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Surgery for Crohn’s Disease

What are the pros and cons of Crohn's disease surgery? Here is information you need about the types of surgery for Crohn's disease, when they might be used, and possible complications. Use this information when you want to talk to your doctor about your options so you can make an informed decision about treating Crohn's disease.

WebMD Health Check: Coping With Crohn’s Disease

What is Crohn's disease?

Crohn's disease is a chronic illness in which the intestine, or bowel, becomes inflamed and marked with sores, or ulcerated. Along with ulcerative colitis, Crohn's disease is part of a group of diseases known as inflammatory bowel disease (IBD).

Crohn's disease most commonly affects the lower part of the small intestine known as the ileum. It can, though, occur in any part of the large or small intestine, stomach, esophagus, or even the mouth. It can occur at any age, but it's most common between the ages of 15 and 30.

What are the symptoms of Crohn's disease?

People with Crohn's disease experience periods of severe symptoms. These are followed by periods with no symptoms when the disease is in remission. With Crohn's disease, remission can last for weeks or even years. Unfortunately, there is no way to determine when a remission will occur or when symptoms will return.

The symptoms of Crohn's disease depend on where the disease occurs in the bowel. They also depend on how severe the disease is. In general, symptoms can include:

abdominal pain and tenderness -- often in the lower, right section of the abdomen
bloody stools
chronic (long-term) diarrhea
delayed development and stunted growth in children
feeling of fullness in the abdomen, particularly in the lower, right section
fever
weight loss

How is Crohn's disease treated?

There is no cure for Crohn's disease. Treatment is determined by the severity and location of the disease. Because the disease can sometimes go into remission on its own, it's not always possible to determine whether a specific treatment has been effective.

When Crohn's disease is active, treatment has three objectives:

relieve symptoms
control inflammation
help the person get proper nutrition

Medications are generally the first step in treating Crohn's disease. A partial list of these medications includes:

anti-inflammatories
antibiotics
corticosteroids
antidiarrheals
anti-TNF blockers
immune-suppressing medications

For patients who have nutrition problems, supplements are often prescribed.

Two-thirds to three-quarters of people with Crohn's disease will eventually need surgery to treat their illness. There are several reasons why surgery might be needed:

The medications are not working to control symptoms or do not work effectively enough.
The side effects of medications are unbearable.
The person has serious complications that only surgery can correct.

What are the complications of Crohn's disease that might require surgery?

Patients who have the following complications of Crohn's may need surgery:

an obstruction or blockage in the bowel
the formation of a stricture, which is a narrowing in the bowel that can cause blockages
extensive bleeding in the intestine
a hole, or perforation, in the bowel wall
the formation of a fistula, which is a connection between two parts of the body that do not normally connect
the formation of an abscess, which is a pocket of pus caused by infection
a condition known as toxic megacolon, in which the colon, or large intestine, is severely stretched out and toxins spread through the blood.