I have read people asking how you know if a stricture is scar tissue or inflammation. For me it was an endorectal ultrasound that was the deciding factor in opting for surgery.
I have a stricture in sigmoid colon and the ultrasound showed thickening throughout all the layers at the site. Plus there was some mild asymmetry to the degree of thickening. Apparently this is abnormal. Quoting from the operative report "Given the difficulty advancing the radial scope to the stricture, we did not attempt to use the linear scope (which is required for FNA). The linear scope is larger diameter, stiffer and the relatively sharp end would increase the risk of perforating significantly."
In other words they could not do further needle biopsies into the stricture and even if they could they cannot rule out cancer 100%. They would rather be safe than sorry later.
I also had a colonoscopy in January and the stricture site is the only sign of active Crohn's.
Remember I am the lady with no symptoms. I have had numerous scopes and have had 6 GI's and now four surgeons consult with me over the last 18 months. This decision did not come easily but am comfortable with the decision. I know there are others who would probably live with it for some time.
Now waiting to hear when surgery will be scheduled.
55 yr. old F dx. CD 07/07
Was on prednisone for three months but no medication for next 11 months.
Started weekly methotrexate injections 09/22/08.