Crohn’s disease is one of the diseases that boil down to irritable bowel disease (IBD). Much like ulcerative colitis, Crohn’s disease can be devastating and debilitating in its symptoms. One major difference is that ulcerative colitis affects the colon, with Crohn’s disease affecting not only the colon but also the small intestine or stomach. Medications may be tried first to relieve Crohn’s disease. However, if the disease does not respond to medication, surgery may be necessary. But even during surgery, the disease can reappear in a part of the intestine that was not previously affected. The goal of Crohn’s surgery is to preserve as much bowel as possible, reduce complications, and achieve the best possible quality of life for the patient.
Depending on the type of complication, the location of the disease, and the severity of the disease, various surgical options are available. These options are called stenosisplasty, resection, abscess and fistula surgery, and ileostomy. Complications of the disease that may lead to surgery include perforation of the intestine, formation of an abscess or fistula, severe bleeding in the intestine, constipation or blockage of the intestine, as well. as the enlargement and loss of muscle tone well known in the large intestine as toxic Megacolon.
Strictureplasty: Strictureplasty is an option if the disease affects the small intestine and the diseased part alternates with areas of the normal intestine. The diseased section blocks the passage of digested food by forming strictures, which are due to the narrowing of the intestine. The normal intestine presses against the stenosis to compensate for the diseased part. This leads to severe cramps. Strictureplasty stretches the area of stricture without having to remove part of the bowel.
Resection: A resection involves the removal of the affected parts of the intestine and is an option for several closely spaced strictures or for longer strictures. Once the diseased section has been removed, the two healthy sections of the intestine are put together in a procedure called an anastomosis. Patients are generally symptom-free after resection surgery. However, it is known that the disease can recur around or at the anastomotic site.
Surgery for abscesses and fistulas: Abscesses and fistulas are common in patients with Crohn’s disease. One in four people will be affected in their lifetime. An abscess is a tender lump that is filled with pus, which is often the result of infection. Pus is a collection of liquid white blood cells, living and dead, dead tissue and bacteria, or other invaders or foreign material. It can be fatal if left untreated and immediate drainage of the abscess is necessary. Using a CT scanner, a needle is inserted and guided to the site of the abscess. This is a very simple operation which, depending on the severity, requires a very short hospital stay or is performed on an outpatient basis. To relieve the swelling and pain, which also helps with additional drainage, a warm hip bath is very helpful during recovery. A fistula is an abnormal connection between two organs, an organ and another structure, a vessel or an intestine. It can even form between an abscess and a hollow organ. While some are treated with medication, others require surgery to resect the affected bowel.
Colostomy: Ileostomies are performed in patients with severe Croon’s affecting the colon. An colostomy is an opening made at the end of the small intestine, the ileum. The ileum passes through the abdominal wall, creating a so-called stomp. Waste is collected in a specially designed pouch attached to the outside of the body. These sachets are lightweight and are attached with a self-adhesive pad made of pectin or other organic material. The blister pack has a cutout hole that fits around the stomp to prevent it from leaking onto the skin and thus prevent skin irritation.