A stricture and surgery in my future

Hi All

So a little update. September of last year developed a fistula, ultimately formed an abscess that I had surgically drain twice and a seton put in. I started Remicade in January of this year and was back to work February 1st.

I visited my GI yesterday - 2 weeks after my 3rd infusion and I get bombed on! After being told that my small bowel looked good, I now have a stricture that has to be removed! He told me it's not an emergency, but recommends I have it removed while I am healthy. The remicade is doing wonders for my colon and he wants it to be a little more healthy before the surgery. September will probably be the date.

So tell me - is this surgery usually done laproscopically? Should I be watching what I eat more closely? How long was your recovery time after surgery (those of you who have had the surgery)? What all is involved in this?

Thanks!

Hi there! Thanks for your reply. My GI said the stricture is in my small bowel, close to where it connects to the colon.

I used to have problems with certain foods, but since starting Remicade I have fewer problems than before. I usually have to avoid tomato based sauces, green leafy foods and caffeine – but other than that I am pretty good. I just don’t want to be eating foods that could cause a blockage. I have heard to avoid foods with nuts and grains, also to avoid foods with small seeds. I’m really going to miss my fruit if I have to start avoiding it. I usually peel my fruit (fruit that can be peeled of course) as the peel on apples, pears, peaches etc often upset me.

The surgery was just mentioned to me during my last visit – my GI suggested I have it done before it becomes a major problem. I have yet to see the colorectal surgeon – I will have that appointment sometime in June. I’m sure I will learn more about the surgery then.
I was just hoping I could get some insight from those who have already had the procedure.

I’ve also read that some individuals have a problem with diarrhea after a small bowel resection – is this common?

Again, thank you for your reply.

I have heard that the section I am having removed is quite common. Apparently, Crohn’s likes to hide out in this area.

The reason I am choosing to have the stricture removed is because I do plan on having children in the next year or so. On the advice of my GI he recommended I have the surgery before I get pregnant. He stated that it would be horrible for me to become obstructed and lose the baby. So, surgery it will be. I am also confident that if I have the surgery while I am relatively healthy my recovery will be easier and will probably be much faster. I am fortunate that I do not have any inflammation or active Crohn’s in the small bowel at this time. Hopefully, the Remicade can keep all of that at bay. My doctor has upped my Remicade actually – I am now on 400mg and on a 6 week schedule instead of an 8 week. I think this is this is to insure that the Crohn’s stays in remission. I was also very fortunate that the Remicade put me into remission quite quickly. A week after my first infusion I was eating Chinese without a problem – something like that would have killed me in the past.

It won’t be the same blending the fruit, but I suppose to save myself pain and agony in the future it will all be worth it.

Short bowel syndrome - I have heard of this but do not know exactly what it is. Could you explain?

Any other information others have about this procedure would be great!

I agree with being proactive on this. I waited a good year after being told I needed the surgery. It was a year of daily pain & having to watch my diet more than normal.

This was my second resection, first for stricture surgery. It was done in January and started as laproscopic, but ended up open surgery due to scar tissue. I was in hosp. 5 days including the day of surgery. Of course when I came out of surgery, I had the NG tube, cath and 2 IV's. But by day 2 I was up & moving around with minimal pain ( I had a nerve block done). Recovery was slower than I anticipated but I'm 49 yrs old so that could have played a part. It took a few weeks to work back into normal food, but I'm ok now.

Prior to surgery you may have to limit fiber & red meats, these seemed to trigger problems with me. I think it depends on how tight the stricture is -- mine was "the tightest" the surgeon had even seen.

I have had D issues post surg, but controlled with Imodium. The pain is gone -- yippee! And I can eat fresh fruit & veg without pain -- my CD isn't acting up right now.

Good luck!

I agree with Lamb, red meat is something you should avoid. It is very hard to digest, even for a healthy intestinal tract. I would try to stick with a low residue type diet. Its easy to chew, and easy to digest. You can google the diet to get some ideas. Good luck~

Hi far!

Congrats for your plans to have a baby. I agree its a good reason to have a surgery beforehand. Making a baby can turn the marriage in a second honeymoon :).

If I were you I would try to be in a cautious diet. Maybe a new flare would postpone your surgery (and your baby). Remi is very good but it's transpassable by the CD if we mess with our gut.