Surgeries
Surgery for Crohn’s disease
Medication is always the first option in trying to control the disease, but close to three fourths of
Crohn’s patients will have to undergo surgery to manage their illness. Surgery may occur for
serious complications, disease that won’t respond to medications or treatments, or as a last option
for patients who symptoms won’t go into remission. Generally, surgeons will try and maintain as
much bowel as possible for future nutrient absorption. Surgery can increase the quality of life in
patients who have not responded to conventional therapy.
Crohn’s Disease complications that may require surgery are:
Crohn’s can not be cured with surgery, unlike Ulcerative Colitis. Even when the diseased portion of
intestine is removed, the disease can reappear right at the resected area immediately or within
years. Typically these types of surgeries are done laparoscopic or with an incision from the belly
button down to the pelvic area. Most Crohn’s surgeries are called resections, when the small or
large intestine is cut to take out the diseased portion and resected back together. When strictures
(narrowed bowel) occur in the small intestine from active disease, strictureplasty may also be an
option. When strictureplasty is performed, the surgeon can use different techniques to try and
open up the narrowed sections with balloons or incisions.
In more drastic cases, when the colon is extremely diseased, a colectomy may be performed to
remove the entire colon and it can be tied back into the small intestine for normal bowel function.
Some patients may need to get the colon and rectum removed, which is a proctocolectomy that is
performed with an ilieostomy, which is bringing the small intestine through an abdominal hole and
the waste is collected in a bag on your belt line and changed several times daily.
Unfortunately, about fifty percent of patients who have experienced a resection will have disease
reoccurrence within five years and half of those patients with recurrent disease will need another
surgery. Taking out the ileocecal valve is not always without consequence, and can lead to chronic
diarrhea. It is important to weigh out the consequences with the benefits, and to make sure overall
health and nutrition is as good as it can be prior to a procedure. Recovery from a surgery can vary
from each procedure and depends on the patients prior health. Surgery can be an excellent way
to provide patients with a better quality of life but isn't the first line of treatment in most cases.
Medication is always the first option in trying to control the disease, but close to three fourths of
Crohn’s patients will have to undergo surgery to manage their illness. Surgery may occur for
serious complications, disease that won’t respond to medications or treatments, or as a last option
for patients who symptoms won’t go into remission. Generally, surgeons will try and maintain as
much bowel as possible for future nutrient absorption. Surgery can increase the quality of life in
patients who have not responded to conventional therapy.
Crohn’s Disease complications that may require surgery are:
- Intestinal Blockage or Obstruction due to inflammation or scar tissue
- Excessive Bleeding in the intestines
- Bowel Perforation
- Formation of an abscess or Fistula
- Toxic Mega colon (dangerous condition of an enlarged bowel that isn’t functioning)
Crohn’s can not be cured with surgery, unlike Ulcerative Colitis. Even when the diseased portion of
intestine is removed, the disease can reappear right at the resected area immediately or within
years. Typically these types of surgeries are done laparoscopic or with an incision from the belly
button down to the pelvic area. Most Crohn’s surgeries are called resections, when the small or
large intestine is cut to take out the diseased portion and resected back together. When strictures
(narrowed bowel) occur in the small intestine from active disease, strictureplasty may also be an
option. When strictureplasty is performed, the surgeon can use different techniques to try and
open up the narrowed sections with balloons or incisions.
In more drastic cases, when the colon is extremely diseased, a colectomy may be performed to
remove the entire colon and it can be tied back into the small intestine for normal bowel function.
Some patients may need to get the colon and rectum removed, which is a proctocolectomy that is
performed with an ilieostomy, which is bringing the small intestine through an abdominal hole and
the waste is collected in a bag on your belt line and changed several times daily.
Unfortunately, about fifty percent of patients who have experienced a resection will have disease
reoccurrence within five years and half of those patients with recurrent disease will need another
surgery. Taking out the ileocecal valve is not always without consequence, and can lead to chronic
diarrhea. It is important to weigh out the consequences with the benefits, and to make sure overall
health and nutrition is as good as it can be prior to a procedure. Recovery from a surgery can vary
from each procedure and depends on the patients prior health. Surgery can be an excellent way
to provide patients with a better quality of life but isn't the first line of treatment in most cases.
Surgery For Ulcerative Colitis
Medication is always the first option in trying to control the disease, but as many as 40 percent of
Ulcerative Colitis patients will have to undergo surgery to manage the illness. Surgery may occur
for serious complications, disease that won’t respond to medications or treatments, or as a last
option for patients who symptoms won’t go into remission. Surgery can increase the quality of life
in patients who have not responded to conventional therapy.
Ulcerative Colitis complications that may require surgery are:
Removal of the colon and rectum (proctocolectomy) is the standard surgery for Ulcerative Colitis
patients. A proctocolectomy can be performed with an ileostomy, where the small intestine is
connected to the outside of the abdomen through a hole, into a bag that collects waste and is
changed daily. A Restorative Proctocolectomy (a.k.a. J-pouch) can also be performed, with
two operations, the first to connect the small intestine like a pouch into the anus with a temporary
ileostomy. The second operation removes the ileostomy and the patient passes bowel movements
through the anus. The average amount of bowel movements after the operation is six times per
day.
Some complications can occur after a proctocolectomy, and they can include pouchitis, which is an
inflammation of the pouch area, and can include diarrhea, pain, fever, joint inflammation and
dehydration. This condition is normally treated with antibiotics. Bowel obstruction can occur,
although it is rare and may require surgery or bowel rest. Approximately eight to ten percent of
patients could have pouch failure and would have to return to a permanent ileostomy. There are
a lot of support groups for ileostomy patients and restorative proctocolectomy patients which may
help with the transition after the operation.
Ulcerative Colitis can be cured by a proctocolectomy, unlike Crohn's Disease, which is not
curable.
Medication is always the first option in trying to control the disease, but as many as 40 percent of
Ulcerative Colitis patients will have to undergo surgery to manage the illness. Surgery may occur
for serious complications, disease that won’t respond to medications or treatments, or as a last
option for patients who symptoms won’t go into remission. Surgery can increase the quality of life
in patients who have not responded to conventional therapy.
Ulcerative Colitis complications that may require surgery are:
- Excessive Bleeding in the colon
- Bowel Perforation in the colon
- Terrible and sever flare of the disease
- Toxic Mega colon (dangerous condition of an enlarged bowel that isn’t functioning)
Removal of the colon and rectum (proctocolectomy) is the standard surgery for Ulcerative Colitis
patients. A proctocolectomy can be performed with an ileostomy, where the small intestine is
connected to the outside of the abdomen through a hole, into a bag that collects waste and is
changed daily. A Restorative Proctocolectomy (a.k.a. J-pouch) can also be performed, with
two operations, the first to connect the small intestine like a pouch into the anus with a temporary
ileostomy. The second operation removes the ileostomy and the patient passes bowel movements
through the anus. The average amount of bowel movements after the operation is six times per
day.
Some complications can occur after a proctocolectomy, and they can include pouchitis, which is an
inflammation of the pouch area, and can include diarrhea, pain, fever, joint inflammation and
dehydration. This condition is normally treated with antibiotics. Bowel obstruction can occur,
although it is rare and may require surgery or bowel rest. Approximately eight to ten percent of
patients could have pouch failure and would have to return to a permanent ileostomy. There are
a lot of support groups for ileostomy patients and restorative proctocolectomy patients which may
help with the transition after the operation.
Ulcerative Colitis can be cured by a proctocolectomy, unlike Crohn's Disease, which is not
curable.
| Last Updated 2/24/07 |
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