Sigmoid Stricture

[piglet08]

I have had altered bowel habits and on occasion some blood smearing on the toilet tissue. Left sided pain and back pain low down. I have had a colonoscopy that failed and a sigmoidoscopy that failed. A barium enema showed a Sigmoid Stricture and I have a diverticular desease in the descending colon. I have had a CT Tomonography and a CT Colonography and I'am having a Flexi sigmoidoscopy on 2nd Sept, before having a Sigmoidectomy on 6th Sept. Is it usual to have all these procedures and i still don't know what a stricture is and why i have one. What's caused it.No-one seems to know and there seems to be lots of concern. I was diagnosed in April, surely if it is malignant or there's a posibility this should have been dealt with quicker [taken out]. I'am so worried now as i haven't been told to much fine detail and would preferr to know.I'm also concerned that i've had so many procedures involving xrays that this could cause cancer even if i don't have it now. I'm sooo confused ?


This discussion is related to Side and back pain.

[CalGal]

Piglet, narrowing in portion of the colon (strictures) can occur when someone has diverticular issues. With diverticulosis 'pouches' form, but in addition sections of the bowel can also narrow. No one understands exactly how diverticular disease starts or why it progresses, why some only pouch while others form strictures.

Your docs are probably trying to get all the answers to decide the best form of treatment, and also decide if surgery is necessary just how much of the colon is affected. The vasculature of the descending portion of the colon varies greatly from person to person. So if a portion needs to be removed, they're going to want to save the maximum amount of colon possible - leaving clear margins for reattachment. It can take a bit of time to figure that out. I'm sure if they had a large suspicion the problem was cancer you would have been in a surgical suite long before this.

Keep asking questions of your docs. They're going to be your best source of information.

[Kaneda2112]

From the journal Radiology -

"Sigmoid strictures are most frequently caused by carcinoma or diverticulitis. In 1940, Schatzki (1) stated, “The difficulty in differentiating diverticulitis, particularly of the sigmoid colon, from a carcinoma is as old as the knowledge of diverticulitis as a disease.” Despite the multidisciplinary approaches of clinical examination, endoscopy, double-contrast barium enema examination, and computed tomography (CT), a gray area persists in the diagnosis of some sigmoid strictures, particularly when carcinoma and diverticular disease coexist or when a carcinoma causes perforation and a pericolic abscess develops (2). If a malignant stricture is called benign and managed conservatively, diagnosis will be delayed; even a 3-month delay can alter the stage of the disease, with a dramatic effect on therapeutic options and patient prognosis (3). If a benign stricture is called malignant, the opportunity for conservative management is lost. "

I believe the chance of cancer from X Rays is pretty remote. Diverticultis can cause strictures so it's best to see what they come up with.