Is Surgery an Option for Crohn's?
Surgery is one step in the treatment program for patients who have Crohn’s disease. In fact, approximately 70 percent of Crohn’s patients will eventually need surgery. Surgery often initiates remission, providing relief from symptoms, and improves quality of life.
What to Expect
If your symptoms persist and you no longer respond to medication (or you have a complication, such as a blockage, perforation, abscess or bleeding in your intestine), your physician may recommend surgery.
There are several common surgical procedures for Crohn’s disease. Your surgeon may opt to remove only the damaged portion of your intestine. Once the diseased part of the colon is removed, he or she will reconnect the ends. This is called resectional surgery. Another common surgical procedure is strictureplasty. With strictureplasty, your surgeon widens a segment of the intestine that has narrowed due to disease. Strictureplasty has gained support as an alternative to resectional surgery for some patients, although sometimes the two procedures are used together.
If you have significant colon damage, you may need a colectomy to remove the entire colon. Then your surgeon will make a small opening in your abdomen that will allow waste to pass out of your body. This opening is called a stoma. Colectomy patients wear a pouch under their clothes to collect waste, which they empty as needed. Although a colectomy may sound daunting, most patients go on to live normal lives after surgery.
Surgery…Not a Permanent Solution
Crohn’s is a chronic disease; so surgery does not cure it. Many patients require one or more additional surgeries. According to the American College of Gastroenterology, approximately 70 to 80 percent of Crohn’s patients will require surgery again within 10 to 15 years.
Researchers are studying why Crohn’s disease returns after surgery. They call this phenomenon post-operative recurrence, or POR. The medical community does not have all the answers yet; however, researchers do believe that environmental factors and genetics play a role. They have identified one factor that is consistently associated with higher risk: smoking. In fact, smoking cessation programs are one of the more beneficial therapeutic measures for preventing POR in Crohn’s.
Discuss these surgery options with your physician. Learn as much as you can about each procedure. Armed with knowledge, you can feel confident about making the right decision when the time comes. Your surgeon will determine when to perform surgery so you will have the best improvement in symptoms and quality of life.
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