autoimmune disease blog

About two-thirds to three-quarters of people with Crohn’s will eventually undergo surgery as part of the therapeutic management of their illness. Surgery may be needed for serious complications or if the disease doesn’t respond to medication or as a last resort to relieve symptoms that cannot be brought under control.

The primary goals of surgery are to alleviate complications, achieve the best possible quality of life, and conserve as much bowel as possible. It can often make the difference between severe pain/steroid-dependence and the possibility of living a healthy and productive life.

Crohn’s disease surgery may be needed when someone has:

• Bowel blockage.
• Abscesses or tears in the anal area or when abnormal connections form between two parts of the intestine or between the intestine and other internal organs.
• Perforations in the large intestine.
• Severe disease that does not respond to other treatment.
• Severe bleeding that requires ongoing blood transfusions.

Four types of crohn’s disease surgery

Correcting Fistulas – Fistulas that connect the intestine to another internal organ, such as the bladder, must be surgically closed in order to keep intestinal contents from draining into the organ and causing infection.

Partial Bowel Resection - Resection is usually performed when a portion of intestine has been so damaged by disease that a permanent partial obstruction has formed. The most common areas removed are the terminal ileum, the ileocecal valve, and a small portion of the large intestine.

Usually, the surgeon will attach the healthy ends of intestine together during the procedure. Sometimes, however, there is mild inflammation throughout the intestine, preventing such reattachment. In these cases, a temporary ostomy is created. The ostomy allows intestinal contents to drain directly out of the body into a collecting bag through the abdominal wall. The ostomy is usually closed and the bowel reattached six to eight weeks after the initial surgery.

Strictureplasty – Strictureplasty is a procedure that opens up small strictures. An incision is made down the length of stricture. The incision is pulled together and sewn across the stricture, shortening the intestine slightly but widening the formerly narrowed area.

Draining Abscesses – When an abscess does not respond to medical treatment, it must be drained to promote healing. Needle aspiration is the most common method. A hollow needle is inserted through the skin and into the abscess then used to withdraw the infectious material. In another method, a surgeon exposes the abscess surgically, removes the infectious material, and places a wick to promote drainage and healing from the inside.