Stricture question

My son who is 16 yo had a colonoscopy yesterday which showed a stricture (which meant he could not see past the cecum which is where his disease has been most active). The GI said he would probably need to start REmicade. He is currently on 6MP, his symptoms are mild (occasional D), inflammatory markers are normal, and the main concern is his weight (90lbs) and he has not grown much the last two years. He has also ordered a special kind of MRI to see his gut.

My questions are the following: 1) can a fissure heal if it is due to inflammation rather than scar tissue? 2)what meds can help it heal 3) are there dietary measures to help? 3) won't Remicade cause it to scar (according to lit)? 5) if it's inflamation can one "dis" inflame it and then start Remicade?

Any help/advise would be so appreciated....I am so scared about him trying Remicade but will do so if necessary to prevent further damage...I just don't want it to cause more permanent damage!!

My understanding:
1) A stricture with inflammation becomes narrower than what it was before the inflammation. Medicine will help the inflammation and may leave additional scar tissue, but should help it from the state it was in during inflammation.
2) My doc usually goes with a course of steriods when I am in an active flare, and then goes with another long-term maintenance med (I've been through pentasa, 6mp, biologics) that I would continue after the steriods hopefully knock out the immediate flaring issue.
3) Diet tends to be individual. There are various theories about anti-inflammatory foods. What I tend to do is switch to a bland, low residue diet to minimize bowel effort and that seems to help with the crohn's symptoms and side effects.
4) I'm not sure Remicade causes more scarring than any other drug that heals the inflammation?
5) Same answer as #2. In my case, I usually need a course of steriods to "knock it out", or disinflame it, and maintenance meds to keep it at bay.

Strictures are common in that area unfortunately. They start out as inflammation, and over time become scar tissue, as the body repeatedly heals over the area. As long as it is predominantly inflammatory, which will be determined by the MRI, it can fully heal. Remicade can be a really good drug to halt the inflammatory process, and then allow healing. It is usually combined with 6mp, which he is already taking. I've also read that it can cause rapid healing and lead to some scarring but according to my G.I it doesn't usually happen that way. Scarring will certainly occur if the illness is left to smoulder away over a long time. They can also give Prednisone but it is best used as a short term drug. The side effects can be unpleasant. Entocort is probably a better option if going that route. Liquid diets also have been shown to be effective in calming inflammation, but are a challenge to stick with.
You are right to question all this, and you should definitely discuss all your queries with the G.I., which should ease your concerns.

^That's what happened to me. I didn't really have issues with stricturing until I started Remicade and then the youknowwhat hit the fan and I needed surgery 18 months later.

I'm in the same boat AWMOM.  I am currently on Remicade and I have a stricure in the cecum as well.  During my colonoscopy my GI doc could not pass the scope beyond that point even with a pediatric scope.  He told me that it was probably due to the remicade.  Old inflammation "cured" by remicade in turn causing scar tissue.  It's a catch 22.  Hope your son is feeling good :)