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Crohn's Disease
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Posted 2/16/2017 10:57 PM (GMT 0)
So I just had a follow up with my new GI since my visit to the ER last week for the supposed stricture.

He still doesn't think it's due to inflammation since my scope in December showed endoscopic remission. So here is the plan. After I finish the xifaxin I'm going to start "pushing" my diet beyond just low residue. If there are issues he wants me to try budeside(?) and see if it helps. If not then I have the choice of trying a capsule endoscopy. Then depending on how that would turn out we proceed from there.

There is a good chance that what I've been experiencing randomly is being caused by scar tissue outside of the bowel. Bottom line if I go through all this and no crohns issues show up and if I keep having these bouts of pain, nausea and vomiting then I'll need to talk to my colorectal surgeon about the possibility of removing any scar tissue/adhesions in the area that is painful.

I'm exhausted just thinking about all we discussed.
Posted 2/16/2017 11:44 PM (GMT 0)
I think an MRI or small bowel follow through test is better for visualizing strictures than the pill cam. If the scar tissue is outside the bowel, you won't see it at all with the pill cam....I don't understand what your doc is thinking?? If you do the pill cam, make sure you take the trial capsule that disintegrates first so it doesn't get stuck. The budesenide would be a good idea if there is any inflammation, but if it is scar tissue it won't help. Go very cautiously with advancing your diet. Chinese food caused one of my bowel obstructions....too much fiber isn't a great way to experiment with a stricture.
Posted 2/17/2017 5:46 AM (GMT 0)
I agree with gumby. If you may have a stricture or narrowing (whether new inflammation or scar tissue), a capsule endoscopy is not a great idea. An MR enterography is a much better idea. It should show any narrowing, if there is any, plus anything going on outside the inner lining of the intestines - things such as scar tissue or adhesions outside the bowel.

Capsule endoscopy is used more for diagnosis when other tests (colonoscopies and MRIs or CT scans) are inconclusive. Once a diagnosis is established, it isn't used that often. And then, it's only more appropriate to use it when scopes are clean but you have ongoing symptoms *other than* things that could indicate narrowing.
Posted 2/17/2017 1:06 PM (GMT 0)
Thanks guys, I thought about that last night after I had a chance to think things through. I will ask for the MRI instead of the pill cam based on the fact he thinks it might be scar tissue outside the bowel.
I left there feeling good because he took so much time and talked things through but then after I had a chance to think about it I'm not so sure. Next time I take a list.
Posted 2/17/2017 7:14 PM (GMT 0)
Lamb61,

Before I pushed my diet...personally....I would have the MRI and get all my information. I wouldn't play with a stricture...they come out of no where and kick your hinney. ..

MRI, dissolvable pill cam, pill cam if still needed and then think about if you should change your diet....after confirming with your colorectal surgeon. Keep your colorectal surgeon in the loop all the way. Do your doctors work together?

Clo
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