Is Cleveland Clinic worth the trip?....I need a second opinion!

[reese09]

Please help.......I have been told by my surgeon that I have to have a SECOND bowel resection.  I swallowed a endoscopy capsule over 4 weeks ago and is is stuck in a stricture just above my surgery sight.  I don't want to have a second surgery.  I live in WV and have made an appointment with a dr. at the Cleveland Clinic for next week.  I hope that someone there can give me a less invasive option.  Is there anyone out there that has had this problem with the "cam pill"?  

[CalGal]

I believe the only other way to retrieve the 'pill' - if it's in the small intestine - would be via double balloon enteroscopy. However, with the presence of your Crohn's the procedure might prove too irritating to the whole of your small intestine. Barring that, the only way to 'get' the pill would be via surgery, and if you have a stricture they might be able to resection that at the same time.

[reese09]

Oh boy...that is not what I wanted to hear.  I don't know if I can go through that surgery again or not!

[CalGal]

Sorry to say that reese. But the only one who can say whether or not there's an easier way to handle this is going to be your doc. No one wants to have surgery but if you've got a stricture that's impeding the passage of the pill and the pill is stuck, that portion of your intestinal tract has really closed down. The pill is 'big,' but not huge. You might be able to get a fluid like chyme through, but the pill camera may not be made to stand the pH of those fluids for extended periods of time. And that could be problematic. It's possible the pill could be retrieved by the double balloon technique, but the tissues lining the intestine in someone with Crohn's can be very fragile as you well know.  

Find a doc to sit down and discuss this with.  

[reese09]

Can I ask you if you know anything about Entocort?  My doctor told me to take this 3x day for 1 wk, 2x day for 1wk & 1x day for 1wk.  Then I should see him again for another xray to see if the pill has passed.  I am afraid of the affects of this steriod as I also have a stomach ulcer.  Anyway, I have two little boys and I can't afford to have to side affects of this medicine on top of the panic I'm feeling over the certainty of another surgery.  Thank you so much for posting back to me.  I feel like no one so far thinks that it's any big deal that this pill is stuck and I'm afraid of what it may be doing to my intestines.  I will see what the doc at Cleveland Clinic says on Tues. morning.  Hope I'm not waiting too long.

[mammo]

I  once had to take my son to the Cleveland Clinic due to complications from removing his colon. We got much better results at the University of Cincinnati Hopsital.  They are a teaching hospital, and have the best trauma unit.  I won't go any place but there!

[CalGal]

Reese, Entocort is a 'different' type of steroid. It's not one that extensively acts on the whole body system. In many ways it confines its effects to the GI system. It might be a wonderful alternative to prednisone for you, and I think that you're doc was a rather nice guy for suggesting you give that a try. It may reduce the inflammatory aspects enough to allow passage - it's that's what's hanging things up. I can't swear that you wouldn't have any of the side-effects that are associated with drugs like prednisone, but most on Entocort find that the side-effects are much, much less and that the normal endocrine/cortisol system kicks back in earlier without the 'step-down' effect of prednisone. Can't say it's 100% perfect, but Entocort - if it works for you - is a great alternative.

You're going to have to watch that stomach ulcer, though.

[reese09]

Thanks again for your concern...very helpful.  I'll try to keep you posted.....this is such a bizarre thing that maybe me going through this will help someone else that may find themselves in the same position.  They told me that 99.9% of the time, people pass it within the first 3 days.  I'm here to tell everyone that.....THAT 1% DOES EXIST....I guess I was unlucky enough to be her.  
Trying to keep a positive attitude!