What is Crohn’s disease?
Crohn’s disease causes inflammation of the bowel. The disease most often affects the end part of the small bowel, called the terminal ileum. Crohn's disease causes the bowel wall to thicken, which can block food from passing through. The affected area of the bowel can also fail to absorb nutrients from your food.
What are common Crohn’s disease symptoms?
You may suffer from:
- Abdominal pain and bloating
- Weight loss
- A hole in your bowel, which can cause an abscess or an abnormal connection (fistula) to develop between the bowel and the bladder
- A blocked bowel, which requires urgent surgery
- Problems with your back passage, causing fluid to leak out or pain when you open your bowels
- Problems with other parts of your body such as your eyes or your joints
What are the benefits of abdominal surgery?
Your surgeon may recommend surgery to remove the diseased part of your bowel. Surgery should improve your symptoms. Your doctor may also be able to reduce or stop your medication.
Crohn’s disease can be treated using drugs, such as mesalazine, steroids, azathioprine and infliximab. For details of side effects, speak to your doctor. These treatments may have been unsuccessful and so your doctor has now recommended surgery.
You will be asked to drink some fluids that are high in carbohydrates to give you energy for the operation.
The operation is performed under a general anaesthetic and usually takes between an hour and an hour and a half. Your surgeon will make a cut in your abdomen and remove the diseased part of your small bowel.
They will often need to remove a part of your large bowel.
Your surgeon will join the ends of your bowel back together. At the end of the operation, they will close the cut with stitches or staples. They will place a drip (small tube) in a vein in your arm. They will also place a catheter (tube) in your bladder to help you pass urine.
For more information, and if you have any queries about the procedure, speak to your consultant.
Continue taking your normal medication unless you are told otherwise.
The following lifestyle changes can help make the procedure a success:
- Giving up smoking. This significantly reduces the chances of the disease coming back
- Eating healthily. If overweight, you have a greater chance of developing complications
- Exercising regularly. Your GP can recommend exercises.
- Pain, which happens with every operation
- Bleeding after surgery
- Infection in the surgical wound, which may need antibiotics or further surgery
- Unsightly scarring of the skin
- Developing a hernia in the scar caused by failure of the deep muscle layers to heal. If this causes problems, you may need a further operation
- Anastomotic leak. This is a serious complication that may happen if the join (anastomosis) between the ends of the bowel fails to heal, leaving a hole. Bowel contents leak into the abdomen, leading to pain and serious illness. This often needs another operation
- Chest infection
- Injury to the bowel. The risk is higher if you have had abdominal surgery before
- Abnormal joining together of tissue (adhesions), which form when scar tissue develops inside the abdomen.
Adhesions do not usually cause any major problems but can lead to bowel obstruction.
This is not a definitive list and symptoms will vary with each patient. Please ask your consultant for more information.
You may be transferred to the high-dependency unit or intensive-care unit for a day or two. You will be reviewed regularly by your consultant.
You should be able to go home after five to ten days. However, your doctor may recommend that you stay a little longer. Remember, you won’t be able to drive after the operation.
It may take up to three months for you to fully recover. Most people feel much better after the diseased part of their bowel has been removed. When a part of the bowel has been removed, it is normal for your bowels to be more loose than they were before the operation and open more frequently.
This should improve with time. Your doctor may prescribe some medication to slow down your bowel. Regular exercise should help your recovery – ask your GP for advice.
Crohn’s disease sometimes comes back and affects another part of the bowel or a part near to where the join was made.
For further information, speak to your consultant.
Paying for your procedure
Abdominal surgery for Crohn’s disease costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the operation will be explained and confirmed in writing when you book the operation. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.