how to know it's scar tissue?

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emrose
Regular Member


Date Joined Oct 2008
Total Posts : 63
   Posted 11/18/2008 10:13 PM (GMT -7)   
the doc thinks it's scar tissue because there was a stricture so narrow in the first colonoscopy that he couldn't get the scope through and after several weeks of 60mg of prednisone it didn't be any better. The second scope was the same thing - couldn't get through. So he said it was scar tissue and sent us to he surgeon.

Well, now my husband is down to 20mg of pred, taking probiotics, fish oil and a multi vitamin and feels good! Some fatigue but 1 BM a day and no cramps. But surgery is already scheduled for December 9th. I'm starting to think that it seems weird to cut him open when he feels fine!!

The doc said there is no way to be 100% SURE it's scar tissue withouth cutting him open. He's believes it is because he prednisone didn't help. Is there any other way to know if it's really scar tissue!?

Bammer
Regular Member


Date Joined Mar 2008
Total Posts : 381
   Posted 11/18/2008 11:54 PM (GMT -7)   
Similar situation so will be watching for replies. I have a stricture in sigmoid colon which they have trouble getting through with scope (use pediatric scope). Was put on Prednisone but although I felt it had improved bowel movements, scopes have always showed inflammation at stricture site. Colorectal surgeon said it would require about six inches of colon removed. My present GI who referred me to the surgeon realizes how good I am feeling so we are trying to reduce inflammation with methotrexate before we proceed any further. Decisions are much harder when you are feeling good and in my case I have felt good since being diagnosed. Last visit GI said something about an ultrasound might show more how much is scar tissue. Also have talked to surgeon about dilation.
Good luck.
55 yr. old F dx. CD 07/07
Was on prednisone for three months but no medication for next 11 months.
 Started weekly methotrexate injections 09/22/08.


emrose
Regular Member


Date Joined Oct 2008
Total Posts : 63
   Posted 11/19/2008 12:05 AM (GMT -7)   
interesting Bammer - That is VERY similar to my husband. Surgery is scheduled to remove 6 - 8 inches of his sigmoid colon. Do you think that's a total coincidence or is there something different about the sigmoid area?

Anyway, I wish you luck with the new meds! We obviously have to figure this out by the 9th so I'll keep you posted. If we do opt for surgery it will be very interesting to see what she finds in there!

Thanks and I look forward to hearing what others might have to say.

Ps. Sorry about the typos above - posting from my iPhone :)

broomhilda
Veteran Member


Date Joined May 2007
Total Posts : 1488
   Posted 11/19/2008 6:46 AM (GMT -7)   
Scar tissue is difficult to be seen on any imaging. Unfortunately surgery for a looksee is about the best you can get. Sounds like the Doc is on the right track to me. Good Luck to you.
Dx'd Jan'06, 1st Resection 7/06, Humira, Imuran, B12 injections, Nexium, Lexapro, Nulev, Glucosamine, Multi-Vitamin, Calcium Citrate, Ultracet. Secondary conditions: Psorasis, Osteoarthritis, Fibromyalgia, Lactose Intolerant, gallstones, kidney stones & peri-menopausal.


gachrons
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Date Joined Mar 2007
Total Posts : 4527
   Posted 11/19/2008 7:09 AM (GMT -7)   
I think they go alot on if the narrowing improves with meds or if it doesn't. They can still see if it is narrowed. lol gail
Hallarious woman over 50 ,CD ,IBS 27 years--resection,fistula's,obstructions,hemmies,and still alive.lol gail


Bammer
Regular Member


Date Joined Mar 2008
Total Posts : 381
   Posted 11/19/2008 10:46 AM (GMT -7)   
Emrose, in my case, I have two inches of sigmoid colon that is narrowed and inflammed, so surgeon said he would take that as well as two inches on either side. Sounds pretty simple and he should be able to do it laparoscopically. Will see.
55 yr. old F dx. CD 07/07
Was on prednisone for three months but no medication for next 11 months.
 Started weekly methotrexate injections 09/22/08.


Bammer
Regular Member


Date Joined Mar 2008
Total Posts : 381
   Posted 11/19/2008 10:51 AM (GMT -7)   
PS. But you can also get scar tissue or adhesions at the resection site from surgery, can't you? All fairly new to me and learning as I go.
55 yr. old F dx. CD 07/07
Was on prednisone for three months but no medication for next 11 months.
 Started weekly methotrexate injections 09/22/08.


Joie1
Regular Member


Date Joined Oct 2008
Total Posts : 376
   Posted 11/19/2008 11:07 AM (GMT -7)   
Yep...supposedly we get more strictures/adhesions/whatever near the scar tissue.
27/f/CD. 4 CD related surgeries: 2 resections, 2 JP drains, 3 NG tubes, many absesses (including the one my most recent surgery scraped off my ovary) and fistulas.
Currently trying to figure out hip and knee joint pain.
Have lost in these surgeries: appendix, 8 in. intestine, R fallopian tube, gallbladder, 10 in. intestine
Dx'd: February 2007.
Pentasa (and much mental screaming)


Bammer
Regular Member


Date Joined Mar 2008
Total Posts : 381
   Posted 11/19/2008 1:51 PM (GMT -7)   
Am I wrong in thinking it's the surgeons who are reluctant to do the surgery except as a last resort. GI called in a surgeon during my first colonoscopy (July 2007) to view the screen. She said you don't want surgery unless absolutely necessary and in follow up in December, thought I wasn't at that point yet and referred me to specialist. He referred me to colorectal surgeon who I saw in May 08 and although surgery is an option, it was not my only option. The specialist thought when he did his first colonoscopy on me (Feb 08) I would require surgery within the next year but in August when I had almost decided, 'let's do the surgery', he wasn't so sure since he said he'd seen me long enough by then to see I good I was doing. I do not see high power, long term drugs as a good option either (unless you really need them).
Hope this isn't straying from your original post but helps you as well. In the end, people have to make the choices they think are best for them. I could have had surgery last year and everything could have been fine but back then Crohn's diagnosis came as a shock and I knew nothing about it. Now at least I can make a better informed decision.
Take care,
55 yr. old F dx. CD 07/07
Was on prednisone for three months but no medication for next 11 months.
 Started weekly methotrexate injections 09/22/08.


inflamed
Veteran Member


Date Joined Nov 2005
Total Posts : 1340
   Posted 11/19/2008 3:44 PM (GMT -7)   
scarring doesn't have to mean surgery. I have definite scarring at the TI and it is VERY narrow, however, I have no symptoms so long as any inflammation is treated. I've avoided surgery for 5+ years and am still doing great. That said, if it is scar tissue and you still feel bad once the inflammation is under control, surgery is the only option to remove it. At that point the risk of recurrence at the same spot is still better than the current pain anyway. Just my two cents.

HJ
Hoping to stay in remission after the birth of a healthy baby girl. On Pentasa during my pregnancy, but Ive gone rogue and med-free to nurse.


emrose
Regular Member


Date Joined Oct 2008
Total Posts : 63
   Posted 11/19/2008 7:55 PM (GMT -7)   
hey everyone

Thanks for the responses! Bammer - niether of the surgeons we've seen have been reluctant to do the surgery. In fact they haven't questioned it at all but I just figured it's because it's what they do! Our GI first said surgery is a last resort option but then referred us to the surgeon after our next visit!

Inflammed - iteresting that you have been fine with the scar tissue for so long! I hope it continues!! Thanks for sharing your experience.

I worry about surgery only leading to more scar tissue down the road but I would also like someone to get in there and really see what's going on! Tough choices with this disease!!

Krica
Regular Member


Date Joined Apr 2007
Total Posts : 99
   Posted 11/20/2008 3:35 PM (GMT -7)   
hi, i have three strictures and one of them is very tight , scope could not pass through, i have been with strictures over three years and i am doing very well. I am pregnant 14 weeks, feeling very healthy and happy. Strictures does not mean surgery, surgery is necessary when medication fail to control the disease. Good lucky!! Take care.

Krica
Regular Member


Date Joined Apr 2007
Total Posts : 99
   Posted 11/20/2008 3:40 PM (GMT -7)   
hi, i have three strictures and one of them is very tight , scope could not pass through, i have been with strictures over three years and i am doing very well. I am pregnant 14 weeks, feeling very healthy and happy. Strictures does not mean surgery, surgery is necessary when medication fail to control the disease. Good lucky!! Take care.

inflamed
Veteran Member


Date Joined Nov 2005
Total Posts : 1340
   Posted 11/20/2008 4:10 PM (GMT -7)   
Krica, congrats! I just had a baby. I worried she might push on my stricture and cause problems, but she didn't. I felt great the whole time. In the end, though, I was curious about where my TI and stricture were located since I seemed like all baby. Maybe somewhere near my ribs?? :)
Hoping to stay in remission after the birth of a healthy baby girl. On Pentasa during my pregnancy, went med-free 2 months to nurse (stupid), but back on Pentasa and still nursing.


Joie1
Regular Member


Date Joined Oct 2008
Total Posts : 376
   Posted 11/22/2008 10:31 AM (GMT -7)   
I've never been told I had strictures...just got this as an answer, "Looks like a mess in there." and all the other surgeries were to drain abscess (in a hidey spot), to explore the original problem where they removed stuff, and the removal of fistulas that were not healing. Actually, I think about what I know now and I get so mad. Why didn't any of these doctors just TALK to me? All I ever remember is being told to sign papers where I may never wake up again. My first surgery, I was totally informed about what they might end up doing as a worse case scenario but every single following surgery wasn't as clear cut as that.
27/f/CD. 4 CD related surgeries: 2 resections, 2 JP drains, 3 NG tubes, many absesses (including the one my most recent surgery scraped off my ovary) and fistulas.
Currently trying to figure out hip and knee joint pain.
Have lost in these surgeries: appendix, 8 in. intestine, R fallopian tube, gallbladder, 10 in. intestine
Dx'd: February 2007.
Pentasa (and much mental screaming)

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