I would like some opinions about
my options to treat my increasingly troublesome stricture from long-term chronic Crohn's.
As shown in my signiture, I was diagnosed with Crohn's over 35 years ago and have had 2 resections since but none in over 20 years. After my second resection (jejunum), I have suffered from relatively mild but chronic Crohn's that has caused over the years a fibrotic stricture at the site of the 2nd anastomosis. While it has caused occasional partial blockages, I have been able to live a relatively normal life, being able to eat most foods (at least in moderation for certain ones) if I am careful to keep up with my regime of sulfasalazine, a relatively benign and old fashioned drug. The disease has rarely been acute, with few incidents on flaring other than the occasional physical blocking of the stricture due to lack of vigilence on my part.
The problem is that sulfasalazine doesn't seem to be able to stop the fibrotic scarring and the incidents of partial blockages are becoming much more common- maybe twice a month. A recent CT enterography shows a 7mm thickening of the intestinal wall. Not only is my tolerance for certain foods significantly reduced but I find that when I have consistent but moderate pressure on my abdomen, such as a pair of elastic shorts under a warm-up with an elastic waist band or a pack hipbelt, I have a back up in my intestines and the symptoms of a partial blockage, often for 6-10 hours of moderate to severe pain. I find myself sitting at my desk with my pants undone and holding my underwear elastic away from my stomach to decrease discomfort. Not the best for office decorum. I started a new job last year and after a trip to the firm cafeteria for lunch the first day and too many vegetables, I had to miss my second day due to a blockage; not a good way to start a job.
Medical options have changed significantly since I had my last resection (though evidently there still is no drug to be use prophylactically with minimal side effects to prevent scarring from chronic mild Crohn's). My GI's have been reluctant to recommend surgery as the stricture is not changing much, I am mostly on a regular diet, no fistulas or abscesses, and the disease is not acute but I not longer feel confident that I can always make an appointment or do certain things as I fear I will have a partial blockage. Reading recent medical articles, strictureplasty and laprascopic procedures seem to be less drastic procedures with less long-term downsides than a resection that may address my issues and let me live a more normal (and less painfull) life.
What so people think of these options?