Surgery

Approximately 70 per cent of people with Crohn’s disease (CD) and 40 per cent of those with ulcerative colitis (UC) will require surgery at some point in their lives. Surgery should not be regarded as a last resort in the treatment of IBD, nor is it a sign that you or your treatment program have failed. In reality, surgery should be regarded as just another treatment option for the management of CD and UC. Take a tour through our booklet “The Cutting Edge” for more details.

Surgery for Ulcerative Colitis

Removal of the large intestine and rectum (colectomy) effectively removes ulcerative colitis from your body with the result that you are “cured” of UC. Because the rectum is gone and thus the passage for feces has been removed, your surgeon may have also created an ileostomy (connection of the small bowel to the exterior of your body). An ileostomy uses a bag (otherwise known as an ostomy appliance) attached to the skin of your abdomen for the elimination of feces.

In some cases, surgeons can convert an ileostomy to an ileal pouch anal anastomosis (IPAA). For those who are eligible for this surgery, the IPAA offers a high degree of satisfaction because a pouch for collecting feces is made inside your body and stool continues to be expelled though the anus rather than into an ostomy bag.

Surgery for Crohn’s disease

Because CD can involve any part of the GI tract, there are many varied surgical treatments. If you have acquired an abscess, stricture or obstruction, a resection (removal of all or part of a section of the gut) may be required to repair the problem. In some cases, a strictureplasty can be done to open up a narrowed segment of the intestine. As with UC, a colectomy and ileostomy are possible surgeries. In addition to bowel­-specific surgery, patients with CD can also have surgery to treat problems associated with complications of the disease. For example, if you have developed a fistula, there are procedures available to reduce the pain and pus.

Laparoscopic surgery

Minimally invasive surgery, or laparoscopic surgery, is performed through small incisions in the abdomen with the aid of special instruments and a camera. Because of the smaller scars, younger people find the prospects of this surgery more appealing than “open surgery.” In addition, healing time is faster and there is less post-­operative pain.

Unfortunately, not all IBD patients are candidates for laparoscopic surgery, usually because of extensive scarring within the abdomen or because the disease is so extensive that a wider field of view is needed than that offered by the scope.