Elective Resection and Strictureplasty

I was recently hospitalized with a small bowel perforation.  I have actually been kicking and screaming for surgery for almost a year because I feel that my strictures have grown unmanageable and they haven't responded to steroids -- they suddenly just stopped responding.  My own personal hypothesis is that my stricutres are caused mostly by scar tissue, but I am awaiting an MRI to confirm this hypothesis (I am literally in the waiting room right now as I write this.)

I just saw my surgeon and he seems very reluctant to commit to surgery.  He wants to analyze the results of my MRI and says that surgery may not be needed at all.  Part of his reluctance comes from the fact that Crohn's can recur, even after a resection.  He is a great doctor, but is being far too conservative in my opinion, and I am frustrated with the doctor's reluctance to commit to a specific plan of action.  Meanwhile I am stuck on an all liquids (SCD-compliant no less) diet until they decide what to do, which could be 4 or 5 more weeks.

Has anyone been in a situation like this?  I have never had surgery before and am by no means looking forward to it, but I also know my own body and know that it is most likely needed.  What does one need to do to convince the docs?  Should I just keep shopping around until I find a good doc who is willing to do the surgery?

I'd get another opinion from a colon-rectal surgeon. How did you escape surgery with a small bowel perforation? I thought emergency surgery was needed in that situation. I didn't know an MRI could confirm scar tissue. Wouldn't you need TPN if you had to be on liquids for 5 weeks? Are there insurance issues? Good luck and keep us posted.

The liquid SCD diet is a major pain, much like the regular liquid diet. I make almond and coconut milk by blending almonds or coconut in spring water and then passing it through a cheese cloth or coffee filter to remove the residue. You can then use the milk as a base for making smoothies. You can also use the SCD yogurt for smoothies as well and add a bit of SCD peanut butter for extra protein. I use fresh blueberries and banana and just liquify the whole thing -- it really isn't too difficult.

I escaped surgery because the perforation healed itself, but there is a small abscess there now. My surgeon is being so incredibly stupid about not wanting to do the surgery, but the area right before my stricture in the small bowel is distended to a width of 7cm and the stricture itself is just 5mm wide. I just emailed my GI doc to ask if there is another surgeon who can do it, but the surgeon I have now is supposed to be very good with small bowel Crohn's. I am so pissed at the surgeon and if something happens while I am waiting for him to make up his mind I am going to be absolutely furious.

The name of my colo-rectal surgeon is below. I had my stricture removed last month. I lived with that thing for some 8 or so years, and enough was enough. I dunno if you are willing to come to memphis, tn, but if so...

I didn't have to beg, or whine, I just told him how much it was bothering me, and he told me all the risks of surgery. I was in the hospital 5 days.

Doctor Alexander Matthew
Suite 120
1910 Nonconnah Boulevard, Memphis, TN 38132
(901) 448-2300

Wolfie -- what maintenance meds did you use after surgery? Asacol? I already had the SBFT before the MRI and the worst stricture was 5mm in diameter.

Homeboy -- thank you for the recommendation. Did your doctor do a laporoscopy or laparotomy (full open surgery)?

Rider -- I hope you are right about that. I also hope that I am a good candidate for strictureplasty, otherwise I could lose 2 or 3 ft of small bowel.