Crohn's Disease - Surgery
Surgery is rarely done for
Crohn's disease and it is not a cure. When surgery is
needed, as little of the intestines as possible is removed to preserve normal
function. The disease tends to return in areas that were previously not
affected, and you may need surgery again.
Surgery may be needed
for Crohn's disease if no medicine can control your symptoms, if you have
serious side effects from medicines, if your symptoms can be controlled only
with long-term use of corticosteroids, or if you develop complications.
Surgery is not usually done for Crohn's disease. If you
do have surgery, it will most likely be one of the following:
- Resection: The diseased portion of the intestines is removed,
and the healthy ends of the intestine are reattached. Resection surgery does
not cure Crohn's disease, which often comes back near the site of
- Strictureplasty: The surgeon makes a lengthwise cut in the
intestine and then sews the opening together in the opposite direction. This
makes the intestine wider and helps with obstruction of the bowels. This is
sometimes done at the same time as resection or when a person has had resection
in the past. Strictureplasty is used when the doctor is trying to save as much
of the intestine as possible.
- Proctocolectomy and ileostomy: The surgeon removes the
large intestine and rectum , leaving the lower end of the small intestine (the
ileum). The anus is sewn closed, and a small opening called a stoma is made in
the skin of the lower abdomen. The ileum is connected to the stoma, creating an
opening to the outside of the body, where stool empties into a small plastic
pouch called an ostomy bag that is applied to the skin around the stoma.
- Bowel Disease: Caring for Your Ostomy
Another procedure that may be done is balloon dilation.
This is not a surgery. The doctor runs an
endoscope through your intestines from your anus. The
endoscope is a long, thin tube that has a video camera on the end. Next, the
doctor uses the endoscope to thread an uninflated balloon across the stricture
(the narrowed part of the intestine). When the balloon is inflated, it makes
that part of the intestine wider. The balloon is deflated and then removed.
Balloon dilation is a new technique and not as much is known about its
long-term success compared to the surgical procedures listed above. Balloon
dilation might be done if you want to put off a more complicated surgery for a
while or if you have had surgery before and the doctor wants to save as much of
the intestines as possible.
What To Think About
These surgeries can be done on
children. Surgery can improve a child's well-being and quality of life and
restore normal growth and sexual development.
In rare cases,
intestinal transplant is used to treat Crohn's
disease. In this complex procedure, the small intestine is removed and replaced
with the small intestine of a person who has recently died and donated his or