Crohn Disease (cont.)
Senthil Nachimuthu, MD, BS
Paul Piccione, MD
Simmy Bank, MD, MB, ChB
Francisco Talavera, PharmD, PhD
BS Anand, MD
Venkatachala Mohan, MD
IN THIS ARTICLE
Crohn's Disease Surgery
The most widely used operation in Crohn's disease is removing the diseased part of the intestine. Surgery is usually necessary in people who have intestinal obstruction or very severe symptoms that are not relieved by medication. It can improve the condition, but it does not cure it. Surgery also may be necessary for an abscess or certain types of fistula.
People who have part of their bowel removed may require an ostomy. The normal bowel is attached to an opening in the lower abdomen called a stoma. Feces are no longer passed from the body through the rectum and anus, but through this stoma. An ostomy bag is worn on the outside of the body to collect the waste. The ostomy often is called by which part of the bowel is attached, such as colostomy or ileostomy.
Crohn's disease recurs frequently after surgery. If a part of the bowel is removed, the recurrence often occurs at the place where the diseased bowel was cut in the operation. Hence careful follow-up after surgery is important, even when the patient feels well, to detect early signs of recurrence. Patients may have to continue treatment even after surgery to help in reducing the rate of recurrence of Crohn's disease.
People who have part of their small intestine removed may experience a complication known as short bowel syndrome. Ironically, the symptoms of short bowel syndrome often are similar to those of Crohn's disease. This complication is now uncommon with modern surgery.
Patients who have had large portions of their intestine removed often need to rely on intravenous nutrition (total parenteral nutrition, or TPN) for the rest of their lives.
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