Resection is the most common type of surgery for Crohn’s disease, said Conor Delaney, MD, PhD, chief of the division of colorectal surgery at University Hospitals Case Medical Center and Case Western Reserve University in Cleveland. Other procedures, such as bypassing a segment or strictureplasty (widening a segment) can be performed, but for most people with Crohn’s disease, a resection is the safest and best way to deal with problems.
How Crohn’s Treatment Progresses to Surgery for Crohn’s
Crohn’s disease causes inflammation in the bowel, which can lead to strictures (narrowings) or perforations in the intestine and, in turn, infections or fistulas. “Treatments are aimed at minimizing inflammation, but they don’t always work,” said James Church, MD, a colorectal surgeon at the Cleveland Clinic. “Sometimes medical treatments have bad side effects or cannot be tolerated.” This is when your doctor may suggest bowel surgery.
Crohn’s disease can occur in multiple areas of the gastrointestinal tract. It also tends to recur. “Therefore, some patients with aggressive Crohn’s disease may need multiple resections throughout their lifetime,” Dr. Church said. Doctors have to be careful not to remove too much of the bowel so there’s enough left to maintain nutritional functions. There are surgical alternatives to resection for treating strictures but no alternative for treating perforations or fistulas.
Resection surgery was traditionally done as an open abdominal operation, but now, Dr. Delaney said, most people are able to have minimally invasive surgery, called laparoscopic colorectal surgery.