Crohns Surgical Treatment Options
Crohn’s disease is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract. While medication and lifestyle changes are often the first-line treatments, surgical intervention may be necessary in certain situations. While surgery can treat complications and improve symptoms it is not a cure.
Surgery is not always considered to be a last resort therapy for medically refractory or complex Crohn’s disease. Recent evidence indicates that earlier surgery could also be a good alternative in terms of effectiveness, quality of life and costs of first line treatments. Surgical management of Crohn’s disease is dependent on the individual’s disease location and severity.
Surgery is typically performed under general anesthesia. A hospital stay of 3-7 days may be necessary. The length of stay will depend on your condition, and whether it is an open or minimally invasive procedure. Full recovery can take four months.
- medication therapy fails to control symptoms and inflammation, or they cause significant side effects
- the bowel is obstructed due to strictures, fistulas, inflammation or scar tissue that causes a complete or partial blockage, resulting in symptoms such as severe abdominal pain, bloating, and vomiting. Surgery may be necessary to relieve the obstruction
- bowel abscesses (collections of pus) develop within the intestinal wall or in the surrounding tissues. Surgery may be necessary to drain the abscesses
- a bowel fistula develops (abnormal connections between different parts of the bowel or between the bowel and other organs). Surgical intervention may be required to repair the fistulas
- there is a bowel perforation that causes the bowel rupture. This is a rare complication and may require emergency surgery.
- there is uncontrolled bleeding
- Crohn’s increases the risk of developing colon cancer. When precancerous changes are discovered, surgery may be recommended to remove the affected tissues and prevent the spread of cancer.
- Strictureplasty: This procedure is performed when there are strictures or narrowed segments of the bowel that are obstructing the passage of stool. Instead of removing the narrowed section, the surgeon makes lengthwise incisions along the stricture segment and then sutures them transversely, allowing the bowel to widen.
- Small Bowel Resection: In cases where there is a diseased segment of the bowel that cannot be effectively treated with medication or other conservative measures, a bowel resection may be necessary. The surgeon removes the affected part of the intestine and then reconnects the healthy sections. It may be performed as open surgery or laparoscopic minimally invasive surgery.
- Subtotal colectomy: Also called a partial or segmental colectomy, it is a surgical procedure to remove a portion of the colon, the large intestine. The diseased segment is removed, and the remaining healthy ends of the colon are reconnected. The reconnection is called an anastomosis. The goal is to alleviate symptoms, manage disease progression, and improve quality of life. It may be performed as open surgery or laparoscopic minimally invasive surgery.
- Colectomy: If Crohn’s disease affects the colon extensively, a colectomy may be required. This surgery involves the removal of the entire colon.
- Proctocolectomy: In severe cases of Crohn’s disease that involve both the colon and rectum, a proctocolectomy may be recommended. This procedure involves the removal of both the colon and rectum. A permanent ileostomy may be performed to allow waste to exit the body.
- Abscess Drainage: If an abscess (a localized collection of pus) develops due to Crohn’s disease, it may require drainage. This can be done either through a needle aspiration or by placing a drainage tube.
- Fistula removal: when a fistula develops surgery to open, close remove or drain the fistula may be necessary.
- Ileostomy: An ileostomy is a surgical procedure in which the small intestine, specifically the ileum, is brought to the surface of the abdomen to create a stoma. A stoma is an artificial opening through which waste products from the digestive system can exit the body. During an ileostomy, the surgeon diverts the flow of intestinal contents away from the colon and rectum, and instead, the stool is expelled through the stoma. it may be temporary or permanent. Temporary ileostomy may be used to allow the bowel to heal after surgery or to divert the stool away from an inflamed or diseased area. In such cases, a subsequent surgery may be performed to reverse the ileostomy and restore normal bowel continuity.
Your Rockford Gastroenterology Associates doctor will thoroughly evaluate your specific situation and discuss the potential risks and benefits of surgery in your case. They will consider the severity of your symptoms, the impact on your quality of life, and the potential benefits of surgical intervention when recommending surgery.
