Surgical Options for Crohn's Disease/Ulcerative Colitis

Alright so we talked about many of the different treatment options available for people suffering with Ulcerative Colitis or Crohn's Disease including immunosuppressants, steroids, anit-inflammatories, and probiotics; however I thought that I would post about the surgeries available for these people. The problem with surgery is that the Crohn's & Colitis Foundation of America have found that about 50% of patients that have surgery will see a recurrence of the disease, but they do state that medication (like the ones listed before) taken after the surgery can help the patient avoid, or at least delay, a recurrence.

There are really three options depending on the severity of symptoms. The first surgery is called a strictureplasty. This procedure is used to widen the narrowed diseased areas of the small intestine. FYI the diseased areas are called strictures and are a result of scarring brought on by the chronic inflammation of the disease. The surgery is as simple as cutting open the stricture then sewing it back up crosswise.

The second option is called a resection. This surgery is used when strictures are very long or there are many of them within a close vicinity and simply cuts away the diseased section then the healthy ends to the intestine are reattached. Finally if the damage done by Crohn's is really bad then a colectomy or proctocolectomy may be needed. The colectomy procedure removes the whole colon while the proctocolectomy does the same but also removes the rectum which means that another procedure (ileostomy) would be needed to create a stoma that would allow the patient to pass stool.

There are two quality of life issues that are presented to a patient; especially with a surgery like the proctocolectomy. The first is that a colostomy bag is needed when the rectum is removed; which means that it will have to be emptied multiple times a day and obviously would have to be worn all day. Also if too much of the intestine is taken it is possible to end up with short bowel syndrome. Essentially this can lead to malnutrition/dehydration and diarrhea. This happens because the decreased length of intestine does not provide adequate room for absorption of nutrients, minerals, and water. To counteract this people with short bowel syndrome have to take supplements and eat very small meals at a much more frequent pace then normal.

All in all it may seem as though surgery is a bad option; however it is essential when medications no longer control the symptoms.

Here are the websites where I found this info:
http://www.ccfa.org/info/surgery/surgerycd
http://digestive.niddk.nih.gov/ddiseases/pubs/shortbowel/
http://www.umm.edu/patiented/articles/what_surgical_procedures_crohns_disease_000103_10.htm