Crohn’s disease is an inflammatory bowel disease that causes inflammation of the lining of the gastrointestinal tract. This inflammation and irritation can occur in any part of the gastrointestinal tract, but it most commonly affects the colon and small intestine. The condition causes painful and debilitating symptoms, such as severe diarrhea, abdominal pain, and fatigue. These symptoms can get in the way of living a normal life and can lead to serious health complications. As a result, many people with Crohn’s disease spend years trying various medications in hopes of finding one that helps ease their symptoms. When medications don’t work or complications develop, some will turn to surgery to find relief.
It’s estimated that nearly 70 percent of people with Crohn’s disease may eventually require surgery to treat their symptoms. Some may have the option to choose surgery, while others will need it due to complications of their disease.
Several surgeries are available for people Crohn’s disease, one of which involves removing the inflamed section of the colon or small intestine. While this may provide relief, there’s still no cure for Crohn’s disease. Even after the removal of the affected area of the intestines, the disease may eventually begin to affect a new part of the gastrointestinal tract, causing a recurrence of symptoms.
Partial Removal of the Intestines
The removal of part of the intestines is called a partial resection or a partial bowel resection. This surgery is generally recommended for people who have one or more strictures, or diseased areas, close together in a particular part of the intestines. A partial resection involves removing the damaged areas of the intestines and then reconnecting the healthy sections. It’s performed under general anesthesia, which means people are asleep throughout the procedure. The surgery generally takes one to four hours to complete.
A partial resection can ease the symptoms of Crohn’s disease for many years. It’s important to note, however, that the relief is usually temporary. About 50 percent of people will experience a recurrence of symptoms within five years after having a partial resection. The disease often occurs at the site where the intestines were reconnected.
Some people may also develop nutritional deficiencies after the surgery. The intestines have the important job of absorbing nutrients from digested food. When people have a part of their intestines removed, they have less of the intestines left to absorb food and the nutrients it contains. As a result, people who’ve had a partial resection may need to be put on a regimen of supplements to ensure they’re receiving proper nutrition.
The Importance of Quitting Smoking After Surgery
Many people who undergo surgery for Crohn’s disease will have a recurrence of symptoms. However, people may be able to prevent or delay recurrence by making certain lifestyle adjustments. One of the most important changes to make is to quit smoking. Aside from being a possible risk factor for Crohn’s disease, smoking can increase the risk of recurrence among people in remission. According to the Crohn’s and Colitis Foundation of America (CCFA), smokers in remission from Crohn’s disease are more than twice as likely as nonsmokers in remission to have a recurrence of symptoms. Most people with Crohn’s disease also see an improvement in their overall health once they stop smoking.
Medications After Surgery
Doctors usually prescribe medications to help minimize the risk of recurrence after a partial resection. Antibiotics are often a less potent but effective solution for preventing or delaying recurrence in people who’ve undergone surgery. Metronidazole (Flagyl) is a type of antibiotic that’s commonly prescribed because it’s safe enough to take for extended periods of time. Metronidazole cuts down on bacterial infections in the gastrointestinal tract, which helps keep symptoms of Crohn’s disease at bay. Like other antibiotics, however, metronidazole will become less effective over time as the body adjusts to the drug.
Aminosalicylates, also known as 5-ASA medications, have also been found to be effective in treating people in remission from Crohn’s disease. However, these drugs sometimes contain sulfasalazine, which has negative effects on the many people who have an intolerance to it. Its most common side effects include:
Taking the medication with food may minimize these side effects.
Budesonide is sometimes prescribed to people who’ve had a partial resection. The medication is a corticosteroid. Generally prescribed for sinus issues and allergies, budesonide is a corticosteroid that’s sold under the brand names Rhinocort, Pulmicort, and Entocort. In people with Crohn’s disease, the drug begins to reduce inflammation in the intestines as soon as it comes into contact with the affected tissues. Budesonide causes minimal side effects, making it very safe for most people. However, it hasn’t been clinically proven to be effective in preventing the recurrence of Crohn’s disease, so it may not be the best medication for people in remission.
You asked, we answered
- What can I expect during recovery from a partial resection?
There are some important points to consider during the recovery phase. Mild to moderate pain at the incision site is commonly experienced, and the treating physician will prescribe pain medication. Fluids and electrolytes are infused intravenously until the patient's diet can gradually be resumed, beginning with liquids and progressing to a regular diet as tolerated. Patients can expect to be out of bed approximately eight to 24 hours after surgery. Patients are usually scheduled for a follow-up examination within two weeks after surgery. During the first few days after surgery, physical activity is restricted.- Steve Kim, M.D.