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Now what? a Stricture?!

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Posted 10/19/2017 5:33 PM (GMT 0)
Hi all -
So, I am back home from my colonoscopy. Had propofol, so I am not too zoned out except I did not sleep well last night, so I am tired. Please excuse any wrong notes.

The GI said that overall the colon looked good. There was a little inflammation at the very bottom, and some "lumps and bumps" up high, but at about 20 cm, there was a STRICTURE! He said it was so narrowed he couldn't get the scope in. First he switched out for an upper-type endoscope (aha! So now I know that those are a bit narrower than tushy copes) and still couldn't get it through, so then he switched to a pediatric scope and got all the way through (made swirly, zig-zaggy motions all over his abdomen.)

What the heck?!

So now we wait for the pathology results.

I had an interesting dream while under: I dreamt that my husband was also being scoped, and was in the next bed, and that other patients in the place were the group of friends I just went on vacation with a few weeks ago! LOL
Posted 10/19/2017 6:38 PM (GMT 0)
That's kind of a nice dream... at least you didn't feel lonely!

So what happens when you have a stricture? What if anything can be done?
Posted 10/19/2017 6:41 PM (GMT 0)
That is surprising. Have you suffered any symptoms from the stricture? I hope the pathology is good.
Posted 10/19/2017 7:02 PM (GMT 0)
Strictures are rare with UC but can occur with long term cases (you've had UC since 1983). Certainly have a good talk with your gasteroenteroligist regarding the implications thereof and ask a lot of questions. "Although uncommon, benign strictures are a recognised complication of long standing UC. Careful and detailed consideration including histological and radiological assessment is needed to rule out dysplasia and malignancy."

A benign-stricture can be monitored with increased frequency but sounds like it does increase one's CRC risks with UC from what I was reading. Prognosis seems to vary depending on where it is found. At 20cms, that's within the sigmoid colon territory and my reading said 47% chance of it becoming malignant in that location. Certainly with precancerous cells and now a stricture they are going to want to take more looksies...

Sources:

/www.ncbi.nlm.nih.gov/pmc/articles/PMC1379408/

gut.bmj.com/content/60/Suppl_1/A221.2
Posted 10/19/2017 7:21 PM (GMT 0)
Stricture at 20cm would be in the sigmoid. Where were the the other dysplasia in the past?
I hope the doc took biopsies in that area.

Sounds like a nice dream you had....could mean misery loves company or you feel close to your husband and friends and trust them on a very personal level?


Have a good rest and sleep tonight.

q
Posted 10/20/2017 2:31 AM (GMT 0)
Surprised to hear about the stricture because that's more common to Crohn's. Best to wait for your gastro's comments rather than to speculate, but you may need some diet modification at the least. That might explain some of the pain you had been feeling more recently in your UC experience. *** Funny about your dream & hubby would probably think so, too, but the friends ... ? / Old Hat (37 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 10/23/2017 12:55 AM (GMT 0)
I will have to look up, but I believe the other dyplasia cells were more in the ascending side....?

My thought, too, was "oh gosh, stricture is a Crohns thing!" until I read the links John included. (Thanks,John!) So... maybe not so unusual for 30+ years of UC....?

The thing is, none of this, the stricture or the "lumps and bumps" were there 6 months ago. Yuck.

NSSG, no symptoms from the stricture, except this morning I had a vague pain in tat are and though, oh, shoot! I must say, since the scoping I am a little paranoid about what I eat and whether it might cause a blockage. Trying to chew well.

To add to the fun, my dear FIL has died and we are involved in long-distance arrangements and some travel (across half the US) this week. I just know we'll be out the cemetery when my GI calls with the results.....

eyes
Posted 10/23/2017 3:36 AM (GMT 0)
Deepest condolences to you and your husband .

Hugs,
q
Posted 10/23/2017 11:23 PM (GMT 0)
Likewise. Take care as best you can. / Old Hat (37 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 11/3/2017 1:52 PM (GMT 0)
So while I was away for the funeral my GI called me with my pathology results. "Nothing bad;" he started. But there are "abnormal" cells around the stricture at the 30 cm area, which is where the goblet cell had been found 6 months ago. He said that actually, "abnormal" could mean scarring from the inflammation that had been in that area. But in any case he suggested I talk to a surgeon, just to "start the conversation" since it looks as though I am heading that way at some point....and recommended one at a nearby Ivy League university hospital who has a lot of excellent results with UC surgeries. Also, GI is conferring with the oncologist I saw in the spring (who did tests and gave me a clean bill of health at that point.)

And then I got a call yesterday that the GI wants me to have a CT scan, and it is scheduled for next week. I have to tell you, that has made me nervous, although I guess they are not that uncommon....? But this is my first.
Posted 11/3/2017 2:22 PM (GMT 0)
What exactly makes you nervous?

The surgery aspect, considering the biopsies, seems a best bet. It's good your scopes have been close together.

Hugs,
q
Posted 11/3/2017 2:38 PM (GMT 0)
Hi Q -
I guess I am nervous that the CT will show cancer elsewhere that has surrounded the colon at that spot and caused the stricture....?

I think I have wrapped my mind around the colon surgery, I have researched this surgeon and I am set to make an appointment; but I am hoping that my "only" problem is in the colon and that nothing else pops up. Our bodies are so complex, I think it's amazing any of us are walking around most of the time with most parts working.... I feel as though I am waiting for another shoe to drop. No logical reason - it's probably because of family deaths and illnesses that I'm feeling as though the dominoes are tumbling.

Thanks for asking - I feel better for articulating all that.

Hugs back at you.
Posted 11/3/2017 2:58 PM (GMT 0)
I totally understand and would have the same fears. It's good the scan is very soon. Your updates are appreciated.

q
Posted 11/3/2017 3:15 PM (GMT 0)
Just wanted to say I'll be following your posts. I'm ki d of in the same boat -- maybe. My last biopsy report noted some cells showed some possible changes so were in the watch and wait stage. Trying to educate myself on surgery and such right now just because I don't want to be surprised and flail around making decisions at the last minute.

Condolences on your loss! What a stressful time for you!
Posted 11/4/2017 8:31 PM (GMT 0)
RE CATscan: are you getting a double contrast? I had to do the oral last Nov. in combo with IV for gyn C. surgery follow-up & it proved a nuisance because it was a liter of chilled liquid tasting like Tang. It made me shiver; then tech had trouble inserting IV needle; Cupcakespinkgal later reported in reply to my post here about it, that the same thing happened to her! Plus we both got explosive D a short time after the scan session. So-- if your GI tract is sensitive to cold liquid that's definitely a point to bring up prior to your scan date. The actual body scanning is done while patient lies flat on a revolving gurney for 10-15 minutes, not a big deal mechanically in comparison to MRI or endoscopy or mammography. *** It could be that your gastro just wants to have a more accurate picture of your whole GI tract because of the sigmoid stricture, not necessarily due to cellular concerns from the past c-scope. Continuing best wishes! / Old Hat (37 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 11/4/2017 11:57 PM (GMT 0)
Connor: the link that iPoop shared above indicates that sometimes a stricture might form if one has had UC for several decades. The "lumps and bumps" were apparently scar tissue from long-standing inflammation (healed since I started Humira 5 months ago?)

I would certainly want to make sure the diagnosis of UC is correct before having surgery, but having had 34 colonoscopies over the course of my UC (which includes one every 6 months for the last 2 years) I think the GI is likely solid on the diagnosis.

Thanks for the reassurance, OH! It was the nurse that called me, and I talked to her while in transit between planes coming from my FIL's funeral, so I didn't ask many questions. I will call early in the coming week to ask several things!

Meanwhile, I walked my first 5 K today...... smile
Posted 11/5/2017 12:08 AM (GMT 0)
I am so sorry about the results and your FIL. Coming to terms with surgery is very difficult to wrap your head around. On the positive side, I am a surgery survivor, and while surgery is no walk in the park, since surgery, UC has been the furthest thing on my mind. There were periods that I struggled a ton, but overall, I love life without UC.
Posted 11/7/2017 9:37 PM (GMT 0)
A 5K walk post-hip repls? You are definitely a Trooper, Songlady!!!!!!!!!! / Old Hat (37 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 11/8/2017 1:08 AM (GMT 0)
Well, on a recent international trip (I was leader of a tour group) we were walking 7 -8 miles a day, so I figure I could handle the 5 K at this juncture. In a few months, after a winter of sitting around, maybe not so much! lol

Thanks, OH.
Posted 11/8/2017 1:14 AM (GMT 0)
Wishing you the best song lady! You are truly an inspiration to keep on with exciting adventures despite this awful disease. You seem to just take life by the reins and live it to the fullest. I can't drive to the store without worrying and her you travel around the world.
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