Approximately 47% of people with Crohn’s disease and 16% of those with ulcerative colitis will require surgery at some point in their lives. Surgery should not be regarded as a last resort in the treatment of these diseases, nor is it a sign that you or your treatment program have failed. In reality, surgery should be regarded as just another treatment option.
Surgery for Ulcerative Colitis
Removal of the large intestine and rectum (colectomy) may be recommended as a treatment for severe cases of ulcerative colitis. Because the rectum is gone and thus the passage for feces has been removed, your surgeon may have to create an ileostomy (connection of the small bowel to the exterior of your body). An ileostomy uses a bag (otherwise known as an ostomy appliance) attached to the skin of your abdomen to collect expelled feces.
In some cases, surgeons can convert an ileostomy to an ileal pouch anal anastomosis (an IPAA, also sometimes referred to as a pelvic pouch). For those who are eligible for this surgery, the IPAA offers a high degree of satisfaction because a pouch for collecting feces is made inside your body and stool continues to be expelled though the anus rather than into an ostomy bag.
Surgery for Crohn’s disease
Because Crohn’s can involve any part of the GI tract, there are many varied surgical treatments. If you have acquired an abscess, stricture or obstruction, a resection (removal of all or part of a section of the gut) may be required to repair the problem. In some cases, a strictureplasty can be done to open up a narrowed segment of the intestine. As with colitis, a colectomy and ileostomy are possible surgeries. In addition to bowel-specific surgery, patients with Crohn’s can also have surgery to treat problems associated with complications of the disease. For example, if you have developed a fistula, there are procedures available to reduce the pain and pus.
Minimally invasive surgery, or laparoscopic surgery, is performed through small incisions in the abdomen with the aid of special instruments and a camera. Because of the smaller scars, younger people find the prospects of this surgery more appealing than “open surgery.” In addition, healing time is faster and there is less post-operative pain.
Unfortunately, not all people with Crohn’s or colitis are candidates for laparoscopic surgery, usually because of extensive scarring within the abdomen or because the disease is so extensive that a wider field of view is needed than that offered by the scope.
One of the possible outcomes of surgery is an ostomy. During an ostomy, the surgeon creates an opening (stoma) from an end of the intestine inside the body to the outside surface of the abdomen. Ostomies are performed after a section of diseased bowel has been removed and an alternative to passing feces from the body is required. To learn more please visit our Living with an Ostomy page.
learn more about surgery for Crohn's and colitis
Click on the image below for a downloadble pdf brochure about surgery for the treatment of Crohn's and colitis.
Watch the video below to learn about surgery from a surgeon and expert in the field. This presentation was part of the Gutsy Learning Series and is suitable for adult audience affected by Crohn's or colitis.
Click on the short video below to hear an overview of surgery options for the treatment of Crohn's and colitis.