The good, the bad, and the unknown

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Carnival Huckster
Regular Member


Date Joined Oct 2009
Total Posts : 159
   Posted 11/17/2009 2:18 PM (GMT -7)   
I just had a follow-up appointment with my GI doctor and here were the results:
 
The good:
+ No signs of inflammation
+ She said I looked heathier than anytime in any of the years I have seen her (thank you SCD.)
+ I have lost about 10 lbs in the past 90 days, but she thinks it is good weight loss rather than sick, chronie weight loss
+ She likes the sound of the diet I am following (finatical SCD for past 3 months, I fell of the SCD wagon for several years before that)
+ LDN is a possibility once I get the OK from the GI people at the research center who have experience prescribing off-label LDN for Crohn's
 
The bad:
- My stricture appears to be mostly scar tissue because, in the absence of appearant inflammation, it still causes an occasional problem (once per week or so I have pain despite taking full steroids)
- She wants to send me for a second opinion with a GI doctor who deals exclusively with stricturing cases to formulate a recommended course of action with the possibility of surgery being on the table.
- If I did have surgery, she would want me to go on 6MP for an extended period of time, which is something I really want to avoid.
- They will probably do another upper GI scan (she says this can help confirm that stricturing is caused by scar tissue rather than inflammation as the scarred areas will show no peristalsis when looked at in real time.)
- There is now some debate about the exact locations of the strictures and she is not sure that the strictures could be removed by laparoscopy; in other words, I might have to have full-blown surgery.  Admittidely she is not a surgeon so she may be mistaken about this.
 
The unknown:
Does anyone have experience with laparoscopy versus traditional surgery for removal of strictures?  I was under the impression from several conversations already had with board members that removal of diseased areas of the jejunum could be done by laparoscopy.  My doctor seemed to think otherwise, but like I said, she is not a surgeon.  My diseased / scarred areas continue for about 10-15cm in the jejunum.
 
Any other opinions or information I should look at would be apprecaited.  If anyone has been through similar circumstances, what course of action did you follow and would you do the same thing if you could do it over again?


+ 34 year old male
+ Crohn's Disease DX in 1997, doc said it was "moderate to severe"
+ Currently taking 9mg entocort and 40mg prozac
+ SCD for past 10 years
+ 4,000 mg MSM, Calcium, Vitamin D, Multivitamin, S. boulardii, Acidophilus
+ Section in lower jejunum is badly strictured (5mm wide opening continues for 10cm!) but otherwise no other problems in bowel
+ No surgeries so far


Carnival Huckster
Regular Member


Date Joined Oct 2009
Total Posts : 159
   Posted 11/18/2009 10:58 AM (GMT -7)   
Bump ... this stricture is giving me problems today (yet again.) It's making a lot of noise and causing pressure to build up, but no outright pain so far. I don't think I am going to be able to avoid surgery. I've been googling about laparoscopic jejunal resection and have found a few resources, but nothing incredibly helpful. I couldn't get in to see the specialist until Dec 8. Anyone have any ideas? I want to go into the appointment armed with as much information as possible.

+ 34 year old male
+ Crohn's Disease DX in 1997, doc said it was "moderate to severe"
+ Currently taking 9mg entocort and 40mg prozac
+ SCD for past 10 years
+ 4,000 mg MSM, Calcium, Vitamin D, Multivitamin, S. boulardii, Acidophilus
+ Section in lower jejunum is badly strictured (5mm wide opening continues for 10cm!) but otherwise no other problems in bowel
+ No surgeries so far

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