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Crohn's Disease
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Posted 2/21/2008 7:02 PM (GMT 0)
Well, my girl went in this morning.  Her endo. showed improvement which is great.  Her col. showed areas of improvement but he wasn't able to get a scope into the illeum at all.  This caused him concern and they will do a small bowel follow through the first of the week.  He believes there is either an obstruction or further narrowing.  I have a few ?'s, if I may...... He said not to worry he can do surgery to remove that portion.  I know many of you have had surgeries, what is your take on this?  I feel that surgery should definately be a last resort.  I may be jumping the gun here but I feel like that is a drastic measure.  He switched her from 3 entocort to 6 prednisone daily.  Also, She has another anal abcess which he is treating with flagyl.  Is this just going to keep coming back?  She is to continue the liquid diet since solids make her vomit.  Any suggestions?  Thanks in advance for your input! 
Posted 2/21/2008 7:44 PM (GMT 0)
Well as far as the abscess goes, she needs a good colorectal surgeon to drain the abscess in an operating room, and then clean out the abscess cavity, and then leave it open to heal from the inside out....otherwise, it will just come back. Also, the surgeon can look around to see if the abscess is connected to a fistula.

If the obstruction or narrowing is from inflammation then drugs should do the trick, but if it is from scar tissue then more then likely it will have to be removed. Obviously at her age, you want to preserve as much as the bowel as possible.

Pentasa and entocort did absolutely nothing for me. Remicade might be an option for her....
Posted 2/21/2008 8:01 PM (GMT 0)
Even if there is a stricture, and it is made of scar tissue, she might not need surgery. If effective meds keep her in remission, the stricture might not bother her. My own daughter has had a stricture made of scar tissue for at least two years, but is in full remission on Entocort, with no symptoms. 

The following link to CCFA talks about various types of surgery, and about draining abcesses. 

http://www.ccfa.org/info/surgery/surgerycd

Posted 2/21/2008 9:43 PM (GMT 0)
I am still thinking of your daughter. Has she tried the sitz baths and hot compresses for some relief for the anal abscesses? When I was her age and in college I found much relief from the sitz baths---after the incisions were made, I could even get the abscess to drain myself after a number of baths. I agree with the previous post about saving as much of the bowel but every case is difference. A second opinion before surgery might be the way to go. I remember several times when my own GI (with whom I've been for 23 years) suggested that I might want a second opinion.

For some of my colonoscopies, my GI has been able to get to the ileum but he was not able the last time. Things change quickly with Crohn's. I hope it is ok that I ask about her weight? Is she able to keep any weight on with the liquids? Able to use boost or ensure or powerade yet? Baby food or eggs?

I hope the prednisone works quickly for her.
Posted 2/21/2008 10:12 PM (GMT 0)
about the ccfa link concerning draining abscesses....it mentions having it drained by ct guidance as an option, but that is a bad option. I have had two of those done, and they don't work!
Posted 2/22/2008 2:18 AM (GMT 0)
She had a double anal abcess (one on top of the other) in Nov which the anal surgeon lanced and drained. Sitz bath to comfort her for short spells. She is 5'9" and 116lbs right now. She can keep liquids down and most mushy textures, it's when she attempts to eat solids that she vomits. She has been on entocort since sept but he has replaced that with prednisone. I agree with a second opinion if it comes to that since I felt as if he jumped to that.
Posted 2/22/2008 5:47 AM (GMT 0)
Is your daughter getting the prednisone orally? How many mg of pred?  

How long has she been on the Entocort? How long on the 6mp?

Posted 2/22/2008 6:30 AM (GMT 0)
I have never had an abcess. I have had surgery. But no crohns was found. It was exploritory to look at terminal illieum...they took appendix out while in there. I wanted to reply to you though to tell you I will keep you and your daughter in my prayers! I have 3 boy's ages 17, 15 and 9. I am so glad I am sick and not them. God Bless you! Tammi
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