Anyone with a stricture in colon--please help!!

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ConsideringABag
Regular Member


Date Joined Aug 2007
Total Posts : 65
   Posted 10/5/2007 6:12 PM (GMT -6)   
I have had severe Crohn's since I was 15, and am now 26. At my last colonoscopy, they found that I had a stricture (narrowing of the colon due to scar tissue) about 40 cm into my colon. This prevented them from being able to push the colonoscopy camera any further in, and so they were NOT able to look at nearly 75% of my colon.

My concern is that I know I am a high risk for colon cancer--and now, with this stricture, they cannot see most of my colon. I can have a barium enema done to see things past the stricture, but if they find any unusual polyps past the stricture, how they will get them out may be major surgery...

Has anyone ever had a stricture in the colon?? If so, is there a procedure they can do to dialate it (stretch it back open)?? Please let me know...

My username came from my last visit to the doctor, where the surgeons were pushing me to get an ileostomy (my Crohn's is atypical--it is and has only ever been located in my colon--my small intestine has always been healthy, so an ileostomy would essentially "cure" me--at least thats what they keep saying...)

Please help. I am so down right now. I have been feeling bad for about a month now.. I am a teacher, and feeling horrible stomach pain at school has to be the worst, because I have kids constantly needing me to give my time and energy...

Thanks ahead of time for any replies.

:-)

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14994
   Posted 10/5/2007 8:42 PM (GMT -6)   
Was there any reason they didn't try to dialate it while they were in there? There are a few folk on here who have had their strictures dialated. Maybe PB4 will be along soon and maybe she can give you more info. I know she has Crohns Colitis herself, don't know if she's had a stricture though.
Been living with Crohn's Disease for 32 years.  Currently on Asacol, Prilosec 60 mg, Estrace, Prinivil, Diltiazem, Percoset prn for pain and Calcium.  Resections in 2002 and 2005.  Recently diagnosed with Fibromyalgia and doing tests to see if I have Inflammatory Arthritis or AS.


belleenstein
Veteran Member


Date Joined Feb 2007
Total Posts : 1010
   Posted 10/5/2007 10:37 PM (GMT -6)   
What about a stricturplasty? In that procedure they cut open the stricture and then sew it up across its width to make it wider. Strictureplasty has been shown to have better outcomes than resection in terms of disease recurrence, but obviously the diseased area of bowel has to meet certain criteria in order to be considered amenable to this procedure.

I can also understand your physicians' interest in ileostomy. It is an option, but one that in a crohn's patient does carry a degree of risk. Even though you have never had crohn's in your small bowel there is no guarantee that it won't come back at the site of your stoma or higher in your digestive tract. I would consider all my other options before opting for that route. Maybe you've already done that. have they explained why a resection and then maintenance medication is not a good option for you?
Belleenstein:

30+ years living with Crohn's.


chrissy27
Regular Member


Date Joined Oct 2007
Total Posts : 67
   Posted 10/6/2007 8:24 AM (GMT -6)   
Hi :-)
I have crohn's colitis and was diagnosed back in april.  I also was told that i had a stricture of my colon.  They weren't able to get the camera through to see what was past it so they did a CT scan on me, which they told me it just confirmed the crohn's.  I wasn't really told much about the stricture.  I knew what it was but i wasn't told if it was bad.  They were going to start me on remicade to see if that would heal it but my insurance dropped me and my GI never tried to get me in his office to get it started.  So right now---i'm going to go see a different GI.  I was told if the stricture didn't get better i would have to have that part of my colon taken out.  I'm getting a second opinion on my treament options.  I know i probably haven't helped much...i'm still new to this...but I feel for you....having to devote your time to kids is hard when you feel bad.  Hang in there...
 
God Bless,
 
Christina
27 yr old female, diagnosed with crohn's colitis with stricture of the colon april 2007--still new to this whole thing--
 
medications:  Imuran 50 MG, Lialda 1.2g


Mormor Vicky
Veteran Member


Date Joined Mar 2007
Total Posts : 684
   Posted 10/6/2007 9:09 PM (GMT 0)   
I had a stricture in my sigmoid and opted for a resection. This was before I knew I had Crohns. Doctor thought it was diverticulitis but I also had a fistula to my bladder so sugery was a better option. Needed to repair the bladder. Half of my colon was removed but I'm pretty sure my Crohns has come back. My energy level has been way down and I'm pretty sure I have disease activity in my rectum. I would not go to the extreme of having a bag because Crohn's can and does come back. I really think you should consider a strictureplasty or a resection. I know the colon cancer is a concern but until it's necessary I wouldn't dare go to that extreme. Just my thoughts.
Vicky / 47 years old
DX'd with Crohn's during a resection August 2006
DX'd with Steriod induced Diabetes November 2006
Considered in Clinical remission but have minor signs of disease activity
 
Daughter (26) also has Crohn's since she was 12.
 
Currently on 4000mg of Pentasa only for Crohn's
No longer able to take 6-MP because of Bone-Marrow Suppression
Cymbalta, Metformin, Lipitor


ConsideringABag
Regular Member


Date Joined Aug 2007
Total Posts : 65
   Posted 10/6/2007 5:17 PM (GMT -6)   
Thanks for the replies/information/encouragement, everyone. :-)

Nanners, they did not dialate it when they were in there because that procedure would have to be performed by a colo-rectal surgeon, and my GI was the one doing the colonoscopy. (this is what i was told, at least). Also, the stricture is not currently causing any functional problems (stuff can still pass through without much of a problem), but as I said my main concern is that they can no longer see polyps in the early stages and cut them out now.

I have already had a recurrent stricture in my anus, but dialating this is a minor procedure I have had done already a few times. Dialating colon has much more risk of rupturing...

Belleenstein, thanks for the info about stricturplasty. That sounds like the least-invasive procedure--I would definitely opt for this if my doctor thinks it will work for me. :-) I REALLY do not want to get a resection if possible... As for the ileostomy comments, I agree that that should be a last resort only. My surgeons (who are some of the best in the country, truly), have been telling me I should get one since I was 18...

Chrissy, I am sorry that you are having health problems too, and dealing with insurance companies--especially when you are sick--is a nightmare. I hope that you find a good GI that will help you to take the best care of yourself. It took me 3 years to find a GI who actually found a treatment that worked for me.

Mormor Vicky, I am the same age as your daughter, and my mother also has Crohn's colitis. Last year, they found that she had colon cancer, and she had much of her colon removed. She has recovered fully and there is no sign of the cancer left. :) Her having cancer is part of the reason I am so concerned about getting it as well. She had no Crohn's symptoms until she was in here 30's, but my Crohn's came out when I was only 15. They say that after 10 years with the disease, your risk of cancer is quite high. I intend to hold off and ileostomy as long as possible..it sounds horrible to have a bag, but when you compare it to getting cancer and dying at a young age it doesn't seem so bad at all..
:-) :-)

Thanks, everyone. I will look into stricturplasty, and let you know if they say it is right for me! Have a good weekend.

bauerSoCal
New Member


Date Joined Jan 2013
Total Posts : 9
   Posted 1/13/2013 10:01 PM (GMT -6)   
Hi everyone,

I'm so glad I found this string of comments. I am new to the forum.

45 yr old female
proctitis in '96
UC since 2000 after being given several antibiotics for adult acne (argh!)
various minor flares treated with 5ASA meds, suppositories, enemas
traumatic colonoscopy in 2008
one major flare led to hospitalization in Feb 2010
after some healing, colonoscopy done in Apr 2010 found stricture at 40cm (most likely caused by traumatic colonoscopy in 2008 accordg to new docs) -- it's 15mm in diameter, enough for pediatric and/or endoscope to pass through

I'm now being told I need to choose a perm ileostomy or J-pouch due to stricture, yet I have normal BMs every day with no pain, no bleeding, etc. I only take meds when I flare since I do not like to be on meds all the time. Currently only using canasa supp. when needed. I have a repeat colonoscopy set for Feb 4 2013 with new GI doc and with a surgeon present to assess "options".

Anyone have a stricture dilation or stricturplasty in this situation that worked well?
Thanks for any suggestions / advice!

NiceCupOfTea
Veteran Member


Date Joined Jan 2010
Total Posts : 5942
   Posted 1/13/2013 10:42 PM (GMT -6)   
Bumped old threads don't tend to get many replies, so you might get a few more if you make a new one. That said, colonic strictures in Crohn's are rare: we usually have them in the small bowel. In your case, a resection is another thing to consider, though it might not be possible - that is something you would need to speak to your doctors about. I can certainly understand the reluctance to have major surgery given the lack of symptoms - I am a bit surprised at that, tbh. Do you still have left-sided inflammation or has that gone?
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