Strictures in the Small Intestine

I know this can be very frustrating, especially from the Parents perspective. As for the stricture or possible stricture, since Crohn's can appear anywhere from mouth to anus, inflammation and strictures can appear outside of the typical areas, which for most is the terminal illium.

Inflammatory markers can often be a unreliable indicator of what's going on. Many will tell you this. They're a guideline at best. An MRE should give you a much clearer idea of what's happening.

It sounds like your Son has been doing pretty well except for this recent bout. This could be fairly minor, and easily treated. If the results show inflammation, then they may opt for a short course of Prednisone. Hopefully, they don't need to transition to another anti-TNF, but at worst this might be an option as well.

Try to stay positive. My Daughter has always struggled with iron levels. Even in remission hers remain fairly low. Her GI doesn't have Crohn's, but her iron is lower than my Daughters. Keep us posted. Hope things improve soon.

Try not to stress until you have results from the tests. (Easier said than done) As mentioned by the others, having low iron (or any other vitamins, etc) is common -- especially if the small intestine near the terminal ilium is involved (or been removed). This is where the body absorbs most of the nutrients it needs to function.

It's not your responsibility as to what your son puts in his mouth. However, you can encourage him to continue taking supplements and eating healthy. (This can be difficult for anyone. And with the holidays....)

I would suggest a good multivitamin and addition B-complex.

Also, as others mentioned, inflammation markers are a guideline, not a certainty. I've had "bad" labs with no Crohn's symptoms and "good" labs with abdominal pain. My doctor freaked out one time when my CRP was elevated -- until he heard I was getting over the flu. Anytime there's inflammation, CRP is elevated. Doesn't matter where in the body.

On another note -- As a caregiver, make sure you are taking care of yourself. Find ways to destress. This disease is a marathon, not a sprint. *hugs*

Hi Betty Sue,
I recently had a scope and they found that my previously moderate CD was now completely resolved, except a small 4cm patch. But I apparently have a rectal stricture, which they dilated. These things happen unfortunately, we have inflammation then we have healing then inflammation etc and the body is just trying to heal itself. Next stop surgery for me if it doesn’t recede but I think it’s a fairly minor surgery.

How common is a small intestine stricture outside of the terminal ileum? I have six strictures in ileum, but not in terminal ileum.

Is it possible to have a stricture and perfect blood work (inflammatory markers good?). I have always had low inflammatory markers from blood test, but have had strictures for many years.

Some 19 years ago, my blood test showed I was anemia. So I took iron tablets, which made my Chron's Disease much worse. So instead I received iron injections over a period of several weeks, which brought my RBC and HGB to about normal level.

Since then I have eating red meat rich in iron for most of the days (if not every day) to keep my iron level up. But my RBC and HGB keep slowly dropping year after year, probably due to poor absorption. A few months ago, my blood work show my RBC at 4.02 (normal > 4.5) and HGB at 12.4 (normal > 13.5). Maybe I am due for another round of iron injection after 19 years.

If your son iron level decreased quickly over a short period of time, I would want to make sure there is no bleeding. If the iron level dropped very slowly over a long period of time, then it could be just poor absorption and maybe his diet. Hope it is the latter.

Awesome news BETTY SUE. Iron tablets can cause issues for people that do not have crohns/UC. I would stay with the infusions. There is no reason for another pillcam, the MRI is sufficient for ruling it out.

Take care.