Surgery for Crohn’s disease

Surgical operations are a very important part of the treatment of Crohn’s disease and it is estimated that as many as 8 out of 10 patients will require an operation at some stage in their life. The main reason for needing surgery is to remove thickened blocked segments of the intestine. Medicines are unlikely to help these and an operation to cut out a short section of affected intestine is usually very successful and restores full health quickly. Sometimes, colonoscopy can be used to open up narrowed sections (with special dilating balloons) but this is only possible in certain cases. Surgery is also needed when badly affected parts of the intestine have caused an abscess or fistula (see above). An operation can sometimes be the best option when severe Crohn’s disease is not responding to drug treatment.

Does surgery mean having a stoma bag?

Many people presume that surgery for Crohn’s disease means having a permanent stoma bag. In fact, stomas (ileostomy or colostomy) are not often needed and are nearly always a temporary measure. After a section of affected intestine has been removed, a very delicate join (or ‘anastomosis’) is made between the unaffected ends of the intestine. In order to protect this join while it heals, the surgeon will often make a temporary stoma above, which is then taken away at a second smaller operation a few months later. This is done particularly when someone is underweight or taking steroids which reduce the ability of body tissues to heal.

Does Crohn’s disease come back after surgery?

Yes. There is no cure for Crohn’s disease so it does slowly come back, often in the section of intestine just above a surgical join. However, despite this, most people have no problems for many years after their operation. Recurrence is two-times more likely in smokers compared those who do not smoke. Drugs such as aminosalicylates or azathioprine can also reduce the chances of recurrence.

Does Crohn’s disease affect my chances of having children?

Overall, Crohn’s disease does not have a significant effect on the chances of becoming pregnant or carrying a baby. In a small number of cases, inflammation or infection in the pelvis, or surgery to this area, can affect the ovaries, fallopian tubes or uterus reducing fertility. The commonly used drugs used in Crohn’s disease are safe during pregnancy. It is always best to talk to your specialist if you have Crohn’s disease and are planning a pregnancy or already pregnant.