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Crohn's Disease Forum » Surgery » Do a surgery or not? please help


11-18-2017, 11:53 AM   #1
gryzelda
 
Join Date: Nov 2017
Location: Poland
Do a surgery or not? please help

Hi, Iím looking for some help to make a decision about a surgery.
Iím 22. I have Crohnís disease for almost 2,5 years. I sometimes had abdominal pain and a little bit looser stool (but once a day). I had a colonoscopy and doctors gave me mesalazine, after one year they added azathioprine and now adalimumab. But in MRI I had in March doctors found some narrowing in terminal ileum and in ileocecal valve. For 3 weeks I sometimes feel some bigger mass in the right abdomen, but in 1 day that feeling goes away. One week ago I had an ultrasonography - doctor found narrowing and a little bit wider intestine before the narrowing. My doctor suggest me to do a resection about 20 cm of ileum and a valve. Do you think itís a good idea? Now I feel very good, no pain or discomfort in abdomen. Iím afraid that after a surgery Iíll have diarrhea because of a resection and of more frequent intestinal infection. Iím studing and itís important to me to be able to continue my studies Please, help me
Sorry for my bad English
11-18-2017, 03:08 PM   #2
Guerrero
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Hi gryzelda,
Your doctor suggest a surgery as the widening before the narrowing means the food stay a bit stuck there, and there may be a risk of intestinal obstruction.

However instead of resection modern surgery favour stricturoplasty as a conservative approach to avoid losing the length of your ileum. You could maybe ask if strictureplasty is possoblenin your case or seek for a second opinion.

Also switching from humira to another biologics may also help
11-18-2017, 03:39 PM   #3
gryzelda
 
Join Date: Nov 2017
Location: Poland
Thank you for your answer
I've talked to a surgeon recently and said about stricturoplasty. But he said that this method is used when a patient has a short part of intestine left after previous surgery, because that part of intestine narrows in a few years again I was sad he said this beacuse I hoped I could avoid resection. Do you think I should insist on stricturoplasty instead of resection?
11-18-2017, 05:05 PM   #4
ronroush7
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The disease will eventually come back but I tend to agree with the surgeon.
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Diagnosed in 1990. On Humira, Imuran, Gabapentin, Colestipol, Synthroid, Lialda. Resection in April of 2010. Allergic to Remicade, Penicillin, Flagyl, Doxycycline. Thyroid issues and psoriasis and neuropathy and mild cerebral palsy. Mild arthritis in my lower back.
11-19-2017, 05:24 AM   #5
Guerrero
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In my case strictureplasty was the first approach but I had many strictures (like 5 or 7 I dont remember) so maybe this was too long to cut.
You are also young so maybe it could worth a try asking a second opinion to another surgeon with good experience in strictureplasty.

Usually cutting "only" 20 cm shouldnt lead to small bowel syndrome (more diarrhea etc...) , but cutting the valve could make you go more often to toilets, but ask your doctor about that as i'm not 100% sure.

I hope someone else can share experiences about strictureplasy or resection of the valve.
12-05-2017, 12:50 PM   #6
gryzelda
 
Join Date: Nov 2017
Location: Poland
Hi again, thank You all for answers
I'm after an appointment with my gastroenterologist. He said that according to him the surgery isn't necessary now because it's a high risk that the disease will soon come back in the anastomosis after surgery and another ones will be needed and I'll loose more and more intestine.
Now I feel very good, no abdominal pain, discomfort, normal stools etc. I'm afraid that I'll choose wrong, especially that doctors say different things
12-05-2017, 02:21 PM   #7
ronroush7
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Maybe you should go for a second opinion.
12-05-2017, 05:42 PM   #8
dzwilks
 
Join Date: Nov 2017
Location: Cleveland heights, Ohio
Hi. I am 57 years old. I had a resection losing my ileocecal valve, 20 cm of ileum, and 10 cm of colon. That was 16 years ago. I did have recurrence at the site after my first colonoscopy.
Over the years, however, I usually had no symptoms of Crohn's. I did continue to medicate with various low risk medications. Most recently my doctor added Humira.
I did not have diarrhea due to the surgery. I started to get diarrhea recently but the Humira took care of that.
I am very happy that I did the surgery. I was in terrible pain and that has never returned, thank God.

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