How do we know though if it is scar tissue or active chronic inflammation??? I am thinking that I should ask why don't we get more aggressive and try other drugs to get rid of inflammation and then repeat tests to see if is scar tissue. Can they tell from a colonoscopy? Also what is a small bowel follow through?? I thought you only developed scar tissue from surgery resections? Do you think you still have inflammation. I know it is still bad because of the pain and diarrhea.
A small bowel followthrough (SBFT) is a whole series of x-rays. You drink barium and they photograph you every few minutes, until the stuff has worked its way from one end of your system to another. It's very effective in showing whether you have a stricture in your terminal ileum. There is, however, no way to tell whether the stricture is made up of inflammation and edema or scar tissue.
Scar tissue doesn't only result from ileal resections. If your ileum gets irritated and your immune response activates, you'll get inflammation. After bouts of inflammation, eventually you'll get all scarred up. As the above posters said, you may be able to alleviate inflammation with meds and diet, but, once you've got scar tissue, it stays there, permanently narrowing that area of your intestinal tract. Once you've developed scar tissue, you've greatly increased the likelihood that you'll need surgery eventually.
The best thing is to assume (hope!) that any stricture that shows up in the SBFT is inflammation and to try throwing meds at it (and trying a more restrictive, less irritating diet), so that it may heal. Interestingly enough, the severity of your symptoms (pain, diarrhea, nausea) may not necessary correspond to the severity of your stricture. But, believe me, if you ever have a complete ileal obstruction, you'll know--that's a whole different level of discomfort!