When is surgery an option for Crohn’s disease?

August 3, 2019 By ashwin

When is surgery an option for Crohn’s disease?

Crohn’s disease is an inflammatory bowel disease that damages the small and large intestines. A doctor may recommend Crohn’s disease surgery for a person with severe symptoms if other treatments are not helping.

Surgery does not cure Crohn’s disease, but it can reduce complications associated with the disease.

According to the United States’ National Institute of Diabetes and Digestive and Kidney Diseases, an estimated 60 percent of people with Crohn’s disease have surgery within 20 years of their diagnosis.

When is surgery an option for Crohn’s disease?

Doctors may recommend surgery in severe cases of Crohn’s disease.

Doctors typically prescribe medications and recommend dietary changes to help keep Crohn’s disease flare-ups and symptoms to a minimum.

However, a person can still experience inflammation and other complications, especially if the disease is severe.

Surgery is invasive, so doctors will not usually recommend it unless absolutely necessary. Examples of these instances include if a person has:

  • an abscess or pocket of infection
  • a fistula
  • intestinal bleeding
  • intestinal obstructions
  • irreversible intestinal damage
  • symptoms not reduced by other treatments

Doctors may also use surgery in emergency situations, such as a bowel obstruction. Researchers in one study estimate that 6 to 16 percent of people with Crohn’s who present with acute symptoms require surgery.

Small bowel resection

Small bowel resection surgery

This surgery removes a portion of the small intestine because of an obstruction or severe damage from Crohn’s disease.

A doctor may be able to perform the surgery laparoscopically, meaning they will make a few tiny incisions and insert instruments that enable them to see the small intestine and remove the affected portion. At other times, a doctor may need to make a larger incision known as open surgery.

Subtotal colectomy

types of colectomy

Subtotal colectomy is a surgery to remove all or a portion of the large intestine, also known as the colon.

Similarly to a small bowel resection, doctors may perform this surgery laparoscopically or via an open surgery method.

Stricturoplasty

diagram of strictureplasty surgery

This surgical procedure involves widening the small intestine to reduce narrow areas where it is difficult to pass stool.

However, the strictures, or narrow areas, must be limited to a small portion of the bowel to avoid removing a portion of the small intestine.

Proctocolectomy and ileostomy

This surgery involves removing the entire colon and rectum. A surgeon will also bring a portion of the small intestine known as the ileum through an opening in the abdomen. This is known as an ileostomy.

A person will wear a plastic pouch over the opening known as an ostomy. They will need to change the bag frequently, as it collects stool throughout the day.

A doctor will try to preserve as much of the bowel as possible, which will aid the digestive function.

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