Treating bowel problems can be easier than you think.
If you have been experiencing abdominal discomfort (regardless of your age), it's best to visit your doctor in case it's Crohn's disease.
What is Crohn's disease?
The main symptom for Crohn's disease is inflammation of your bowel. The disease most often affects the end part of your small bowel, called the terminal ileum. However, it can affect any part of your digestive system. Crohn's disease causes your bowel wall to thicken, which can block food from passing through. The affected area of your bowel can also fail to absorb nutrients from your food.
What are the benefits of surgery?
There are a few treatments for Crohn, such as medication. However, for some people, it is not enough. Sometimes, taking medicine does not completely reduce inflammation. Therefore, your doctor may give you the option of having surgery, which increases the likelihood of improving your symptoms. Depending on the patient and the outcome of the surgery, your doctor may also be able to reduce or stop your medication.
Are there any alternatives to surgery?
Inflammation can be treated using medication such as mesalazine, steroids, azathioprine and infliximab. These have side effects and your doctor will discuss them with you.
Sometimes a narrowing of your bowel can be stretched by a procedure that uses a flexible telescope and a balloon dilator.
What does the procedure involve?
The operation is performed under a general anaesthetic and usually takes an hour to 90 minutes. Your surgeon will make a cut on your abdomen and remove the diseased part of your small bowel. They will often need to also remove a part of your large bowel.
Your surgeon will usually join the ends of your bowel back together. If they are unable to join the ends of your bowel, they will make a colostomy or ileostomy (your bowel opening onto your skin).
What complications can happen?
There are a few complications that your doctor should be able to discuss with you prior the procedure.
- Infection of the surgical site (wound)
- Unsightly scarring of your skin
- Developing a hernia in the scar
- Blood clot in your leg
- Blood clot in your lung
- Chest infection
- Difficulty passing urine
Specific complications of this operation
Like all surgical procedures, there are some specific risks that patients should always bear in mind. However, if you are worried about the following complications, your doctor will be more than happy to discuss them in detail.
Keyhole surgery complications
- Damage to structures such as your bowel, bladder or blood vessels
- Developing a hernia near one of the cuts used to insert the ports
- Surgical emphysema
Surgery for Crohn's disease complications
- Anastomotic leak
- Continued bowel paralysis
- Damage to other structures inside your abdomen
- Injury to your bowel
- Tissues can join together in an abnormal way
- Death. The risk is less the fitter you are
How soon will I recover?
Nowadays, you should be able to go home after three to 10 days. It may take up to three months for you to recover fully. Most people feel much better after the diseases part of their bowel has been removed. Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice. Crohn's disease sometimes comes back and affects another part of your bowel or a part near to where the join was made.
If your doctor diagnoses you with Crohn's disease, which causes inflammation of your bowel, then surgery is usually recommended if medication fails to improve your symptoms.
Author: Mr Jonathan Lund DM FRCS (Gen. Surg.)
Illustrator: Medical Illustration Copyright © Medical-Artist.com