Medication is the first treatment option for Crohn's disease. However, if the disease isn't responding to medication or if you experience a severe flare-up that can’t be controlled, your doctor may recommend surgery. Here’s some info about the major types of Crohn’s surgery and some considerations for after surgery.
Strictureplasty
A stricture occurs when parts of a diseased bowel begin to narrow and block food that’s passing through during digestion. A strictureplasty may be performed to widen the narrowed area, leaving the small intestine intact.
Resection
A resection may be needed if a stricture becomes too long or multiple strictures form close together. In a resection, the surgeon removes the strictured section of the intestine. He or she then joins the healthy parts of the intestine together, in a procedure known as an anastomosis.
Proctocolectomy
This procedure involves the removal of both the colon and the rectum and is performed with another procedure called an ileostomy. Afterwards the patient will need to wear an external bag for waste to empty into. The bag can be hidden under normal clothing with minimal adjustments.
Surgery for abscesses and fistulas
An abscess is a mass that’s filled with pus from an infection. Abscesses need to be drained, which may be done by piercing the mass with a needle through the skin, guided with the help of computed tomography. In other cases, it may be drained surgically, or a resection may be performed.
A fistula is a tunnel that connects an abscess to a hollow organ (like the intestines) or that connects the intestine to another part of itself or to a different organ. If a fistula is causing symptoms and not responding to drugs, a resection may be required.
Special considerations for surgery
Unfortunately, about half of adult patients who have a resection will experience the symptoms of Crohn's disease again within 5 years. It tends to recur where the anastomosis or ileostomy was performed. However, with the help of your doctor, you can reduce the chances of recurrence by taking medication, such as 5-ASA agents and immunomodulators.
See also: Crohn's treatment options, Doctors and insurance, Stories from people with Crohn's
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