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Posted 7/6/2014 11:06 PM (GMT 0)
Can spasming of the intestine cause strictures? Would they be temporary?

A few weeks back I started developing spasms following surgery. They eventually didn't go away and got worse. I then started having numerous partial obstructions that also progressively got worse. Eventually wound up back in the ER. Imaging showed proximal dilation with a lead point (a narrowing) followed by normal bowel afterwards, due to a partial obstruction, leading to a parylitic ileus since I kept trying to eat!

My doc and I talked about it and believe it is most likely mechanical and due to scar tissue (it always starts with intense spasming, pain, and sounds indicating mechanical causes, ie the loud rushing gurgling, tinkling, etc, followed by extremely thin watery gushing output) I am scheduled for a exploratory laparotomy with lysis of adhesions.

My question is, how likely is it that this could be a temporary stricture caused by a spasm, or more likely mechanical from scar tissue. Can spasms even cause that kind of narrowing or temporary stricturing, especially since mine got worse and has progressed over 3 months. I just don't want him to go in there and find no scar tissue and have had surgery for no reason!!!

Just a bit nervous!

Post Edited (boatnerj) : 7/6/2014 5:22:50 PM (GMT-6)

Posted 7/6/2014 11:52 PM (GMT 0)
Well, I can't absolutely say there is no such thing as a temporary stricture caused by intestinal spasms, but I've never heard of such a thing: strictures cause the spasms, and not vice versa. Intestinal narrowing can be caused by two things: 1) scar tissue; 2) inflammation. In your case, unless you have Crohn's of the small bowel, I strongly suspect your stricture is caused by adhesions.

I had a stricture in the terminal ileum for a couple of years before having surgery and what you describe sounds very similar to what I went through: the endless gurgling noises; the rhythmic spasms, etc. I could also feel an unrelenting pressure at the site of the obstruction, which was painless but a horrible sensation: loud and prolonged gurgles would indicate that the partial obstruction was clearing itself. Amazing how many hours it always took, though.

In my case, my stricture was predominantly inflammatory because it would temporarily improve whenever I began yet another course of steroids. Steroids won't do anything for a mechanical stricture.

I doubt you will end up having surgery for no reason. Think the surgeon will find scar tissue there, if that's of any solace at all.
Posted 7/7/2014 1:14 AM (GMT 0)
Thanks. Nope, no ibd luckily. So far eating a ton of sugar and extremely ripe bananas blended in protein shakes has helped keep the pain relatively minor and prevent any big obstructions. Just gotta grind the days away until surgery.

My stricture is about midway through my ileum bases on the imaging.
Posted 7/7/2014 1:59 AM (GMT 0)
Yeah, I stuck to a low residue diet. Pretty boring, but fairly effective for dealing with strictures.

Hope the surgery sorts the problem. What day is it?
Posted 7/9/2014 12:42 AM (GMT 0)
tommorrow at 1 pm, send some positive vibes my way!
Posted 7/9/2014 12:43 AM (GMT 0)
crossing my fingers for a shorter 3-4 day hospital stay but we shall see ;)
Posted 7/10/2014 3:29 PM (GMT 0)
Just updating. Surgery went great. I actually had NO scar tissue or adhesions at all. I did have a very bad vovlvulus involving mesentery, my small bowel, etc. my doctor said that it looked like my intestines had entangled and flipped over along with some surrounding mesentery gradually over the years leading to progressively worse obstructive symptoms. It's more common in ileostomates (and thin people like myself) since we have no colons and more free space in the abdominal cavity. He untangled everything and tacked/attached my intestines to the abdominal wall and other structures for support and prevent it from doing that again. Another important thing is for me to put son some weight ;)

I am already feelin pretty great, sans a little abdominal bloat and discomfort but I am progressing food wise very quickly and not feeling bad at all. I had been having such discomfort over the years I had forgotten what normal felt like! Just feeling very optimistic and upbeat now ( some of that is probably drugs as well :). )

Hope everyone is doing well.
Posted 7/11/2014 1:05 AM (GMT 0)
I'm so grateful everything went well and it wasn't as serious as first intended. I hope you continue to do better and that the past is well behind you now!!!
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