All the Information You Need to Understand Crohn's Disease Operation, Everything You Need to Know About Crohn’s Disease Surgery

 

All the Information You Need to Understand Crohn's Disease Operation,  Everything You Need to Know About Crohn’s Disease Surgery

While Crohn’s disease, a form of inflammatory bowel disease (IBD), can often be controlled by medication, up to 75 percent of people living with the disease will require surgery at some point in their lives, according to the Crohn’s & Colitis Foundation.

There are a few reasons why a person with Crohn’s may need surgical intervention.

“The most common reason is that despite trying different medications to control inflammation, the patient develops worsening disease, such as intestinal blockages, abscesses or fistulous tracts, or a hole in the intestine leading to sepsis,” says Antonia Henry, MD, a colorectal surgeon with University of Michigan Health West in Wyoming, Michigan.

Surgery may also be necessary to remove cancerous or precancerous lesions in the intestines.

Types of Surgery for Crohn’s Disease

Crohn’s disease can affect the entire gastrointestinal tract, and there are different surgeries to treat each area.

Each procedure is tailored to the “extent and behavior of the patient’s disease,” says David Row, MD, the chief of colorectal surgery at Loma Linda University Hospital in California.

“When talking about extent, Crohn’s can involve the small intestine only, both the small and large intestine, and only the large intestine,” he says. “Crohn’s can also behave as inflammatory only, stricturing (causing narrowing of the intestine), or fistulizing (creating abnormal connections with other portions of the intestine) disease.”

Below are the different types of surgery for Crohn’s disease and what they entail.

Bowel Resection

A bowel resection is a procedure in which a surgeon removes the diseased part of the small or large intestine and stitches the healthy portions together.

This type of surgery may be recommended to treat strictures, or the narrowing of the intestines caused by scarring from inflammation. If left untreated, this scarring can lead to blockages that prevent waste from moving through the intestines.

Stricturoplasty

A stricturoplasty is another type of procedure to treat strictures. It involves widening the narrowed part of the intestine without removing any part of the organ.

Proctocolectomy and Colectomy

If the large intestine — made up of the colon and rectum — becomes extensively diseased from Crohn’s, all or part of it may need to be removed. In a proctocolectomy, the colon and rectum are removed, while in a colectomy, only the colon is removed.

With a proctocolectomy, surgeons invert the end of the small intestine through a small opening in the abdomen (called a stoma) through which waste can flow into an ostomy bag.

For individuals who undergo a colectomy, the lower part of the small intestine is surgically connected to the rectum, allowing waste to pass through the anus normally.

Fistula Removal

A fistula is an abnormal connection between the intestines and another organ, such as the skin around the anus. Fistulas occur as the result of sores or ulcers that develop on the intestinal wall because of inflammation from Crohn’s. Fistulas may lead to open skin abscesses that drain liquid, pus, or stool.

Fistulas that don’t heal with medications will need surgery to drain and close them.