inflammation vs stricture...treatment difference?

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bad-bell
New Member


Date Joined Sep 2007
Total Posts : 16
   Posted 3/5/2010 1:59 PM (GMT -7)   
I'm still trying to figure this CD thing out.  I was diagnosed a couple of years ago.  For a year I took Entocort and Pentasa. Finally got off Entocort, but was told by GI that if occasional flares continued that 6mp might be the next course of action.  Held that at bay for 6 months, but have been having bouts when I don't have a bm for 3-6 days followed by a day of cramps solid bm and then, D.   So, GI said that it sounds like the stricture is continuing to be an issue and that  dilation  would be the best next step and if that doesn't result in improvement surgery might be needed. 
 
So,  is the Pentasa and 6mp to treat inflammation?  Does the medication not help a stricture?   Thanks for any help. I feel so ignorant.

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 3/5/2010 2:40 PM (GMT -7)   
Generally if the stricture is made up of scar tissue only, then generally meds will not work to heal it, but.... may help to keep it from getting worse. If its from inflammation then meds will work to heal the inflammation. Good luck!
Gail*Nanners* Co-Moderator for Crohns Disease & Anxiety/Panic
Crohn's Disease for over 34 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

inflamed
Veteran Member


Date Joined Nov 2005
Total Posts : 1340
   Posted 3/5/2010 2:43 PM (GMT -7)   
Yup, what Gail said.

I have a stricture that is scar tissue. I can live just fine with that, BUT if I get active inflammation in the area I have problems. So for me, treating the inflammation and getting remission allows me to feel great even while the scarred stricture remains. Just depends on the makeup of your narrowing -- all scarring, all inflammation, mix. You can't really know unless you get rid of the inflammation and the stricture is still there. We figured mine out because even a biopsy showed no inflammation, what was left was scarring. I got the remission on 6mp and Pentasa, by the way.
Mom to a healthy Pentasa baby and pregnant with #2. 5+ years remission, woo hoo!


bad-bell
New Member


Date Joined Sep 2007
Total Posts : 16
   Posted 3/5/2010 3:05 PM (GMT -7)   
Thanks! My last scope was a year ago. Inflammation was low, but stricture from scarring still there. So, guess it's a mixture for me.
Are the pain symptoms different from stricture vs ulcers/inflammation?

My pain symptoms vary soo much. Sometimes, I have a dull stabbing pain in lower right near belly button Other times its like a floating pain....for a little while its upper left, then it can be more upper center, or in my lower right back, then sometime just all over. Don't know if this has to do with any of it.

BeeSting
Regular Member


Date Joined Nov 2008
Total Posts : 392
   Posted 3/5/2010 3:20 PM (GMT -7)   
Our small intestines are moving around the the abdominal area. 6 - 8 meters isn't fixed, so you'll probably feel pain in different areas. My GI explained this to me when I asked him why my pain was "moving around", I too have a stricture and now and then imflammation in that spot. /Bee

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 3/6/2010 8:37 AM (GMT -7)   
Bad-bell when ever I have had obstruction symptoms this is what happened: I get pain that comes in waves much like labor pains, it goes up into a peak and then slowly wanes down. It will do these waves every few minutes or so. I cannot pass gas out of either direction, feel like I need to have a BM but can't, then I will eventually vomit. These episodes are very painful for me, and if you have something like this hit you, get yourself to the ER. Oh by the way the pain is usually right around the belly button area.

Just wanted to give an idea of things to watch out for since you do have a stricture. Good luck!
Gail*Nanners* Co-Moderator for Crohns Disease & Anxiety/Panic
Crohn's Disease for over 34 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

bad-bell
New Member


Date Joined Sep 2007
Total Posts : 16
   Posted 3/7/2010 1:09 PM (GMT -7)   
Thanks for the info! I don't know what I would do if I didn't have this board. You all know so much.

Grandpato2
Veteran Member


Date Joined Dec 2009
Total Posts : 681
   Posted 3/7/2010 10:20 PM (GMT -7)   
scoolI get exactly what Nanners gets, But I also get what you describe bad-bell. That I consider the begining of an obstruction. The more the pain moves and spreads the worse the narrowing is becoming. When the pain becomes a band around your abdomen and back (both kidney's) the next thing will be what Nanners describes as waves or cycles of pain where the peaks are excru****ing. You'll probably not have any bm's as well. The trick is to recognise that the pain moving around is a danger sign mine starts just above the belly button then goes to the upper right side and so on. No more foods solid or soft. Liquids to hydrate only until it passes, which with me is the return of bm's. Hope you can relate and that this helps Robsmilewinkgrin


Male, 54 years old with Crohn's since 15 years old, diagnosed at age 46. Terminal ileum resected 2002. 5 months of remission. Crohn's has now been active since early 2003. Had a gall bladder removed Nov. of 2009. Currently on Remicade every 8 weeks, Nexium, Iron, B-12 injection every 4 weeks,5-asa Asacol, Morphine Sulfate as needed for pain. Cymbalta for long term pain control. 5-asa Salofalk, Entecort, Imuran and Prednisone in the past.

Post Edited (Grandpato2) : 3/7/2010 10:23:16 PM (GMT-7)


bad-bell
New Member


Date Joined Sep 2007
Total Posts : 16
   Posted 3/11/2010 1:30 PM (GMT -7)   
Thanks...a few days late. 
 
Grandpato2,  I appreciate your advice to take the pain as a warning sign.  After this weekend, I am realizing that I have to start paying more attention.  It's almost like you wrote the play by play of my weekend.   Moving pain,  then more of a band of pain,  no bm's for almost 5 days,  finally after taking things easy.... I think it's finally all passed. 
 
 

NiceCupOfTea
Veteran Member


Date Joined Jan 2010
Total Posts : 8584
   Posted 3/11/2010 3:25 PM (GMT -7)   
@bad-bell - your symptoms sound very much like mine, down to the shifting pain part. I had those shifting pains yesterday. And when I walked, each time I put my foot down on the pavement there was a jolt of pain. Had that exact same pain a week ago after my celebatory slap-up meal. Neither resulted in obstruction, but I have had those waves of pain Grandpasto2 described just once. There was a feeling of incredible pressure at a focused point in my abdomen. And a strong feeling of wanting to belch up air but not being able to. No stomach gurgles, no BMs, no gas. I think that was an obstruction, albeit a temporary one. It didn't last longer than a few hours, before something inside shifted and there was a stomach gurgle. It took a day or two to fully resolve.

By the way, do you know if your stricture is in your small intestine or colon? My GI told me a couple of days ago that strictures in the small intestine don't cause constipation, but that kinda goes against posts I've read on this board.

bad-bell
New Member


Date Joined Sep 2007
Total Posts : 16
   Posted 3/12/2010 12:15 PM (GMT -7)   
Nicecupoftea--from what I understand, the stricture is where the small and large intestine meet. I have a consult scheduled with a surgeon and definitely have lots of questions to ask. I've been seeing a GI for several years, but really hadn't asked too much about the stricture because we were focusing on getting inflamation down. But, the GI thinks that the major source of my symptoms is the stricture. Since I often have bouts where I don't have a BM for 3-6 days which includes a painful time until all passes.

Grandpato2
Veteran Member


Date Joined Dec 2009
Total Posts : 681
   Posted 3/12/2010 10:29 PM (GMT -7)   
So sorry you had to go through that. Most of us pay attention when the pain gets that bad. I wish I'd had someone explain it all to me years ago. Glad to be of assistance!
Male, 54 years old with Crohn's since 15 years old, diagnosed at age 46. Terminal ileum resected 2002. 5 months of remission. Crohn's has now been active since early 2003. Had a gall bladder removed Nov. of 2009. Currently on Remicade every 8 weeks, Nexium, Iron, B-12 injection every 4 weeks,5-asa Asacol, Morphine Sulfate as needed for pain. Cymbalta for long term pain control. 5-asa Salofalk, Entecort, Imuran and Prednisone in the past.

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