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Scar tissue, narrowing of the bowel, and periodic cramps

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Crohn's Disease
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Posted 3/26/2010 1:42 AM (GMT 0)
Is it possible to have a narrowing of the bowel due to scar tissue that causes cramping only on rare occasions? Such as once every month or two? Let me give some background.

My CD by all accounts is in remission. According to the bloodwork I have done every six months, I am in excellent health, with nothing indicating health concerns of any type. I usually even have negative CRP numbers. However, about once every two months or so, I have horrific abdominal cramping. It's the exact same type of cramping that initially led me to a GI doc and CD diagnosis. The cramping, we learned, was triggered by a small bowel obstruction (CT Scan and small bowel follow through revealed this).

My GI doc said that the periodic cramping is most likely caused by scar tissue that formed during the healing process, but he is at a loss to explain why it would only happen on rare occasions.

Am I wrong to assume that scar tissue induced narrowing should cause cramping pain almost all the time? If it is scar tissue that causes these periodic episodes, how can it be that it doesn't happen on a constant basis? If my Doc is right, then what could explain the fact that these cramps occur seemingly at random and only on rare occasions? It doesn't seem to matter what foods have been consumed either, whether high fiber or low fiber. Do we just chalk this up as a mystery?

Believe me when I say, I'm not complaining at all about my current state. Compared to what used to be, I consider myself blessed in the extreme. I'm just confused and hoping for some sort of explanation from the wonderful, knowledgable people on this forum.

Posted 3/26/2010 1:57 PM (GMT 0)
I have had two resections myself, and once in awhile I get those kind of attacks, just not as often as you. I wonder if you are getting a adhesion twisting your bowel or something??? Just a thought. Hugs!
Posted 3/26/2010 3:29 PM (GMT 0)
Thank you for the reply, Nanners. I should point out that I've not had a surgery to date and my last SBFT (one year ago) revealed no obstructions of any sort. Bloodwork done since then shows no indication of disease or inflammation. I guess it's one of those inexplicable medical mysteries!

Posted 3/26/2010 3:39 PM (GMT 0)
Is it possible it's because of what you are eating at the time? I just had surgery to remove a very tight stricture in January. The symptoms were always worse if I ate something with fiber.
Posted 3/26/2010 4:56 PM (GMT 0)
Could the scar tissue be causing minor obstructions, by chance? I really don't know, I'm sorry that keeps happening to you. :(
Posted 3/28/2010 11:06 PM (GMT 0)
Before my surgery i would get cramps every now and then (2 maybe 3 times per month) just prior to a BM and once I relieved myself the cramps were gone. I then had a SMFT done and found out that I had severe narrowing due to scar tissue and that surgery was the only answer.
My opinion is that things get backed up a little and then try to go thru the narrowing thus the pain or cramps.
This is just my opinion.
Good luck to you!
Posted 3/29/2010 12:07 AM (GMT 0)
Well Before I had my resection surgery I got the Vomiting, cramps once a month...It was like clockwork...Like I was getting my period, I would get the cramps and vomiting for HOURS! But then it would go away..When i had a G.I series done the surgeon was amazed at how I wasn't in pain constantly....Because the narrowing was so bad....So I suppose it CAN happen...everyones body is very different.
Posted 3/29/2010 2:05 PM (GMT 0)

Thanks to all who responded. I appreciate the information. There doesn't seem to be much rhyme or reason to what foods I eat and what causes these cramps. However, the last attack I had came after consuming a Larabar (all natural, very tough candy bar of nuts and dates). Quite likely that was having difficulty making it through a narrow passageway, although I'd been eating them on a daily basis for weeks.

For now I'm going to stick with a low residue diet and see how that works. One of my dilemmas is that I've been on SCD since July with great results, especially with regard to weight gain. I'm also doing Remicade every 8 weeks. It's difficult to know which treatment is working and to what degree, but I can't deny that the SCD is the only thing that has allowed me to put on any real weight. If my disease is inactive at this point, then there doesn't seem to be much reason to go SCD 100%, although I still intend to stay with it about 99% of the time.

Posted 3/29/2010 8:54 PM (GMT 0)
Hy Han!

I have the same simptoms. My GI just explained to me that sometimes food passes slowly in narrowed or cirurgically manipulated areas. The others parts of the small bowell puts more pression to push the food on. There is a lack of sincronism. It gives us cramps.

It looks like an obstruction in the CT scan. You can't pass gas and it hurts a lot. Some bacteria gathers in the narrowed area.

Then it passes and you have some D to spill the bacteria out!

Nasty...
Posted 3/30/2011 6:41 PM (GMT 0)

Hi Everybody,  this is my first post.

In reply to the past several posts :   I have this problem but it is not often. I had a gastric bypass 20 yrs ago and at that time a stomach cancer was found but removed.  Shortly thereafter, the surgeon removed approximately 90% of my stomach (as a precaution). 

I have incidents of waves of cramps as some of you have described:  I almost feel like I am in labor - the cramp comes and then after 5 - 20 seconds, it lets up.  Then it comes again.  This goes on for HOURS (4-6) and I can't seem to do anything or take any medication to relieve it. 

I have had a SBFT in which a "narrowing" was noticed (in the same area that hurts).  However, when I tell my Gastro that, he just says:  You don't have a blockage.  NO, but I think I have a narrowing and that certain foods bring it on.  I've noticed that if I overeat - and that rice is difficult for me - these are when I seem to have this happen.  It does not happen often - used to be every few months.  Now I am using "preventative" measures (don't overeat mainly) and these episodes have been reduced to a couple of times a year.  I know I shouldn't complain about the infrequency but I feel that one day the scar tissue will be more of a problem and at this point, my Gastro doesn't feel like I have a real problem.

Does any of this sound familiar to you?

Thanks,   Judy in Mississippi where it is currently 44 degrees!!!!

Posted 3/30/2011 7:08 PM (GMT 0)
Judy its sounds like you are having obstructions, at least a partial one. When you describe the pain like labor pains that comes in waves, thats what I have had when I have had an obstruction.

Do you find also that you can't move air out of either direction, no bowel movements and maybe even have some nausea with it? If so, next time that happens take yourself to the ER. Obstructions can be dangerous and you could perforate. Oh and welcome to Healingwell!

Hugs!
Posted 3/31/2011 1:58 AM (GMT 0)
Thank you Gail for your response. One thing I forgot to add was that because I have had a Gastric Bypass, my food bypasses my small intestine so in my mind, I wonder if my food is "less digested" by time it reaches a narrowing in my large intestine.
I will be sure to stay on top of this.......these painful cramping episodes sure aren't easy to endure!
Judy
Posted 3/31/2011 3:20 AM (GMT 0)
I haven't read the other responses but -- yes, yes, yes that does happen. I've been in clinical remission (no inflammation even on biopsy) for several years. I still have bouts of cramping, pain, vomiting ... I have severe strictures and they can cause issues all on their own. Staying on maintenance meds helps, but it can hit me seemingly out of the blue. Having bloodwork and other tests done right at the time show that it's not the disease, but just the scar tissue. I can't find a specific culprit, but there are some foods that may be to blame for some of it. I've been able to handle it easily thus far, but my GI is encouraging elective resection if things escalate.
Posted 4/1/2011 2:35 AM (GMT 0)
Judy, to me, you're textbook partial obstruction. It's probably scar tissue from your last surgery.... at least that's what it was for me. I had a great surgeon take care of mine, although sometimes they comes back. the surgery is laproscopic, if you find the right guy. If eating carefully does the trick, just eat carefully. I get to the point where my movement is compromised, and life sucks worse than surgery, I go in to get cleaned out. Interestingly, my GI can feel when I get adhesions. Do you have a doc you really like? he sounds sort of annoying.
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