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strictures and surgery

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Crohn's Disease
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Posted 10/6/2011 6:06 AM (GMT 0)
So my hubby's mri shows two narrowing strictures in his large intestines. For the most part, it doesn't bother him. He doesn't really feel the strictures or get bloated or anything. His GI is saying he should get surgery. Why should he get surgery if its not bothering him and is it urgent?
Posted 10/6/2011 6:52 AM (GMT 0)
wow that is a tough call. Personally I would wait as long as I could if the strictures are not obstructing and he is having no other issues before having my first surgery. Once you have that first surgery you run the risk of issues at the resection site etc.

I would be asking the GI exactly WHY he thinks urgent surgery is required as I can only assume he has a very good reason.
Posted 10/6/2011 3:35 PM (GMT 0)
THis is a tough issue. I am very prone to strictures myself and have had three resections so far, mostly because the disease at that site keeps getting so inflamed, it leads to GI bleeding. I understand the GI wanting to take care of this now before it could lead to an emergency surgery, however. A great surgeon at a prominent DC hospital told me this: Well, you could have me take care of this now, OR you could wait and get the surgeon on call when you go into an ER in the middle of the night sometime in the future. I've heard too many horror stories about botched surgeries when done by less experienced folks, so that made my decision easy.

All of this being said, though, the surgery won't "fix" his Crohn's. It will just prevent the strictures from being an issue later. Very tough decision. I'd get a second opinion if I were you. Good luck!
Posted 10/6/2011 3:49 PM (GMT 0)
As a veteran of 3 resections, and having been on the emergency end and the planned end of things, I agree with Juliet. A second opinion would definitely be a good idea, plus find out why the urgency from the 1st doctor.

I lived with a stricture for years, plus inflammation apparently :), and it wasn't until my fistula didn't heal after 18 months that I finally went in for a planned resection. My first one was an emergency one, and I lucked out with a very good surgeon. But you never know, so get as much knowledge as possible!

Sudsmom
Posted 10/7/2011 1:06 AM (GMT 0)
Thank you so much for your feedback. I apologize for my ignorance, but if my hubby CD did get better with his current meds (humira and 6mp) would his strictures get better too?
Posted 10/7/2011 2:00 AM (GMT 0)
Get a second opinion.

I didn't--accepted my GI recommendation to get it done laproscopically at the big city (Pittsburgh--ShadySide) hospital by a colerectal specialist.  It came apart and developed infection.  I had to have emergency surgery on Sunday five days later by my surgeon's backup.  It was such a mess I lost most of my colon and had to have a bag for six months.   (I was in the hospital for an additonal two and half weeks after the first surgery.)

I blame the surgeon.  She relocated a year later.

Posted 10/7/2011 2:52 AM (GMT 0)
In reply to the question of whether strictures can get better on medications... I am not a doctor, but I would think it would depend if the stricture is inflammatory in nature (caused by the Crohns itself) or physical (adhesions from previous surgery).

In my experience, once there is a stricture, it is hard to get rid of, but then I think most of my problem has been from adhesions (from prior surgery). It is a slippery slope - once you have surgery, if you are at all prone to adhesions, they just keep coming back, no matter how many times they are cleaned up.

So - short answer is: I don't know, and it depends :) haha

Sudsmom
Posted 10/8/2011 2:25 AM (GMT 0)
I would consider a 2nd opinion. Has the doctor said how narrow the strictures are?

I was diagnosed with a stricture in my small intestines 13 years before I had surgery. However, I've never had one in the large intestines, and my doctor didn't recommend surgery when I was first diagnosed.
Posted 10/8/2011 3:56 PM (GMT 0)
If a stricture is comprised of inflammation, then meds will help to shrink it. But if its from scar tissue, then generally no meds will help it. My strictures unfortunately were always scar tissue and I needed a resection both times.
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