never suggested that I had to go to the hospital. So I suffered through all at home. I don't know what you mean by short term 3peppers, but mine often lasts from after dinner one day untill the morning next day. I have now changed GI and am going to ask what to when this occurs again.
Songstress, you need to become an expert on what fibers that are good for you and not. Cook all your vegetables more than usual and chew well.

cindywchrones
Veteran Member


Date Joined Mar 2005
Total Posts : 1115
   Posted 11/15/2008 12:50 PM (GMT -7)   

I know when I have a stricture due to continous intestinal noise and bad cramps..I can't eat certain things like raw vegetables which really cause an issue..I have found a low residue diet very helpful for this issue.

Cindy


songstress
Regular Member


Date Joined Jul 2005
Total Posts : 393
   Posted 11/15/2008 8:25 PM (GMT -7)   
thank you beesting and cindy....I can tel a difference when I eat certain stuff..the bowels get louder and the cramping gets worse. Im already off meat and on fish and chicken, now I guess veggies go too..unless I know they are cooked well and wont cause gas or be hard to digest

Anyone can give up, it's the easiest thing in the world to do. But to hold it together when everyone else would understand if you fell apart, that's true strength

Dx'd w/Crohn's colitis in May05--spread to ileum & small intestine as of April08. Currently on Humira every 2wks, Pentasa, Entocort, Phenergan, Lomotil, Celexa, Lortab, Ambien, and new this week Zoloft.


Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3110
   Posted 11/16/2008 8:00 AM (GMT -7)   
I have to say the vomiting is a clue that it is a blockage. Miralax shouldn't have even been brought up with your symptoms!! The key is to find out if it is inflammation or scar tissue...definitely pursue it with your doc or even a second opinion. I would stick on low residue until you have an answer...I hope you find out what is happening soon!

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 11/16/2008 10:26 AM (GMT -7)   
I myself have the stricturing type of Crohns. I live on a low residue diet all the time, and that has really helped to stop/slow the effects. One other suggestion other than avoiding the raw veggies, peels, nuts etc. is to stay away from red meat. It is VERY hard for even the normal intestine to digest. It has to literally rot to be digested. I stick to chicken, turkey and fish.

Good luck,
Gail *Nanners*
Been living with Crohn's Disease for 33 years.  Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium.  Resections in 2002 and 2005.  Also diagnosed with Fibromyalgia and Osteoarthritis. Currently my Crohns is in remission.


conorconan1
Regular Member


Date Joined Oct 2008
Total Posts : 245
   Posted 11/16/2008 11:23 AM (GMT -7)   
Hi Pal,
 
I feel for you. I would suggest that you go fo9r the sb followthrough. Best to know and then treat it. I have suspected Strictures and they are being investogated. I always have the really nosie tummy and the GI said that is a sign of it. I had no bowel movement this past two day (whch for me is a miracle in itself), and when I finally went this evening, it was ultra thin. Is that also a sing of a stricture?

cindywchrones
Veteran Member


Date Joined Mar 2005
Total Posts : 1115
   Posted 11/16/2008 4:38 PM (GMT -7)   

Yes..It has been a sure sign for me..I will feel like vomiting before I go along with it..Scar tissue vs inflammation is what those tests can tell you and can be a necessary evil.  I just hate all those tests.  I start seeing the dollar signs of what I am going to owe afterward, and I have half way decent insurance..

Cindy


3peppers
New Member


Date Joined Nov 2008
Total Posts : 8
   Posted 11/16/2008 10:47 PM (GMT -7)   

Hi All,

After reading the posts, just wanted to note 2 pre-surgery episodes (I have had 4 major surgeries total) where partial obstructions were causing me to be hospitalized monthly.  During those 2 episodes the local hospital could not find the problem with UP GI/small bowel follow-thrus or CT scans.  So I went to the Mayo (I have a relationship there because I used to live in Rochester) and their CT scans picked up 4 major strictures from scar tissue the first time, and 2 the second time, both times requiring surgery.  My GI here now recommends that I fly out to Rochester for all my scans.  The Mayo has superior equipment and the process was slightly different also.  And the best thing?  The docs at the Mayo might tell me that they haven't found the problem yet with the tests performed so far, but they never tell me there isn't a problem.  They just keep looking.  They know that Crohn's is complicated and not all patients exhibit the same symptoms, and they really listen to me.  My problem locally is not with my GI doc, he's great, but your typical radiologist working in some run-of-the-mill hospital doesn't see Crohn's, let alone complicated cases of it, very often.  I think they're often looking for the textbook signs associated with Crohn's, thus missing the real problem.  I once had a young radiologist tell me that my terminal ileum looked fine, and since "that is where Crohn's presents" (his exact words) everything was great.  Never mind that my entire terminal ileum had been removed 7 years before, and my Crohn's was currently having a heyday destroying my upper jejunum.

Also, about the thin bowel movement - I had that problem for awhile, and it turned out to be a scar tissue problem also.  My first surgery 16 years ago involved removing the terminal ileum and ceucum (sp?) and reattaching the small bowel to my colon.  Over time scar tissue grew at that resection site to the point they could not even get a pediatric colonoscopy camera through it and into the small bowel (I learned that, at least at the Mayo, during a colonoscopy they try to continue up into the small bowel as far as possible).  Last year they surgically resected that area and I am totally fine now (yeah!).  This problem was never picked up during a CT scan or a SBFT, even at the Mayo.  At least on me it's a difficult place to get to other than with a colonoscopy (I've also had that area ballooned once during a colonoscopy, and I showed some improvement but it didn't last long.).

Hope this info helps -- most importantly don't give up.  Be sure to drink your protein drinks!


conorconan1
Regular Member


Date Joined Oct 2008
Total Posts : 245
   Posted 11/17/2008 2:34 AM (GMT -7)   
wow 3peppers,
 
sounds as though you have got it really bad with this DD. I am glad that you are feeling much better. I can still not have a BM apart from 1 small movement yesterday and it was really thin and flat. I called the hospital GI today and he has advised to watch it over the next day or two and if it does not improve through the use of a lex then to ring him and he will get me in to be checked again. He confirms that he feels strictures are present and that he will have tro sort them, but he wants to given the drug/diet a chance to qwork as he does not like surgery unless it is a must!
DX November 2008 - after years of searching for an answer
 
Prednisolone 50mg -Omeprazole 40mg for acid reflux - Buscopan 10mg (a daily) Remedeine 30mg-Probiotic


3peppers
New Member


Date Joined Nov 2008
Total Posts : 8
   Posted 11/17/2008 8:14 AM (GMT -7)   

conorconan1,

I agree, surgery is always the last choice, but sometimes it becomes no choice at all and that's when it's really no fun.  I got talked into trying the GI camera last year because, like you, they just couldn't find the stricture I was sure was there.  I spent the holidays from Thanksgiving day through January in the hospital, having surgery and recovering from surgery to remove said camera and bisect the stricture it got hung up in.  Any other time of the year would have been fine, but when you have kids you want to be able to make Christmas memorable.  And not because all your gifts were ordered online in a post-surgery drug-induced state and didn't show up until 2 days after.

Anyway, what I've learned from this journey is to trust myself and my intuition about what's going on in my body.  And it's okay to say no to the docs, and to insist on better care. 

By the way, I noticed on your post that you're on prednisone, but not one of the newer tnf inhibitors... just wondering if you've every tried any.  Prednisone always helped my inflammation short-term, but my body always adjusted to it pretty quickly and it was just like I wasn't taking it at all (except for the hideous side effects-they stayed).  I'm just wondering if they increase your prednisone (I know, dirty words), or you try remicade, or something along those lines, you might be able to tell if your problem is more related to inflammation versus hard stricture.  I mention remicade because I had pretty quick results (within days) from it, as opposed to Humira which takes a little longer to kick in.  Both worked for me, but I eventually had an allergic response to the remicade.

Take care.


Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 11/17/2008 12:29 PM (GMT -7)   
There is a possible alternative that has the potential to help with strictures. A study done in the UK on Crohn's and UC patients took 7 strictured Crohn's patients and gave them N-acetyl glucosamine. Of those, three had to have surgery. One had surgery within two weeks, so that subject probably had strictures that were too advanced to help. Another had to have surgery when their supply of NAG was interrupted. The third had surgery after two years in the study when they stopped all meds for some reason. Four out of seven patients - all of whom were candidates for surgery at the start of the study - did not require surgery for the period of the study (about 2 1/2 years, I think). That is not a bad result in itself. When you consider that two of the three surgeries that happened came after discontinuing the NAG, you could possibly get an even higher success rate if the treatment were uniformly followed. There was also evidence of healing that was not found with steroid treatment. For more, see: http://www3.interscience.wiley.com/cgi-bin/fulltext/120708799/HTMLSTART
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