A strictureplasty addresses areas of bowel narrowed by scarring from inflammatory bowel disease, Crohn’s disease, and related conditions. The surgeon locates strictures with the assistance of a balloon catheter in the bowel and cuts through them before sewing them crosswise to widen those sections of bowel. This has the effect of shortening the intestines, but they will no longer have the areas of narrowed tissue that cause cramping and pain. It is possible to perform a strictureplasty on several lengths of bowel at once in the same surgery; patients may need several surgeries over the course of their lives.
Patients with chronic bowel inflammation experience scarring caused by repeated inflammation, swelling, and irritation of the tissue. Over time, this scarring can cause narrowing, also known as strictures. When the patient eats, the digestive tract has trouble moving food past the strictures, which causes pain and discomfort. Over time it can also put the patient at risk of further inflammation and infection caused by stress on the bowel.
Historically, one of the most effective ways to address strictures was a bowel resection, in which the damaged portion of bowel was removed. This more invasive procedure required a longer healing time and over the course of several surgeries it could result in the loss of a large portion of the bowel. Strictureplasty offers a less invasive alternative that preserves the bowel as long as possible, which can improve quality of life and make the patient more comfortable.
In the procedure, the surgeon finds a stricture and makes a cut along it lengthwise. The two ends of the cut are brought together and sewn to widen the diameter of the bowel, which also has the unintended effect of slightly shortening it. Surgeons can move slowly through the bowel to check for multiple strictures and may also need to resect portions of the bowel if the patient has tissue necrosis or very badly damaged lengths of intestinal tract.
Management of inflammatory diseases in the gut can be frustrating and requires a life-long commitment. Patients may benefit from special diets and medication to control inflammation and protect the gut. Many end up needing surgery within 10 years of diagnosis, even if they follow treatment recommendations, and a strictureplasty can be a good alternative to a resection that will preserve bowel function and length to benefit the patient’s long-term health. After a strictureplasty, patients will need to follow some aftercare directions while allowing the bowel to recover before they can resume normal activities.