Colon Stricture

What is a colon stricture?

A colon stricture, or intestinal stricture, is a narrowing of your large intestine (colon). This narrowing is often caused by another condition in your colon or abdomen. Colon strictures can slow or even completely block the passage of waste (poop) through your colon.

The good news is that colon strictures are treatable. With early diagnosis and a plan from your healthcare provider, you can manage this condition and feel better. There are even steps you can take to potentially prevent future issues.

Can you still poop with a stricture?

Whether you can poop with a colon stricture depends on how severe (narrow) it is:

• Mild stricture: You might still be able to poop somewhat normally. But you might find it more difficult to poop or do so less frequently.
• Moderate stricture: Constipation is more likely, and your poop might be narrower or harder to pass.
• Severe stricture: You might be unable to poop at all (complete blockage), which is a serious medical emergency.

What are the symptoms of a colon stricture?

Intestinal stricture symptoms can vary depending on the severity of the narrowing. Some common colon stricture symptoms include:

• Abdominal pain.
• Constipation.
• Diarrhea.
• Bloating.
• Nausea and vomiting.
• Weight loss.

If you’re experiencing any of these symptoms, it’s important to see a healthcare provider to get a diagnosis and discuss treatment options. Early diagnosis and treatment of a colon stricture can help prevent complications.

What does a colon stricture feel like?

A colon stricture can cause various uncomfortable sensations in your abdomen (belly) due to the blockage it creates. These sensations can vary depending on how severe the stricture is, but may include:

• Pain or cramping: These are common symptoms and are often felt in your lower abdomen. The pain may come and go or be constant.
• Bloating: The stricture can cause trapped gas and poop, leading to a feeling of tightness or distension in your abdomen.
• Constipation: This is a frequent consequence as the narrowed passage makes it difficult to pass poop. You might experience straining while pooping or the feeling of not being able to get it all out.

What causes colon strictures?

Colon strictures can arise from various conditions that damage or inflame your colon, leading to a narrowing of the passage. Some common colon stricture causes include:

• Inflammatory bowel disease (IBD): Chronic conditions like Crohn’s disease and ulcerative colitis can cause inflammation and scarring in your colon. Over time, this scarring can narrow the passage.
• Diverticulitis: This condition involves pouches forming in your colon wall. If these pouches inflame (diverticulitis), the swelling and scar tissue can cause strictures.
• Adhesions: Following abdominal surgeries, scar tissue bands (adhesions) can form. These bands have the potential to compress your colon, causing strictures.
• Hernias: When internal organs or tissues push through weak spots in your abdominal wall, they can form hernias. In some cases, these hernias might involve your colon, leading to strictures if they compress your colon.
• Colon cancer: Tumors growing in your colon can obstruct the passage, causing strictures.
• Radiation therapy: If directed at your abdomen, radiation therapy for cancer can damage your colon tissue. This increases the risk of strictures from scarring.

What are the complications of colon strictures?

Colon strictures can lead to various complications if left untreated, including:

• Bowel obstruction: This is a serious complication where the stricture completely blocks the passage of waste material.
• Increased risk of infection: Poop backed up behind the stricture can create a breeding ground for bacteria, raising the risk of infections in your colon.
• Malnutrition: If a stricture causes chronic (long-term) constipation or a complete blockage, your body may have a hard time absorbing essential nutrients from food.
• Stricture recurrence: Even after treatment, strictures can recur (return). This is especially true if you have IBD or diverticulitis.
• Impaired delivery of medications: Sometimes, strictures can make it harder for your body to absorb medications. This may affect how effective your treatment is.

How is a colon stricture diagnosed?

To make a colon stricture diagnosis, your healthcare provider will start by performing a physical exam. They’ll want to discuss your medical history, including any symptoms or past abdominal surgeries.

During the exam, they’ll touch your abdomen to feel for any tenderness or masses. Your provider can’t diagnose a stricture from a physical exam alone. But the exam can provide clues about possible causes and guide further investigation.

What tests will be done to diagnose a colon stricture?

Several imaging tests can help visualize your colon and identify a stricture, including:

• Colonoscopy: This is often the gold standard for diagnosing colon strictures. During a colonoscopy, your provider can see the stricture using a camera they insert through your rectum. They may also take tissue samples (biopsy) to determine the cause.
• Computed tomography (CT) scan: A CT scan uses X-rays to create detailed, cross-sectional images of your abdomen and pelvis. If your provider suspects a severe stricture, they might start your workup with a CT scan. It can reveal the location and severity of a stricture and might also show surrounding tissues or organs involved.
• Magnetic resonance imaging (MRI): An MRI scan uses strong magnetic fields and radio waves to produce detailed images of your colon and surrounding soft tissues. It can help your provider determine the cause of the stricture and assess the level of inflammation.

How do you fix a colon stricture?

Colon stricture treatment depends on the severity of the stricture, its cause and your overall health.

In mild cases, your healthcare provider may recommend lifestyle changes like dietary modifications. A low-fiber diet can help reduce bulky poop, easing passage through the stricture. Your provider or a registered dietitian can advise you on the most suitable plan for you.

For strictures caused by inflammatory conditions, corticosteroids or immunomodulators can help. They can reduce inflammation and may improve the stricture.

In certain cases, your provider may recommend a minimally invasive procedure, like:

• Endoscopic balloon dilation: This procedure involves inserting a scope with a balloon into your colon. Your provider then inflates the balloon at the site of the stricture to widen the passage. This approach is suitable for short, accessible strictures.
• Stent placement: Your provider might place a stent — a small expandable tube — during a colonoscopy to keep the stricture open.

In more severe cases, your provider might recommend surgery. Options include:

• Strictureplasty: This procedure aims to widen the narrowed segment of the colon without removing any tissue. It’s typically used for short, uncomplicated strictures.
• Resection surgery: If the stricture is severe, lengthy or hard to reach, surgery to remove the affected part of your colon (resection) might be necessary. A surgeon then reconnects the healthy ends of your colon.

What is the outlook (prognosis) for someone with a colon stricture?

The prognosis for someone with a colon stricture generally depends on several factors, including:

• What caused the stricture: Conditions like IBD or diverticulitis that can cause strictures are chronic (lifelong). They require ongoing management. The prognosis for these conditions will influence the stricture prognosis, too.
• How severe it is: Milder strictures are often easier to treat. They have a better prognosis than severe strictures that completely block your colon.
• How you respond to treatment: How well you respond to treatment impacts your outcome.
• If you have complications: If you have complications — like bowel obstruction — the prognosis might be less favorable. But a complete cure is possible.

With proper diagnosis and treatment, many people with colon strictures have good outcomes and a good quality of life.

What can I eat/drink with a colon stricture?

Dietary recommendations for a colon stricture can vary. It depends on how severe the stricture is. Your provider may give you specific instructions. But generally, you’ll want to eat more low-fiber foods and avoid high-fiber foods.

Low-fiber foods are easier to digest and put less strain on the narrowed passage in your colon. Examples of low-fiber foods include:

• White bread, pasta and rice.
• Well-cooked, soft vegetables (avoid raw vegetables and skins).
• Ripe fruits (avoid skins and seeds).
• Skinless, lean meats, poultry and fish.
• Eggs.
• Smoothies and juices (without pulp).
• Soups (creamed, clear or strained).
• Mashed potatoes.
• Well-cooked oatmeal or cream of wheat.
• Yogurt (avoid yogurt with high fiber content).

High-fiber foods can be difficult to digest and bulkier poop can put more pressure on the stricture. Examples to avoid include:

• Raw vegetables and fruits (especially with skins and seeds).
• Whole grains (brown rice, whole-wheat bread).
• Nuts, seeds and beans.
• Corn.
• Cruciferous vegetables (broccoli, cauliflower, cabbage).
• Spicy foods (if they irritate your colon).
• Carbonated drinks (can cause bloating).
• Alcohol (can dehydrate you and worsen constipation).

When should I see my healthcare provider?

If you develop any symptoms of a colon stricture, visit your healthcare provider to see what’s going on. Symptoms include ongoing abdominal pain, constipation and diarrhea. Early diagnosis and treatment are vital for better outcomes. They can help you avoid complications like bowel obstruction.

What questions should I ask my healthcare provider?

Here are some important questions you can ask your healthcare provider about colon strictures:

• What’s the likely cause of my colon stricture?
• Are there any other conditions that could be causing my symptoms?
• What treatment options are available for my specific case?
• What are the chances of successful treatment for my stricture?
• Will I need to make any dietary changes to manage the stricture?
• What’s the long-term outlook for someone with a colon stricture?

A note from Cleveland Clinic

Colon strictures can sound scary. But many people experience good long-term outcomes after successful treatment. Early diagnosis is key. And, with a variety of treatment options available, your provider can create a personalized plan to get you feeling better. There are also steps you can take — like changing the foods you eat — to help manage your symptoms.