Communication: Key to Your Crohn's Treatment
To help ensure that your treatment works effectively, it’s very important to take all medications as directed by your doctor. You should never stop taking a medication without consulting your doctor as it could cause symptoms to return.
Because some drugs may cause more serious side effects, your doctor may monitor you as you undergo treatment. So be sure you go to all follow-up doctor appointments and have all recommended laboratory tests.
If you have any questions about your treatment options or concerns about side effects, be sure to discuss these with your doctor. “A patient and physician have to weigh the risks and benefits of each treatment together based on the patient’s comfort level and the doctor’s expertise and experience,” says Edward Loftus, MD, professor of medicine at the Mayo Clinic in Rochester, Minn.
Surgery for Crohn’s Disease
When serious complications develop, medications alone no longer control Crohn’s disease or no longer work as effectively, your doctor may recommend surgery. It can be an important option for long-term relief of symptoms.
Not everyone with Crohn’s disease will need surgery, but many do. “Sixty to 80 percent of people with Crohn’s will need at least one surgery. Half of those people will need a second surgery. The average is about one to two surgeries in a person’s lifetime,” Loftus says.
In people with Crohn’s disease, surgery is used to:
- Widen a portion of the intestine that has become narrowed, also called a stricture. This procedure is called a strictureplasty.
- Remove a diseased section of the intestine or to treat a fistula. After the section is removed, the two ends of healthy intestine are sewn back together. This is called a resection.
- Remove the entire rectum and colon, or just the colon. If only the colon is removed, called a colectomy, the end of the small intestine is connected to the end of the rectum, which allows the person to have regular bowel movements. If both the colon and rectum are removed, called a proctocolectomy, the end of the small intestine is connected to a hole in the abdomen wall in a procedure called an ileostomy. The hole itself is called a stoma. Waste passes through the stoma and is collected in an external bag, which needs to be emptied throughout the day. Clothing easily hides the bag, so no one can tell that you are wearing one.
- Drain an abscess.
Your doctor will recommend the type of procedure that will effectively treat your symptoms and any complications while preserving as much of your intestine as possible.
It’s important to understand that with Crohn’s disease, surgery cannot cure the disease, even when the inflamed part of the intestine is removed. In fact, about 50 percent of people with Crohn’s disease will see the disease come back to another part of the intestine within 5 years after surgery. However, having surgery can help relieve symptoms for years once medications are no longer effective.
Taking immunomodulators or aminosalicylates after surgery may help reduce the chance of the disease recurring. If the disease does return, it can often be treated with medication.