Surgery for Crohn's disease may be done if:
- No medicine can control your symptoms.
- You have serious side effects from medicines.
- Your symptoms can only be controlled with long-term use of corticosteroids.
- You have complications.
Surgery is rarely done, and it's not a cure. When surgery for Crohn's is needed, as little of the intestine as possible is removed to keep the intestines working normally. The disease tends to return to other areas of the intestines after surgery.
Surgery may improve a child's well-being and quality of life and restore normal growth and sexual development.
Types of surgery
- Bowel ResectionBowel Resection . The diseased portion of the intestine is removed, and the healthy ends of the intestine are reattached.
- 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 ileostomyProctocolectomy 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 belly. The ileum is connected to the stoma, creating an opening to the outside of the body. Stool empties from this opening into a small plastic pouch called an ostomy bag that is applied to the skin around the stoma.
- Intestinal transplantIntestinal transplant . This is rarely used for 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 her organs.
What to think about
It may take time to adjust to living with an ostomy. It may help to know that most people are able to adapt and resume all of their usual activities. Talk with your doctor about support groups in your area for people with ostomies.