Crohn's surgery can be divided into surgeries to treat emergent medical issues like fistulas and abscesses, as well as surgeries to resect or otherwise modify the bowel to address declining bowel function. These surgeries can be performed by a general surgeon or a surgeon who specializes in gastrointestinal surgical procedures. Surgery is recommended when other avenues for treatment have been exhausted and it is commonly needed in older patients who have lived with Crohn's disease for a number of years.
Patients with Crohn's disease have a chronic inflammatory condition involving the intestines. Inflammation can occur at anywhere along the length of the intestine, causing symptoms like pain, loose stool, and malnutrition. People with this condition work on managing it with diet and medication, but sometimes damage to the bowel occurs and surgery becomes necessary for patient well being.
Abscesses can form in the bowel as a result of the inflammation, leading to surgery to clean and drain the abscess. Likewise, fistulas — openings between areas of the body normally separated by tissue — can also develop in Crohn's patients, requiring a fistula repair surgery. These types of Crohn's surgery procedures may be emergency surgeries, performed to address a problem before complications like peritonitis develop.
Over time, sections of the bowel tend to narrow, developing what are known as strictures. Strictureplasty is a type of Crohn's surgery used to treat the narrowed bowel to help patients digest food and pass stool more easily. In some cases, a bowel resection to cut out a diseased segment of bowel is required. Surgeries to remove the entire colon or colon and rectum are also sometimes used to treat Crohn's disease when it does not respond to other treatments, and this may require an ileostomy procedure, where the end of the bowel is used to make an opening to allow bowel waste to drain into a collecting bag.
While the prospect of Crohn's disease can be frightening and some patients may avoid surgery because they are afraid of surgical complications, pain, or the risk of needing a procedure like an ileostomy, surgery can be very beneficial for many patients. Early Crohn's surgery can prevent some forms of damage to the bowel, reducing the need for more invasive surgery in the future. Patients wondering about the need for surgery can seek a second opinion from another surgeon before pursuing Crohn's surgery to get the benefit of advice from another perspective.