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Possible stricture?

My GI sent me to a Crohn's Disease specialist because Remicade was causing problems with my scalp. The specialist recommended that I go off of Remicade and go on a medicine called Stelera. It is already approved for psoriasis and soon to be approved for Crohn's Disease. She also wrote up an order for me to be tested for c diff because of the awful smell after a bm. She is also wondering if I have a stricture. Could someone give me more information on strictures. As a side item,, I am being sent to an infectious disease doctor, by my dermatologist's office, because of my scalp issue.

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Ron,
Back in July 2013, I was told I had 3 strictures in the last 18 inches of my small bowel. My GI tried me on Remicade (1st and 2nd intro infusions) just to see if the drug might make the strictures reduce or go away. No such luck. In August, the GI surgeon removed 19 inches of the small bowel and 1 inch of large bowel.
I've been on Remicade since with not much luck. Never been on Stelera.
Good luck with the new treatment plan. You have really been thru the ringer.
 

kiny

Well-known member
a stricture is a narrowed intestine, the actual diameter of the lumen is actually smaller in some people with strictures, because of inflammation / fibrosis / collagen, usually a combination of both
 
Aside from the scalp issue, are you doing well on Remicade? I only ask because once you stop Remi, it's unlikely you'll be able to go back to it. Can the psoriasis be treated with something else? I know of some kids who've added methotrexate to their Remi to help with psoriasis. Just a thought.

My son had a stricture that was removed surgically. Like kiny said, it's when a length of your intestines is narrowed making it hard for material to get through. It can sometimes be seen with an MRE, CT, or scopes depending where it's located. Strictures at manageable to a point. If it's inflammation then meds can work, but if it's built up scar tissue, then it can require surgery. Why did she think you had a stricture? Are you having symptoms?

No experience here with Stelara.
 
Yhr reason she thought I might have a stricture is because sometimes I tend to strain when I go to the bathroom.

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Ron,
A co-worker of my wife sent this to her for me. I thought it might help answer the stricture issue for you.

What if I have a stricture in my small intestine?

Remicade probably won't help. The natural history of Crohn's disease is to form ulcers on the inner intestinal wall which heal and then return over and over. Each time an ulcer heals some scar tissue (fibrosis) is formed. This scar tissue can accumulate over time and cause a narrowing in the small intestine or colon. This is called a stricture. A significant percentage of individuals may develop intestinal obstruction, or "blockage of the bowels," from these strictures. Remicade works best in reducing active inflammation, but has little effect on scar tissue which may be permanent. Reports have demonstrated that individuals who have intestinal strictures are less likely to respond to Remicade.

The full article is here: http://www.gihealth.com/html/education/drugs/remicade.html
 
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