Severe Abdominal Pain

My old colonoscopy shows CD in recto sigmoid and my recent CT Enterography shows swollen stricture in mid ileal loop. I am having tremendous and continuous abdominal pain below navel. Gastroenterologist put me on Prednisolone 30mg tapering in about 2 months.

Does Prednisolone reduce abdominal pain, stomach cramp? After how much time does it start showing results?

What kind of diet helps in avoiding abdominal pain?

The Prednisone will help with the cramping if the stricture is from inflammation, but if it is from scar tissue, then no medication will help and you might end out needing re-section surgery or a strictureplasty for that stricture. I had a partial bowel obstruction several years ago, and the prednisone helped that time, but last year I had IV steroids and there was too much scar tissue and I needed surgery. Usually for a partial bowel obstruction, they will start you higher than 30 mg. If the pain is intense and coming in waves, and you can't pass stool, or are vomiting with the pain then head back to the emergency department, as you might be obstructing.

Stay with liquids and very low residue foods until the pain gets better. You can google low residue diet to get some ideas. Sorry you are going through this...it is miserable!!!

Hi cdinhyd,

I am so sorry for what you are going through. To answer your questions, after I recovered completely from the resection surgery, which honestly took several months, I went into remission and had no pain. I have had lifelong irritable bowel and have continued to struggle with that. Currently, I think I have an infection so I'm struggling with diarrhea, but still no pain like before surgery. I am considered low risk because the Crohn's was only in my ileum and it was completely removed with surgery, I am a non-smoker, and I was diagnosed late in life. (age 47) For those reasons the docs have me on no maintenance medications, but close monitoring. If/when the Crohn's returns, then they will figure out what medication to give me at that time.

Indian food is my favorite ethnic food! My son had one college roommate from Mumbai and another with relatives in Kerala. He was lucky enough to spend 6 weeks traveling all over India after graduation. He ended out coming home and taking Indian food cooking classes, and then taught me how to make several dishes. The turmeric is supposed to have anti-inflammatory properties, so in general it is good for you. But when you have a stricture, you have to be really careful with vegetables. While lentil dal is one of my favorites, lentils can be really hard to digest. Many of the Indian dishes (as you probably know more than me) cook the vegetables for a long time and may be easier for you to digest. The basmati rice is probably safer for you than the wheat products, especially if you have a gluten intolerance at all. You will need to experiment with what works. While you are feeling terrible though, you might have to stay with pureed and well cooked vegetables. When I was really sick prior to surgery, I was only having soups with pureed vegetables and things like mashed potatoes, white rice, smoothies, etc.

Is your Crohn's disease located anywhere besides your ileum and how long is the stricture? It might be worth it for you to consider surgery if the Prednisone does not start to help. What part of India are you from? (just curious)

gumby44:

It is nice to know that your CD is almost removed with surgery as it is located in only in ileum. Hopefully, your other symptoms will be under control.

It is surprising to know that your son and you have experience with India and Indian food. We use turmeric in all preparations. We fry most vegetables and boil less. I am trying now only boiled vegetables, well boiled dal and rice, and some pickle. Daily basmati rice is not recommended.

My Crohns is located in recto sigmoid region (as per 3 year old colonoscopy) and the stricture in mid ileal loop 2.8cm length (as per recent enterography).

I stay in Hyderabad. The doctor is following your experience - to see if Prednisolone will reduce swelling stricture. If it does not, and if it is from scar tissue, may opt for alternatives.