Dilation for Anastomotic Inflammation?

My son saw his primary GI today for a regular checkup and this GI had completed a post operative colonoscopy in November (had his TI, 2 inches of small intestine removed in March). His GI was very pleased with the results (the Crohn's in his sigmoid had disappeared, what he could see in the small intestine looked clear) but there was (and is) anastomotic inflammation which has caused a narrowing of the anastomosis. In November he stated he would "just leave it" unless there were related symptoms. Today he said he had attended a national conference and decided that the latest consensus for anastomotic inflammation (even with NO SYMPTOMS) was dilation. I asked him what would happen if my son chose not to do it. He said it COULD develop into a stricture and causes an obstruction. Dilation sounds so much better than surgery but is this necessary? Has anyone had this done? How long does it last? How often does anastomotic non specific inflammation grow into a stricture and can it go away on its own? My son's GI said he normally would just leave it - except from he learned at this conference. I asked him if this met annual colonoscopies (to see if it ever narrows again) and he said my son will have fairly regular ones. I completely trust and respect my GI doctor but even he seems to feel this is a somewhat new approach. My son feels AWESOME and has gained weight, normal stools etc. Any insights are appreciated!

The GI said it is inflamed due to surgery and that it is quite common. I pushed this question as well and asked what is meant by non specific inflammation and he said that GI inflammation happens often and gave several examples (such as inflammation with gastric bypass surgery). I asked why that inflammation cannot be treated and he said it is not treatable with medications but often it does not get worse? I have no idea if that is scar tissue? I did not ask about passing stool but I will and I will be armed with more questions when we see him in three months. My son's surgery was active disease / scar tissue (he waited two years before telling his dad and I he was sick) so I understand how that works. I do think dilation is pretty straightforward and ANYTHING is better than surgery! Thanks for your insights - it has given me more to consider!

Good to hear and how gratifying it has lasted at least 16 years! It seems I am always learning new things about this disease and having such "seasoned" people on this site is invaluable! THANKS!!

I had two dilations of a scar tissue stricture this summer and it has held up so far. As long as there is no active disease at the site its a good option to avoid surgery. Id be a bit confused about the inflammation but I guess if its not crohns inflammation its okay? risks i was told about were perforation and infection but compared to surgery its much better/lower. I had a bit of pain afterwards but nothing major and supposedly most people have no pain.

Hello...I'm a 46 yr old female that has had 2 complete bowel obstructions. '89 - 2ft removed - '00 - 1ft removed. In 2012, I began taking Humira after a flair up. Now after a stressful change at work have been dealing with daily dry heaving. Had a endo/colonoscopy recently. Endo was clear but colonoscopy showed near blockage from previous scarring. Another colonoscopy is needed urgently - to dilate the restriction. What can I expect ? What are the odds of perforation?

From what I had been told, it is one of those "it depends" answers. In my case the GI I had at that time said absolutely no dialation for me. The reason was the site was so narrow he could not get the child's size scope through so there was no way to get the slightly larger ballon scope through. My new GI did not want to discuss it as he still thinks it's inflammation not scar tissue so wants to cont I to find a med that will reduce it and keep it low.

I don't know. I hope I have some answers soon. And, my Entyvio infusion got cancelled for tomorrow. They had to refile,the insurance and so far it has not been approved. So it will be another week. Ugh.

I had my 1st dilation yesterday. GI took the stricture from 5mm to 10mm. He hoped he could get it atleast to 12mm but it was "too brittle" to attempt further dilation yesterday. So, I need to repeat the procedure on 4/18. Says the small time in between will help heal the "stretching" from yesterday without allowing too much time for it to harden too much. Needless to say, I'm not completely excited to repeat
the prep now 3x in less than 2 months. It appears to be the current way to prevent a surgical intervention. GI led me to believe this could be a continued procedure throughout my medical journey. The time between each dialation would vary based on how my body heals.