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Crohn's Disease Forum » General IBD Discussion » Can you come back from a partial bowel obstruction with medication alone?


08-08-2012, 02:24 PM   #1
kem53
 
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Can you come back from a partial bowel obstruction with medication alone?

Have any of you managed to reverse a partial bowel obstruction with only drugs and no surgery? This is a partial bowel obstruction with inflammation and no scarring. I would appreciate knowing what drugs you took and how long it took you to reach remission. Thanks in advance!
08-08-2012, 02:34 PM   #2
kiny
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Sure if it's just inflammation, any anti-inflammatory that works for crohn will tend to resolve it, doesn't really matter what it is, it just has to work for you.

But differentiating between fibrosis (scar tissue) and inflammation is incredibly difficult. It's often both.

Even if in a colonoscopy they only see inflammation, they have no idea what is under it, there could be thick layers of collagen because of the scar tissue, and on MRI they can't tell either, since if there is inflammation they can't differentiate between collagen strictures or inflammation.

It's easy to find out what it is by trial and error, if it persists even with drugs and you are still obstructed, it's fibrosis, if it resolves itself with drugs, it's inflammation.
08-08-2012, 02:48 PM   #3
Keepingfaith
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Agreed with what kiny said. Many people have partial obstructions and avoid surgery, some for their whole life. They just monitor what foods they eat.
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08-08-2012, 02:51 PM   #4
Keepingfaith
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Agreed with what kiny said. Many people have partial obstructions and avoid surgery, some for their whole life. They just monitor what foods they eat. People usually get surgery only if they are in excruciating pain or have gotten to the point where they get complete obstructions too frequently.

If your partial obstruction is just from inflammation then you can absolutely avoid surgery & just treat it with medications. Even if it was scar tissue, surgery int necessarily used to treat it although no medication treat it.
Take care!
08-08-2012, 03:44 PM   #5
Tummyache
 
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I am one of those who use diet to control symptoms: I had a partial bowel obstruction 6 yrs ago and came home from the hospital with the intent of changing my diet and controlling the IBD without meds. That's when I went gluten free to add to the dairy free and low sugar diet. When I feel like things might be getting out of control again, I go on an all liquid diet for a few days; then a few days of white rice + apple sauce; then, gingerly start back on my regular restricted diet. So far it has worked for me - but then I have mild IBD. I imagine that someone with more sever disease would probably need to take anti-inflammatory meds too.
08-08-2012, 06:14 PM   #6
Jennifer
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Even if it was scar tissue, surgery int necessarily used to treat it although no medication treat it.
If its scar tissue you have a few options depending on severity.

One, you can change your eating habits and hope for the best (not really recommended cause you have to make sure you're getting enough nutrients and water not to mention take into account your personal safety (you still risk a full obstruction) and general well being (you'll likely still have pain even with small amounts of soft foods passing by, really depends on the severity)).

Two, you can have the area stretched with a scope (really depends on where it is and the severity, can't do it in the small bowel).

Three, you can have a strictureplasty where the area is cut, pushed together and re-sewn (again depends on severity).

Four, you can have the area cut out via resection.


For inflammation you can try many medications that work for you like steroids (Entocort, Prednisone etc.) or medications that prevent more inflammation from happening like Asacol etc. There are many different meds to try. Often times its the combination of meds that give the best results. Talk to your GI about your options.
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08-08-2012, 07:54 PM   #7
Peace_and_Charm
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In my case, 7 years after my first surgery my Mom passed, and through the stress of that I had n my first obstruction about 18 months later (scar tissue). I tried to avoid surgery, but wound up enduring about 7 horrendous partial to full obstructions. At that point, my surgeon said either you go ahead with this kind of life, or we take care of it.

So I opted for the 2nd surgery - this was 1989. They could not do a laperoscopy or anything like that, due to my previous surgery. So it was a another major surgery.

I haven't had another surgey since, though I have had occasional obstuctions (not as severe). I found that a significant diet change eliminated the obstructions altogether. Hope you get better.
08-08-2012, 08:30 PM   #8
Keepingfaith
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If its scar tissue you have a few options depending on severity.

One, you can change your eating habits and hope for the best (not really recommended cause you have to make sure you're getting enough nutrients and water not to mention take into account your personal safety (you still risk a full obstruction) and general well being (you'll likely still have pain even with small amounts of soft foods passing by, really depends on the severity)).

Two, you can have the area stretched with a scope (really depends on where it is and the severity, can't do it in the small bowel).

Three, you can have a strictureplasty where the area is cut, pushed together and re-sewn (again depends on severity).

Four, you can have the area cut out via resection.


For inflammation you can try many medications that work for you like steroids (Entocort, Prednisone etc.) or medications that prevent more inflammation from happening like Asacol etc. There are many different meds to try. Often times its the combination of meds that give the best results. Talk to your GI about your options.

Exactly. In my quote I said no MEDICATION can treat scar tissue. All you did was list surgical/diet changes which I already stated I also made it clear that you can treat partial obstructions with medications if it caused by inflammation but that's just common sense.
08-08-2012, 09:10 PM   #9
Jennifer
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I just gave detailed information. Wasn't correcting you Keepingfaith.

It may seem like common sense but the question was still asked. Although sometimes the disease is too aggressive or too far gone where medication no longer has an effect and in that case then even if its just inflammation you will have to have it surgically removed to not just prevent a blockage but to kick start remission. Which is why I had my resection, the medication wasn't working anymore for the inflammation and the longer inflammation continues, the more scar tissue is causes.
08-09-2012, 09:23 AM   #10
kem53
 
Join Date: Feb 2012
Sure if it's just inflammation, any anti-inflammatory that works for crohn will tend to resolve it, doesn't really matter what it is, it just has to work for you.

But differentiating between fibrosis (scar tissue) and inflammation is incredibly difficult. It's often both.

Even if in a colonoscopy they only see inflammation, they have no idea what is under it, there could be thick layers of collagen because of the scar tissue, and on MRI they can't tell either, since if there is inflammation they can't differentiate between collagen strictures or inflammation.

It's easy to find out what it is by trial and error, if it persists even with drugs and you are still obstructed, it's fibrosis, if it resolves itself with drugs, it's inflammation.
Thanks Kiny, we are basing this on the surgeon viewing the MRI and saying it was inflammation and not scarring. I did wonder if you could tell from that.
08-09-2012, 09:25 AM   #11
kem53
 
Join Date: Feb 2012
In my case, 7 years after my first surgery my Mom passed, and through the stress of that I had n my first obstruction about 18 months later (scar tissue). I tried to avoid surgery, but wound up enduring about 7 horrendous partial to full obstructions. At that point, my surgeon said either you go ahead with this kind of life, or we take care of it.

So I opted for the 2nd surgery - this was 1989. They could not do a laperoscopy or anything like that, due to my previous surgery. So it was a another major surgery.

I haven't had another surgey since, though I have had occasional obstuctions (not as severe). I found that a significant diet change eliminated the obstructions altogether. Hope you get better.
Thank you Peace and Charm, the GI doc recommended the "Makers Diet". What kind of diet do you follow?
08-09-2012, 09:32 AM   #12
kem53
 
Join Date: Feb 2012
I just gave detailed information. Wasn't correcting you Keepingfaith.

It may seem like common sense but the question was still asked. Although sometimes the disease is too aggressive or too far gone where medication no longer has an effect and in that case then even if its just inflammation you will have to have it surgically removed to not just prevent a blockage but to kick start remission. Which is why I had my resection, the medication wasn't working anymore for the inflammation and the longer inflammation continues, the more scar tissue is causes.
Crabby, thank you for your answers. You gave the exact kind of information I was seeking. You are correct, it may seem like common sense, but this is a new Crohn's diagnosis and we are still learning the ropes. When my daughter was hospitalized 10 months ago, this partial obstruction left an opening the size of a straw. Since then, she has been on Pentasa, Prednisone, then Entocort. The partial obstruction has let up "slightly" but is still there. We weren't sure whether this kind of situation ever resolved without surgery. We are facing tough choices and hearing everyones experiences and solutions is very helpful.
08-09-2012, 11:13 AM   #13
Thermo
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So the progression of Crohns is inflammation over many flares and months/years that gives way to scarring or stricturing which leads to obstruction. All of this is unavoidable it just depends on how fast each one progresses and also if you have one of the many other side effects of having Crohns. At a certain point surgery is the reality for nearly every single patient. As a person who had obstruction symptoms for many years and didn't know what it was I am going to tell you that surgery was a great choice, no longer do I have to live in constant fear of eating too much and getting pain or worse having to goto the hospital. A week after surgery I was stuffing my face like I was a teenager again it was great. An MRI shows stricturing pretty well so if they are saying its inflammation then try to get it under control as quickly as possible. Just remember the more flares and inflammation that occur the more chances it will lead to scare tissue and require surgery.
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08-09-2012, 12:48 PM   #14
kem53
 
Join Date: Feb 2012
So the progression of Crohns is inflammation over many flares and months/years that gives way to scarring or stricturing which leads to obstruction. All of this is unavoidable it just depends on how fast each one progresses and also if you have one of the many other side effects of having Crohns. At a certain point surgery is the reality for nearly every single patient. As a person who had obstruction symptoms for many years and didn't know what it was I am going to tell you that surgery was a great choice, no longer do I have to live in constant fear of eating too much and getting pain or worse having to goto the hospital. A week after surgery I was stuffing my face like I was a teenager again it was great. An MRI shows stricturing pretty well so if they are saying its inflammation then try to get it under control as quickly as possible. Just remember the more flares and inflammation that occur the more chances it will lead to scare tissue and require surgery.
Thanks Thermo, this is good advice. My daughter also had obstructive symptoms for several years and it went undiagnosed, even though we had seen many doctors. We will see the GI doc today and see about a medication change to see if we can stop the inflammation in its tracks. If not, it looks like surgery may be the only option. It is good to hear you are doing so well after surgery. Food is one of the great joys in life and it saddens me to see so many people suffering while just trying to eat.

I wish you well and hope you continue to stay in remission!
08-16-2012, 03:53 PM   #15
Thermo
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Hi Kem53 has there been any update from the last appointment?
08-16-2012, 09:30 PM   #16
Peace_and_Charm
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Kem53,

I found the following changes coincided with an end to my obstructions:

-NO CHINESE
-replaced bagels in morning with Ensure (this did the most it I think)-less solids are better, heavy bread is hard to digest
-low residue diet, no fried food
-NO BACON
-not even an occasional glass of wine
-water, water and more water
-baked and broiled chicken till your sick of it
-no green leafy vegetables especially broccoli
-never ever any popcorn or even 1 nut

Good Luck
08-16-2012, 11:34 PM   #17
tots
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I was admitted to the hosp and put on high doses of prednisone. No surg although it was a long hard road to getting off the preddnisone and getting into remission.

But, I did it!


Lauren
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