Strictures vs Inflammation?

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GDen
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Date Joined May 2009
Total Posts : 703
   Posted 4/23/2010 12:47 PM (GMT -7)   
Other than a colonoscopy, is there any way to tell whether you have actual stricturing vs just plain 'ol inflammation?
Cimzia, Asacol


nawlinscate
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Date Joined Jan 2007
Total Posts : 656
   Posted 4/23/2010 3:57 PM (GMT -7)   
As I've understood it for the past 11 years, a stricture is a narrowing of the intestines. It can be caused by one of two things: inflammation and edema (just a word for swelling) OR scar tissue. A variety of tests can determine whether you have a stricture (especially an Upper GI series with Small Bowel Follow-Through, where x-rays can clearly show you the narrowed section of your intestine)--but, as far as I know, no test can determine the precise cause of the stricture. If it's inflammation/edema, it can actually shrink, and your intestine can open up again. But there's nothing that can remove scar tissue--so, if the narrowing is caused by scar tissue, you've got to cross your fingers, pay extra attention to your diet, take meds, and pray that you don't build up any more scar tissue and wind up with a blockage that can only be removed by surgery.

Six years ago, my SBTF showed a footlong stricture at the site of my previous resection. My doctor put me on 6MP and a strict low-fiber/low-residue diet. Three years later, I had a second series of tests--and the stricture had disappeared. My doctor explained that we had lucked out, since we'd caught the stricture before scar tissue had developed.

Since there's no way to know what you're dealing with, it's probably a good idea to treat any stricture with extreme care.

camjames
Regular Member


Date Joined May 2006
Total Posts : 229
   Posted 4/29/2010 2:06 PM (GMT -7)   
I once asked this same question on here...until someone gave me a somewhat logical answer:
 
If your blockage symptoms tend to wax and wane quite dramatically, then most likely its nearly all inflammation that is causing the narrowing; If your blockage symptoms tend to be consistant for months and very slowly get worse...then scar tissue may be playing a big role.
 
Alternatively, depending on your GI doc, another quick way to test for scar tissue vs inflammation is to try a short round of prednisone during a blockage flare. If this helps dramatically, then probaby alot of the narrowing was due to inflammation
 
Just a few good ol tricks to assist with diagnosing rather than going thru big procedures :)
 
Current Meds: Remicade 4 bottles every 2 months, Entocort 9mg daily, Methotrexate 15mg SC weekly


GDen
Veteran Member


Date Joined May 2009
Total Posts : 703
   Posted 4/29/2010 3:13 PM (GMT -7)   
Do strictures hurt though when stuff passes through? I know it does with inflammation, for me anyway.
Cimzia, Asacol


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 4/30/2010 6:33 AM (GMT -7)   
The only time I have pain with my strictures is when something is too fibrous or gets stuck.
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"*

Brad P
Regular Member


Date Joined Feb 2010
Total Posts : 51
   Posted 4/30/2010 7:00 AM (GMT -7)   
I have strictures now likely from inflammation. I have no pain. At most I can feel the expanding/contracting/distending of my bowels as food is trying to pass. It's that bad I am likely going in for surgery very soon as I can barely eat, have lost much weight and have little energy. I can eat great in the morning when my stomach is empty but as the day progresses and I try to ea some more, it backs up and I feel sick and distended.
Regular Member...Veteran Sufferer.

CD since Fall 1987
Small Bowel Cancer - Sept 2008
Surgery to remove tumor - Oct 1st, 2008
Chemo - Dec 2008 to May 2009
Jan 2010 - NED
March 2010 - Active CD and Fistula in Duodenum

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