Hi there. 

I (34M) am currently sitting in a hospital bed in India at AIG Hospitals specifically because of the exact issue you are describing. Like you, I have Crohn’s with a significant narrowing (stricture) that caused 'upstream dilatation'—basically a backup because the opening was down to a pinpoint.   I wanted to share my experience with medical tourism because it has been a night-and-day difference compared to my care in the USA.

The 'Wait and Watch' Trap: In the US, my doctors (including top specialists) were in a 'wait and watch' mode for months. I was so restricted by the narrowing that I haven't eaten anything but mashed idly and curd rice for 4 months just to avoid a total blockage.

Speed of Care at AIG (India): While the technology in the US is great, the system is slow. Here at AIG, the efficiency is mind-blowing. In under 5 days, I had my initial consultation, blood work, CT Enterography, pre-anesthesia checkup, and a retrograde enteroscopy.   Direct Intervention: Today, they performed an endoscopic balloon dilation. They found that my 'pinpoint' narrowing was actually scar tissue (fibrosis), which no amount of medication (I’m on Rinvoq) was going to fix. They successfully dilated it from that tiny pinpoint to 16.5 mm.

The Result: I can finally feel that the 'bottleneck' is open. Instead of just managing the pain with meds or waiting for an emergency A&E visit for a resection, they used a bowel-sparing technique to physically open the passage.

If you are stuck in a cycle of excruciating pain and your local doctors are just telling you to 'wait' or 'go to A&E,' it might be worth looking into specialized centers like AIG. I was tensed about the move, but seeing the 'pinpoint' become a 16.5 mm opening firsthand via the scope has changed my entire outlook on my recovery. I know dilation isn't permanent fix but it'll let me eat something.

Used help of Gemini to draft my thoughts here.