Crohn’s disease is a type of chronic inflammatory bowel disease (IBD) with no known cause or cure. Since medication can only help keep the condition under control, if it fails, then surgery to remove the diseased part of the colon remains the only available option. Nearly 75 percent of affected patients will eventually need surgery.
Though surgery does not cure Crohn’s disease, it can improve your quality of life. You can expect less pain and milder symptoms, such as decreased diarrhea and vomiting. You might even be able to tolerate more kinds of foods and gain weight fast.
When do you need surgery for Crohn’s disease?
You may need emergency surgery for Crohn’s disease if you develop the following complications. Or, in some cases, you may choose to opt for elective surgery.
Emergency surgery for Crohn’s disease
The complications of Crohn’s disease for which surgery is necessary are:
- Intestinal obstruction or blockage
- Excessive bleeding in the intestine
- Perforation (hole) of the bowel
- Fistula (abnormal connections) between the intestine and another organ, such as the bladder or vagina, or break through the skin surface
- An abscess (a collection of pus in the abdomen, pelvis, or around the anal area)
- Toxic megacolon (severe infection and widening of the colon)
Elective Crohn’s surgery
Elective Crohn’s surgery is a planned surgery for Crohn’s disease, which may be done for any of the following conditions:
- If your quality of life has been severely affected despite medical treatment.
- If you experience significant side effects from the medications.
- If medications are no longer working.
- If doctors recommend surgery to reduce your risk of developing colorectal cancer.
What are the types of surgeries done for Crohn’s disease?
Your doctor may plan surgery for your Crohn’s disease depending on the severity of the disease and the part of the colon affected. The most common surgeries include:
- Strictureplasty (widening of the narrowed areas of the intestine to avoid blockages)
- Fistula removal (closing, opening, removing, or draining of the fistula)
- Colectomy (removal of all or a part of the colon but sparing the rectum)
- Proctocolectomy (removal of the colon and rectum)
- End ileostomy (rerouting of the end of the small intestine through a small hole in the abdomen that drains the waste in a bag placed outside the body)
- Bowel resection (removal of the damaged part of the small or large intestine and connecting the two healthy ends)
- Abscess drainage
Can Crohn's disease come back after surgery?
Crohn’s disease can return after surgery, which may result in additional surgeries. According to studies, about half of those who have an ileocolonic resection will need a repeat operation within 10 years.
However, here is some good news. You can lower the risk for another surgery by:
- Quitting smoking
- Taking the medications as prescribed by your doctor
If your doctor recommends surgery, do not delay. After your surgery, make sure to follow the proper medical treatment prescribed by your doctor to minimize further complications. With the appropriate care from both a colorectal surgeon and a gastroenterologist, you can expect to live a much better life than before.
Ghazi LJ. Crohn Disease. Medscape. https://emedicine.medscape.com/article/172940-overview
Crohn's and Colitis UK. Surgery for Crohn’s Disease. https://www.crohnsandcolitis.org.uk/about-crohns-and-colitis/publications/surgery-for-crohns-disease#
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