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What Causes Thickening Of Wall In The Descending And Sigmoid Colon?

Posted on Mon, 16 Mar 2015

Question: The latest Abdominal CT showed borderline colon wall thickening in the descending and sigmoid colon - suggest surgical opinion. Why are they suggesting surgical opinion?

Answered by Dr. Dr. Klerida Shehu (46 minutes later)

Brief Answer:
I'm waiting for more information from you...

Detailed Answer:
Hi and thank you for asking!
I read your query and try to understand your concerns. Can you specify the following answer:
- where and when was the last colonoscopy done?
- What was the reason of doing CT scan (routine follow up or any symptom)?
- Do you have any symptom prior or after the CT scan?

Surgery is indicated in patients with Crohn disease only after colonoscopy with biopsy.

I'm waiting for more information from you.
Wish you health!
Dr. Klerida

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Klerida Shehu (48 minutes later)

Last colonoscopy was done last July - approx. 7 months ago and the specialist has told me that if anything shows on the X-Ray as above he would do another colonoscopy. the CT was done as a follow up to the x-ray suggested by the radiologist. Does this bowel wall thickening mean anything?

Answered by Dr. Dr. Klerida Shehu (16 hours later)

Brief Answer:
Follow the suggestions below

Detailed Answer:
Hi back,

The bowel thickening might be due to:
- infection
- strictures
- tumoral mass

Although you had your last colonoscopy seven months ago, I advise to repeat it again now to determine the right cause.

Your clinical symptoms are also important for the diagnosis and evaluate if you are experiencing flare up or remission stage:
- do you have diarrhea?
- mucus?
- blood?

Together with medications you are currently taking other than corticosteroids.

All the best!
Dr.Klerida

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Dr. Klerida Shehu (21 hours later)

I can't take steroids as these affect my heart. All immunosuppressant drugs I have had bad reactions to as well. There is a lot of bleeding and gas/wind and mucus and pain but no real stools. In the past I have always suffered diarrhoea with the crohn's disease but in the past few months I have a very swollen abdomen and feel very nauseated all of the time. Please can you help if you can to explain what may be happening? Thank-you.

Answered by Dr. Dr. Klerida Shehu (4 hours later)

Brief Answer:
Infliximab to be considerd as end line therapy

Detailed Answer:
Hi Back,

Thank you for following up.

The presence of blood, mucus and abdominal distension are indicative for possible Crohn's flare up.

I advise to consult with your GI specialist to schedule your treatment strategy.

Commonly used medications include steroids, masalazine, immunosuppressants.
If you cannot tolerate them, or in case such strategy will cease, should discuss with your GI specialist to start infliximab.

All the best!
Dr.Klerida

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Above answer was peer-reviewed by : Dr. Raju A.T