Depending on the severity, an intestinal stricture can cause symptoms like bloating, cramping, severe abdominal pain, and nausea. Treatment may involve medication, a medical procedure, or surgery.

An intestinal stricture is a narrowing in the intestine that makes it difficult for food to pass through. Sometimes, it can lead to intestinal blockage. More than half of people with Crohn’s disease develop a stricture in their lifetime.

If you have Crohn’s disease, it’s a good idea to familiarize yourself with the signs of an intestinal stricture in case you develop one. Read on to learn about what causes strictures, some of the symptoms and risk factors, and what the available treatments are.

There are two main classifications for intestinal strictures:

  • Inflammatory strictures: These are caused by the inflammation of the digestive tract that accompanies a Crohn’s flare-up.
  • Fibrotic strictures: These strictures are the result of scar tissue building up in the bowel due to long periods of inflammation.

Most intestinal strictures from Crohn’s are a combination of both of these classifications.

Strictures that are predominantly fibrotic tend to be more severe and typically require more invasive forms of treatment.

The symptoms of an intestinal stricture can vary depending on the severity of the blockage. For mild to moderate strictures, symptoms typically include:

  • abdominal cramping
  • abdominal pain
  • bloating
  • loss of appetite
  • fatigue

In more severe cases, symptoms may include:

  • severe abdominal pain
  • nausea
  • vomiting
  • constipation
  • abdominal bloating and distension

If you’re experiencing any severe symptoms, contact your doctor immediately.

Several risk factors may increase your risk of developing a Crohn’s-related intestinal stricture. These can include:

  • being age 40 years or younger at diagnosis
  • having perianal disease
  • needing steroids during your first flare
  • having a history of smoking
  • experiencing deep mucosal ulcerations with locations in the small bowel

Certain genetic factors may also make you more susceptible to intestinal strictures. You can talk with a doctor about whether your family’s medical history increases your risk. They may recommend genetic testing.

Treatment for intestinal strictures varies from person to person. It can depend on the type, length, and location of the stricture.

Doctors may treat strictures mainly related to inflammation with:

  • steroids
  • immunomodulatory drugs
  • anti-TNF agents

But since most Crohn’s disease strictures are a mix of inflammatory and fibrotic, these treatments aren’t always effective on their own. If this is the case, doctors may use procedures or surgery to treat intestinal strictures.

Treatment for intestinal strictures that don’t respond to medication may include:

  • Endoscopic balloon dilation (EBD): In this procedure, a doctor inserts a balloon to expand the narrow part of the bowel to treat single, short strictures that are accessible by endoscopy and free of complications. Endoscopic treatment may help you delay surgery. But there’s a chance you’ll need another EBD within 5 years.
  • Strictureplasty: For short, simple strictures, doctors can perform a bowel-preserving procedure called strictureplasty. In this procedure, doctors cut open and reshape the damaged portion of the bowel.
  • Surgical resection: When strictures are longer and more complicated, resection surgery may be necessary. This involves completely removing the damaged part of the bowel.

If you have an intestinal stricture, you may need to temporarily modify your diet to avoid blocking the narrowed part of your bowel. Try to eat small, frequent meals, and make sure you chew your food thoroughly before swallowing. If possible, you should cook all foods to soften them. You might also want to avoid foods that are hard to digest, such as:

  • gristly meats
  • nuts
  • seeds
  • fruit and vegetable skins
  • fruit and vegetable seeds, including corn
  • mushrooms
  • beans

It is best to consult with a doctor before making any major changes to your diet. Cutting certain things out could lead to vitamin and mineral deficiencies that may make your symptoms worse. They may recommend a nutritional supplement or specific dietary modifications.

How do you treat a stricture in the intestine?

How a doctor treats an intestinal stricture can depend on its type, location, and severity. If it’s inflammatory, they may prescribe medications to reduce inflammation. But if it’s fibrotic, they may recommend an endoscopic procedure or surgery, depending on the location of the stricture and other factors.

What does intestinal stricture feel like?

An intestinal stricture can cause abdominal pain and bloating. You may have other symptoms, including nausea, constipation, and lack of appetite.

What are the symptoms of a colonic stricture?

A colonic stricture can cause constipation, bloating, and abdominal pain, depending on the severity.

Can you live with a colon stricture?

A colon stricture can block the bowel and cause life threatening issues if left untreated. It’s best to seek medical attention if you think you may have a stricture.

Although intestinal strictures are common among people with Crohn’s disease, if left untreated, they can cause life threatening issues. If you think you might have a stricture, contact your doctor immediately.

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