Abdominal Surgery for Crohn’s Disease: Recovery & Complications

Crohn’s Disease is a type of Inflammatory Bowel Disease causing inflammation of the gut or the digestive system. It is a chronic or lifelong condition. It generally affects the end part of the small intestine called ileum and colon but can affect any part of it as well. It is not a contagious or communicative disease.

There is no cure, but treatments are needed to control it or decrease the inflammation.

According to a research, about 66% to 70% of patients with Crohn’s Disease require surgery1-4. Surgeries are needed to treat complications and when the medications don’t work.

Few Types of Surgeries for Crohn’s Disease are-

• Anastomosis- The surgeon removes the affected part and connects two healthy ends together. It can reduce the symptoms of Crohn’s Disease, but cannot cure it.
• Ileostomy- The patient whose rectum is diseased might need this surgery. This surgery connects the small intestine to the skin of the patient’s torso. These results in the opening of the skin and all the waste are collected in the pouches that the patient discharges out of his/her body.
• Strictureplasty- The narrow passage is widened without removing any part of the small intestine.
• Ostomy- It refers to creating a hole in the patient’s body to remove its contents.

A patient must be informed the chances of recurrence of Crohn’s Disease even after surgery.

The operation includes the use of general anesthetics. It can generally take 60 minutes to 90 minutes. The surgeon will make a cut on the abdomen. They will remove the affected part of the small bowel. At last, the surgeon will join the ends of the bowel. If they are not able to connect them, they will make a colostomy.

The recovery time of the patient after the surgery for Crohn’s Disease depends on certain factors the patient’s medical conditions currently and before the surgery, the surgery type performed and it also varies from person to person.

Recovery period depends on the the length and the complications of the Surgery for Crohn’s Disease.

Usually, the patient gets discharged in a few days and sometimes he/she has to stay in the hospital for a couple of weeks or more depending on their condition.

After discharge, the patient most likely is able to start their routine life after 2-3 months after a good diet and regular exercise and after that, the patient feels much better because of the removal of diseased bowel and symptoms.

A good diet includes low fiber food like potato and avocados, they are considered good after the surgery because the bowel doesn’t have to work hard to digest heavy food, so it helps in fast recovery.

• Surgical Site Infection
• Bleeding
• Skin Irritation
• Anemia
• Pouchitis
• Malabsorption
• Difficulty in passing urine.

• Anti-biotics
• Steroids
• Anti-Inflammatory Drugs
• Anti-Diarrheal
• Biologic Medicines.

The symptoms which are experienced by a person suffering from Crohn’s disease are-

• Abdominal Pain
• Fatigue
• Mouth Ulcers
• Weight Loss
• Diarrhea
• Blood in the stool.
• In young children, Crohn’s Disease is most likely to affect their growth and development.
• Symptoms of Crohn’s Disease may vary from patient to patient and their conditions.

• According to crohnsandcolitis.com, approximately 700,000 people are affected by Crohn’s Disease in the United States.
• It mostly affects the age group of 15-35.
• It affects men and women equally.
• It can also affect the patient’s skin, joints, and eyes.

Fistula-

In serious conditions, inflammation can lead to the development of a fistula. Fistula refers to a tunnel which is made from one loop of small intestine to another loop or connecting it to vagina, skin or bladder. The patient who experiences this condition requires immediate medical help; otherwise, the condition can become more severe.

Intestinal Obstruction as a Complication of Crohn’s Disease-

The patients with Crohn’s Disease face difficulty related to intestines because the food is not able to pass through it and causes serious abdominal pain and vomiting.

Strictures-

It refers to the thickened and narrow areas of the intestine which are caused by inflammation. It blocks the intestine and can cause severe problems.

Toxic Megacolon as a Complication-

It is a very rare condition but can be experienced by the patient of Crohn’s Disease. A section of the intestinal wall bulges till it ruptures and bursts out, spilling all its content outside and causes an infection called peritonitis.

Bile Salt Diarrhea as a Complication of Crohn’s Disease-

Most commonly Crohn’s Disease affects the ileum, which usually absorbs bile acid which helps in absorbing fat. So, if the body is not able to process the fat, most likely the patient will get Bile Salt Diarrhea.

The patient can also experience complications like arthritis, skin problems, eye problems, vitamin D deficiency, kidney problems, liver problems etc.

• Cigarette Smoking
• Some anti-inflammatory drugs
• Infections
• Living Environment.

Crohn’s Disease is a type of IBD (Inflammatory Bowel Disease). It is a chronic or lifelong disease which causes inflammation of the digestive system or gut. Its symptoms include abdominal pain, fatigue, weight loss, and blood in the stool. It mostly affects the age group of 15-35 years and approximately 700,000 people are affected by it. Crohn’s Disease cannot be cured completely. However, there are medications and surgeries available which can reduce its symptoms and inflammation by removing a section of the small intestine or the part affected. The small intestine is the most common part which is affected by Crohn’s Disease. Crohn’s Colitis and ileitis are two of the types of Crohn’s Disease. The diagnosis may include tests like blood test, stool sample, endoscopy, and MRI. The operation of Crohn’s Disease includes the use of general anesthetics and may take 60 to 90 minutes. The surgeon makes a cut on the abdomen, removes the affected part and connects two ends of the bowel. The recovery after the operation may take around 2-3 months and a good diet or regular exercise can help in faster recovery. Complication after the surgery may include bleeding, malabsorption and anemia.

Reference

Canin-Endres J, Salky B, Gattorno F, Edye M. Laparoscopically assisted intestinal resection in 88 patients with Crohn’s disease. Surg Endosc. 1999;13-595–599.

Mekhjian HS, Switz DM, Watts HD, Deren JJ, Katon RM, Beman FM. National cooperative Crohn’s disease study- Factors determining recurrence of Crohn’s disease after surgery. Gastroenterology. 1979;77(4 pt 2)-907–913.

Peyrin-Biroulet L, Loftus EV Jr, Colombel JF, Sandborn WJ. The natural history of adult Crohn’s disease in population-based cohorts. Am J Gastroenterol. 2010;105(2)-289–297.

Bernell O, Lapidus A, Hellers G. Risk factors for surgery and postoperative recurrence in Crohn’s disease. Ann Surg. 2000;231(1)-38–45.

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