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Signs and Symptoms of Colon Strictures

Medically Reviewed by Jennifer Robinson, MD on May 25, 2020

Your body is like a network of highways, carrying food, fluids, and waste around and out. When certain sections of those roadways narrow because of disease or other reasons, it's called a stricture.

When this roadblock happens in your large intestine, it's called a colon stricture. Your large intestine, or bowel, is where your body converts digested food into poop. A colon stricture slows or stops that waste from passing through.

Types and Causes

Strictures can happen in different parts of your body. They include the tube that carries food to your stomach (esophagus) and your urethra, which channels pee out of your body.

No matter the location, strictures come in two types. You could have one or the other, or both.

Inflammatory strictures result from swelling in your digestive tract. Doctors can treat them with medication or surgery.

Fibrotic strictures happen when scar tissue builds up in the bowel from chronic inflammation. They require surgery.

One main cause of colon strictures is inflammatory bowel diseases (IBDs) like Crohn's disease and ulcerative colitis. A cycle of inflammation and healing leads to scar tissue that narrows the intestine. Other possible causes include:

One in two adults with Crohn’s disease may get intestine problems like fistulas (sores) or strictures within 20 years of their diagnosis.

Symptoms

Some signs of strictures can feel vague. Other times, the symptoms may be more obvious. Your colon’s job is to process digested food and liquids and push the waste down to your rectum to be eliminated as stool. A serious stricture can block your bowels and make it hard for you to poop.

Symptoms of a colon stricture may include if you:

If you don't treat it early, a stricture can turn deadly.

Treatments

Lifestyle changes, medicine, and surgery are the three main ways to treat strictures. Your doctor will recommend a treatment plan tailored to your needs:

Changes to your diet. A low-fiber or low-residue diet reduces the risk of blocks in your intestine and the number and size of your poops. Studies also show a connection between a gluten-free diet and IBD symptom relief, which could lower your risk of strictures.

Anti-TNF treatment. This medicine eases inflammation from a protein called tumor necrosis factor (TNF) and prevents new strictures from forming. It only works on strictures related to inflammation, not fibrosis.

Colonoscopy. Doctors widen the colon with a balloon inserted through a flexible tube (endoscope). They may use a stent to keep the narrowed area open.

Your doctor may also suggest surgery. Studies show that most people with Crohn's disease who also have a stricture will need at least one surgery at some point. There are two kinds:

Strictureplasty widens the narrow part of your intestine without removing it. This surgery is most helpful in the lower part of your small intestine.

Small bowel resection is when the surgeon takes out the damaged part of your intestine, then joins the healthy sections together. You'll have this surgery if the damage is more severe, or if doctors find that widening the intestine won't work.

WebMD Medical Reference

Sources

SOURCES:

Crohn's & Colitis Foundation: "Strictures," "Strictureplasty," "Small and Large Bowel Resection."

Johns Hopkins Medicine: "Upper Gastrointestinal Series."

Mayo Clinic: "Colonoscopy," "Urethral stricture," "Crohn's Disease."

National Health Service (U.K.): "CT Scan."

National Institute of Biomedical Imaging and Bioengineering: "Magnetic Resonance Imaging (MRI)."

Intestinal Research: "Intestinal Stricture in Crohn's Disease."

Frontiers in Pediatrics: "Crohn's Strictures -- Moving Away from the Knife."

Ostomy Association of Boston: "Understanding Colon Stricture."

Cleveland Clinic: "Esophageal Spasms & Strictures."

American Society of Colon & Rectal Surgeons: "Diverticular Disease."

American College of Surgeons: "Colonoscopy."

Cedars-Sinai: "Gluten-Free Living: Gluten, Crohn's and Ulcerative Colitis."

Gut and Liver: “Benign Colorectal Stricture: An Answer to the Balloon or Stent Question?”

Journal of Crohn’s and Colitis: “European Crohn’s and Colitis Organisation Topical Review on Prediction, Diagnosis and Management of Fibrostenosing Crohn’s Disease.”

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