If you have Crohn's disease, you probably know that your symptoms can be largely controlled with medication and some dietary changes. However, about 80% of people with the disease will eventually need surgery. So, the type of surgery you need will depend on your symptoms.
When is surgery necessary for Crohn's disease?
Your doctor may recommend surgery for Crohn's disease if you develop complications or if nonsurgical treatments are not very effective.
The main reasons for surgery for Crohn's disease are:
- Intestinal strictures: This is a narrowing of your intestines. This is the main reason why many people with Crohn's disease have surgery.
- Fistulas and abdominal abscesses: Fistulas are abnormal openings between two parts of the body. Abscesses are collections of pus that form inside the abdomen.
- Recurrent disease: This means that symptoms return after previous treatment.
There are other reasons that are less common, but may require surgery:
- Gastrointestinal (GI) bleeding.
- Intestinal perforations.
- Peritonitis: This is an inflammation of the membrane that lines the inside of your abdomen.
- Cancerous or precancerous lesions. Because Crohn's disease is a risk factor for developing colorectal cancer.
- Toxic megacolon: This is when the structure of your colon breaks down due to inflammation.
Crohn's disease can be a real pain. Sometimes symptoms flare up and then subside for no apparent reason. The uncertainty can be overwhelming at times. However, while surgery cannot completely cure Crohn's disease, it can help reduce your uncomfortable symptoms and allow you to continue doing the things you love.
What types of surgeries are performed for Crohn's disease?
There are several main types of surgery for Crohn's disease. Let's take a look at what they are.
Abscess drainage
This is done to remove pus that has formed due to an infection inside the abdomen.
Bowel resection
This surgery involves removing part of your small intestine or colon. You may be asked to do this surgery if you have a lot of scar tissue in your intestines, or if your doctor sees cancerous or precancerous cells.
Fistula removal/repair
A fistula is an abnormal opening between two parts of the body. This can cause problems. So, this surgery involves removing or repairing the opening.
Ostomy surgery
This surgery creates a hole (stoma) in your stomach. This means that instead of your poop coming out through the anus, a new path is created for it to come out through the hole (stoma). The most common ostomy surgeries are colostomy and ileostomy.
Proctocolectomy
This Crohn's disease surgery removes part or all of your colon and rectum.
Strictureplasty
This surgery is done to widen areas that have become narrowed and strictured due to scarring, allowing stool to pass more easily.
How long does Crohn's surgery take?
It really depends on the type of surgery you have, the severity of your condition, and the parts of your digestive system that are affected. Your doctor will tell you what to expect based on your condition.
What are the benefits of surgery for Crohn's disease?
In most cases, Crohn's disease surgery can be done laparoscopically or robotically. This means you have fewer incisions, fewer stitches, and less pain after the operation.
In addition, Crohn's disease surgery may result in:
- Reduction in gastrointestinal pain.
- Reduction of symptoms. (Common symptoms of Crohn's disease are fatigue, diarrhea, and vomiting.)
- Reduced need for medication.
- Increased appetite.
- Increased physical strength.
- Being able to go out and work again.
- Improving quality of life.
But one thing to remember: Surgery for Crohn's disease does not guarantee that symptoms will not return. About 20% of people who have surgery may need another surgery within five years of their first surgery.
Are there risks to Crohn's surgery?
As with any surgery, surgery for Crohn's disease carries some risks. Possible complications include:
- Anastomotic leak (This can happen if two parts of your intestine don't connect together properly.)
- Bacterial infections.
- Bowel obstruction.
- Excessive bleeding.
- Problems with your stoma (for example, your ostomy bag not fitting properly).
- Scarring. This can cause your intestinal walls to narrow.
- Vitamin B12 deficiency. (This can happen if your surgeon has to remove part of your intestine to absorb vitamin B12.)
If you have any complications after surgery for Crohn's disease, your doctor will help you develop a plan for treatment. This may include medication, nonsurgical treatments, or even another surgery.
How long does it take to recover after Crohn's disease surgery?
It can take about four to twelve (4-12) weeks to fully recover. Most people are able to return to work in about six weeks.
The time it takes for you to recover depends on several other factors. These are:
- The type of surgery you had.
- How many surgeries have you had before?
- How much of your intestine had to be removed.
- Your body's ability to heal wounds.
- your age.
- Other medical conditions you already have.
Your doctor is always there to help you. If you have any specific questions about your treatment or recovery time, talk to them.
How long will I have to stay in the hospital?
Most people who have surgery for Crohn's disease stay in the hospital for about a week. (Some go earlier, some stay longer.)
After your surgery, your medical team will do the following:
- Monitor how your wounds heal.
- If you are suddenly unable to eat or drink, you will be given saline (IV fluids) through a vein in your arm.
- At the appropriate time, you will be started on a clear liquid diet.
- When you are ready, you will be transitioned to a soft food diet.
If you have had an ostomy, a doctor or nurse will show you how to use and clean your new ostomy bag. They will make sure you are comfortable with it before you leave the hospital.
Can Crohn's disease be cured with surgery?
No, surgery cannot completely cure Crohn's disease. Even after surgery, your symptoms may return.
However, treatment can control or reduce your symptoms. In many cases, it can significantly improve your quality of life.
Your doctor will work with you every step of the way. Whenever your symptoms worsen, they will discuss treatment options with you and create a plan that works for you.
If surgery can't cure Crohn's disease, why should I have surgery?
If you have Crohn's disease, you may be wondering about these questions. The risks of not having surgery vary depending on your condition. However, if Crohn's disease is left untreated, it can lead to:
- Abdominal pain.
- Loss of appetite and unexplained weight loss.
- Anemia.
- Poor quality of life.
- Worsening symptoms.
- Precancerous or cancerous changes to your bowel.
- An increased risk of medication side effects.
- Having to perform emergency surgery.
Some people don't need surgery at all for Crohn's disease. In fact, fewer people need surgery now than they did two decades ago. This may be because of new, improved medications and tests that help detect the disease earlier.
Currently, about 1 in 5 people will need surgery within the first five years after diagnosis. Only your doctor can tell you what is right for you.
When do I need to see the doctor after the surgery?
After surgery for Crohn's disease, you should talk to your doctor if any of the following happens:
- If you don't have a bowel movement for a few days after leaving the hospital.
- If you experience nausea and vomiting.
- If the pain is getting worse.
- If you see blood in your stool or black, tarry stools.
- If you develop symptoms of a blood clot (for example, pain or swelling in the legs).
If you have had an ostomy, tell your doctor if you have not had a bowel movement from your stoma for more than 24 hours. This could mean you have a blockage.
You may have just been diagnosed with Crohn's disease. Or you may have been dealing with it for years. However, the thought of surgery can be daunting - especially if you've been down this road before. Talking to others who have the same condition as you can help you. Consider finding a support group, either locally or online, and sharing your experiences with the millions of people who live with Crohn's disease every day.
So, what are the things we should remember from this story?
Surgery for Crohn's disease cannot completely cure your condition. However, it can often reduce symptoms such as pain, nausea, and fatigue, and improve your quality of life. Your doctor will help you decide what is best for your condition. Don't be afraid to talk to your doctor about any questions you have.
` Crohn's disease, stomach surgery, intestinal surgery, Crohn's Disease, digestive system, surgery, Crohn's symptoms
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