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Surgery for Crohn’s Disease

By Elizabeth Shimer Bowers
WebMD Feature

Surgery for Crohn's disease can change your life.

"Surgery gets rid of the diseased bowel," says surgeon Jon Vogel, MD, of the Cleveland Clinic. It can help you eat and drink without pain. You may also be able to stop taking Crohn's drugs, at least for a while. Almost 3 out of 4 people with Crohn's get surgery at some point.

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There are also things surgery can't do.

"Surgery doesn't cure Crohn's disease," says Mark Talamini, MD, chairman of surgery at the University of California at San Diego. And your symptoms will likely come back at some point. Half of people who have one surgery need at least one more.

Who Should Have Crohn's Surgery?

You are most likely to need surgery because part of your bowel becomes blocked. "Segments of bowel in Crohn's disease go through cycles of inflammation and repair," Talamini says. "Over time, these pieces of bowel become hard, like a lead pipe. People with obstructions may experience vomiting, distention, and abdominal pain when they eat." If the blockage worsens quickly, you will likely need emergency surgery.

You may also get surgery if you have:

  • A fistula – a tunnel that forms in your intestine or between your intestine and another organ, like your bladder
  • Bleeding in your gut
  • A hole in your bowel
  • An abscess -- a cavity of pus that can form near your anal area or elsewhere

 

Types of Crohn's Surgery

Surgeries for Crohn's include:

Bowel resection. This removes a diseased part of your intestine or corrects a fistula that doesn't respond to drugs.

Stricturoplasty. This common surgery opens up narrowed areas of the small intestine. Though it doesn't remove any intestine, you may also need a bowel resection.

Colectomy. If your Crohn's is severe and affects your colon, it may need to be removed. In some cases, the surgeon can connect the small intestine to your rectum, so you can still pass stools in a normal way.

Proctocolectomy. Sometimes both the colon and rectum need to be removed. The surgeon also brings the end of your small intestine through a hole in your belly, called a stoma. Waste passes through it into a bag, which you will need to wear and empty throughout the day. The bag is hidden under clothing, so no one sees it.

Your surgeon will aim to do as little as needed for the best results. "People with Crohn's disease tend to need multiple operations; therefore, we preserve as much bowel as we can each time," Talamini says.

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