Stricture

Hi guys,

I've posted not too long ago about my stricture. I was doing well for a few weeks after doing a booster round of humira and entocort. Now I'm not getting the wave like pain as intensely or as frequent as I was back in December, however I am still not great. Bloating and pain in my abdomen, and constipation followed by some stool after a few days is what I'm dealing with. It hurts my abdomen to try to go to the bathroom if I contract my muscles at all. 😬 I believe a few weeks ago I had a partial obstruction as I was vomiting frequently and forcefully for hours with severe pain. It thankfully subsided and haven't had anything as bad since however I am still rather uncomfoetable. Was wondering what others have had experienced and what helped, as well as if you think it's okay to take a laxative as I have really been struggling to keep myself regular at all.

Thanks!

Okay thanks, I will try the liquid diet. Unfortunately I can't dilate it as it's too narrow and my GI was worried about perforation. I believe it's mostly scar tissue. Ya my next appointment with my GI isn't until June so maybe I'll have to talk about moving it up. Thanks again!

If your stricture is due to scar tissue, no medicine is going to fix it completely. I had that about six years ago. The surgery took care of it. My Surgeon said he removed enough scar tissue to form a basketball and only about 10" of bowel. Got back to eating and feeling much better.
Good luck.

Yes, in that case you should go back. I had the same issue where initially the steroids I was on made things seem better after having a partial obstruction. By the time I got off of them I started to feel it again but less intensely. That's when they scoped it and found the stricture, so you can definitely have it get a better and then worse again. It's worth it to at least discuss it and know what you are dealing with at this point even if you decide against doing something right away about it. I'd worry about potentially having a full obstruction and other complications that would require emergency surgery and that has a lot more of risks than a planned intervention.

Gutsy, I have had a complete blockage, I can tell you from my experience without a doubt you will head to the closest ER. Yes, I ended up having an emergency resection within minutes of them taking out my appendix. Long story on my experience, they thought it was appendicitis lol. I am very lucky I did not perforate. But, without a doubt that type of pain & the vomiting there is a big difference than a partial. I have had partials before & they are no fun even when hospitalized. The problem I have ran into even with partials is dehydration issues which can be serious. The best rule of thumb is any time you think you are obstructing with the pain & vomiting go to an ER. A quick scan can see what is going on. I would also see if I can get in quicker with the gi.

I have always gone into the ER whenever I have had issues with extreme pain and nausea, even if I hadn't thrown up yet. I rather get there, get some IV steroids in my system to get the stricture opened, and get the pain calmed down. The last two times, I had to be admitted due to the fact that oral prednisone didn't work well due to the amount of inflammation.

My doc has always sent me to the ER at that point, so I know it is something that we shouldn't toy with or wait to resolve. Most times, it has just gotten worse. I have pushed through some things which have caused worse issues on the other end.

Sadly, I have just budgeted for the fact that I will hit my out of pocket maximum every year... just something I expect due to this disease.

Fluids are your friend. The cramps from stricturing are like nothing else....I certainly have no go foods. Steak, popcorn, corn. Even large quantites are no go. If I'm starting to feel those waves of pain...I skip food go to water and ensure and trusty pain meds. If in a couple hours I'm not feeling any relief off to hospital. NPO with a nasogastric tube is the definition of six level of dantes inferno. Hoping for a dilation or removal of said structure..even with inflammation under control strictures suck!!

For me personally, each of the following three conditions must be met, before I call it a partial obstruction: (1) Waive like Pain: that means the pain is very severe, then pain subsides, then severe again, working in cycles: (2) Must last many hours, something like 5-8 hours; (3) nausea with or without vomiting.

It happened for the 1st time in August of 2010. The 2nd time was 10 months later. The 3rd time was another 10 months later. Then the pattern got lost afterwards. My last partial obstruction was 2 years ago.

Who am I? Well, a 2000 Upper GI with Small Bowel Follow Through found approximately 30 cm loop of mid small bowel with moderately severe changes of Crohn's Disease. The bowel lumen is narrowed and loops are separated. A 2012 CT Enterography Abdomen and Pelvis with enteric contrast shows 30-40 cm segment of abnormal small bowel with six strictures located 20-30 cm proximal to the terminal ileum. The GI said most of it is scar tissue.

I know everyone is different. But that's my experience.