Scar tissue or inflammation

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Emoney12
Regular Member


Date Joined Mar 2004
Total Posts : 92
   Posted 6/21/2010 7:11 PM (GMT -6)   
Does a colonoscopy show the difference between a scar tissue stricture and an inflamed stricture? The reason I ask as my gi had to dilate a stricture in my descending colon during the colonoscopy. Since I was still out of it he spoke to my fiancé and said some things about scar tissue. She is no expert in crohn's and some of the info she told me didn't make sense. Haha. I spoke to my doctor today who said there was no way of knowing until the biopsies come back. I wouldn't think it would be that hard to tell the two apart. I think I would rather have surgery, if it were scar tissue, and not delay inevitable. Changing my diet and risking a major complication down the road is something I really do not want to deal with. The doctor said the colon looked very well except for the stricture. The bowel was normal above and below it. Is it wrong to hope it is actually inflammation?

ZiggyZagnut
Regular Member


Date Joined Apr 2010
Total Posts : 65
   Posted 6/21/2010 7:32 PM (GMT -6)   
It's not wrong to hope for anything!! At least inflammation can be treated with medication (hopefully), scar tissue needs surgery I think.
30yo/male/western NY
Dx with Crohns in 2001- Asacol and diet beat it into remission in 2004.
Nov. 2009- Crohns is back!
Medical Issues- ADHD, anxiety, depression, kidney stones
Meds- Vyvanse, Lexapro, Xanax, Darvocet, Cimzea


sr5599
Veteran Member


Date Joined Aug 2007
Total Posts : 1202
   Posted 6/21/2010 8:31 PM (GMT -6)   
I would think it would be possible to tell the difference! From the photos from my own scopes, the active inflammation is smooth, red, swollen looking. Healthy bowel is very clear to pick out. It would seem like scar tissue would not look as red and irritated. Not that I know for sure. I did ask my doctor if scar tissue could raise the sed rate and he said no.
1 fistula, crohn's colitis, limited to large intestine
Compounded budesonide 3mg/daily, Cimzia, MTX . Dx Osteoporosis 10/08 started Forteo 1/27/09


Emoney12
Regular Member


Date Joined Mar 2004
Total Posts : 92
   Posted 6/21/2010 9:02 PM (GMT -6)   
My seed rate and CPR are all normal. The only symptoms I was having was bloating and gas. I was still going to the bathroom daily so I didn't even think a stricture would be the cause. Hopefully I will find out soon enough. Is there a reason why they do not do stricturplasties on the large intestine? I wonder if one can be done.

Emoney12
Regular Member


Date Joined Mar 2004
Total Posts : 92
   Posted 6/24/2010 6:31 PM (GMT -6)   
Well I was supposed to get my biopsy results today to determine if the stricture was scar tissue or inflammation. Instead I get a call from the nurse stating I need to get an MRI on the pelvis and abdomen and they already got the authorization and scheduled me for the 1st week of July. Now I am extremely freaked out. Now I have to wait for the results longer since I never got a call back and have to worry about the need for additional testing.

jenngrl81
Regular Member


Date Joined Oct 2007
Total Posts : 208
   Posted 6/24/2010 7:18 PM (GMT -6)   
Well it could be that the sample for the biopsy was bad/lab error, or the result was inconclusive. Don't worry until there's something more to worry about. It could be "good" news for you. At least they aren't cutting blindly and are being thorough. Good luck and hang in there! I know it's hard.
Pentasa- 4 g q day; 1/08; Percocet
Remicade 1st infusion 7/24/08
Ultram ER 200mg; omeprazole 40mg; Xanax-ANXIETY; Effexor ER 150 mg
Hope this clears up soon, I want to start having babies!


Emoney12
Regular Member


Date Joined Mar 2004
Total Posts : 92
   Posted 6/24/2010 9:04 PM (GMT -6)   
Just real nervous that my wedding is in 3 months and this has the potential to cause a significant problem. Not to mention the Vegas bachelor party and the honeymoon to Fiji. I am real worried about having to cancel when everyone has paid so much money and put in a lot of time into the activities.

Bammer
Regular Member


Date Joined Mar 2008
Total Posts : 381
   Posted 6/25/2010 12:37 AM (GMT -6)   
From my experience when they first found a stricture in my sigmoid colon it was reported as "ulcertation with intense acute and cronic inflammation" and "inflamed sigmoid stricture with normal mucosa above and below" on two different colonoscopy reports. It was red and called a real mess. I had four colonoscopies and three sigmoidoscopies (over the course of two years) before I had an internal ultrasound which was the determining factor as far as the stricture being made up of scar tissue and deciding upon surgery. I also read in my GI reports that 'colonic strictures are notoriously difficult to mange medically, and thus I suspect she will ultimately require surgery'. (Other GI's might have different opinions and other members different experiences.) Mind you I was asymtomatic thus the decision for surgery a little more difficult. Plus in my case increased risk of cancer was a determining factor although all biopsies were normal.
 
Doesn't sound like you are having a lot of symptoms at the moment, three months is not very far away and the first week in July is even less far away so hang in there. 
 
Good luck and congratulations on your upcoming wedding.
58 yr. old F dx. CD 07/07
Started weekly methotrexate injections 09/22/08.
Lap assisted sigmoidoscopy done May 11/2009


Emoney12
Regular Member


Date Joined Mar 2004
Total Posts : 92
   Posted 6/25/2010 9:08 AM (GMT -6)   
Just heard back from the nurse and the biopsy of the stricture came back inflammation.  I am still waiting for the doctor to call but it in his report his recomendation was to go back on remicade.  Well it was a nice long run on Humira, 4 years of weekly injection, but I guess it is time to move on.  I am going to see if I can convince him to go the Cimzia route first and then fall back on remicade if need be.  Maybe I just need a loading dose to bring things back under control.  I am little concerended with remicade after being off of it 4 years.  I know the facility can prevent the infusion reactions but I am a little concerened with how effective it would be.  I was also on 6mp for years but eventually my liver went haywire.  I guess maybe we can try that again as well at a lower dose.  My doctor doesn't like treating with steroids, but I would even be willing to go on prednisone for a short time if need be. 
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