Crohn’s disease creates problems—generally in the form of inflammation that causes painful and difficult symptoms—in the intestinal tracts of sufferers. These symptoms can get in the way of living a normal life, as frequent bouts of diarrhea will cause running to the bathroom throughout the day. As a result, many Crohn’s sufferers spend years trying various medications to find one that provides relief from these symptoms. When medication doesn’t work or complications develop, some will turn to surgery to find relief.
Several surgeries are available for Crohn’s sufferers, one of which involves removing part of the colon or intestines. Whether the patient requires removal of the colon or the intestines, it’s important to note that there’s still no cure for Crohn’s. Even with removal of the affected part of the intestines, a patient may find that over time, Crohn’s begins to affect a new part of the gastrointestinal tract and cause the symptoms to reappear.
Resectioning the Intestines
Removal of part of the intestines is called a resection. A resection is generally ordered when the patient suffers one or more strictures (diseased areas) close together in a particular area. It involves removing part of the intestines, then suturing the remaining sections together in what is called an anastomosis.
While resection surgery can usually resolve symptoms, at least temporarily, some patients suffer nutritional deficiencies because of it. Once resectioning has occurred, a patient has a lower surface area in the intestines in which nutrients can be absorbed. Because of this, a patient will usually be put on a regimen of supplements to ensure they’re receiving proper nutrition.
In resectioning, the surgeon will remove as little of the intestines as necessary. Unfortunately, once this section has been removed, another part of the intestines may eventually become affected, requiring another surgery. Often, inflammation will occur at the area of anastomosis.
?For partial removal of intestines, the surgeon will remove the diseased section and reattach the functioning sections while the patient is under anesthesia. The procedure generally takes one to four hours and contains the usual risks during surgery, including risk of infection and blood clots.
Recovery for partial removal of intestines generally takes four to six weeks. During recovery, the doctor will likely recommend a low-fiber diet to allow the digestive tract time to heal.
The Importance of Quitting Smoking After Surgery
About half of Crohn’s patients who undergo surgery will have a recurrence of symptoms. This has many patients asking how to avoid recurrence. Several lifestyle modifications can be made that will help a patient maintain remission as long as possible, one of which is to cease smoking. Smoking has not only been pinpointed as a possible risk factor for Crohn’s, it’s also been found to raise the risk of recurrence among Crohn’s patients in remission. Some studies have shown that smokers in remission from Crohn’s are twice as likely to have a recurrence of symptoms as non-smokers in remission. Recent studies have also shown that the overall lifelong health of a Crohn’s sufferer is improved when smoking is discontinued.
Medications After Surgery
Antibiotics are often a less-potent solution to preventing recurrence in Crohn’s patients who’ve had resectioning. Metronidazole in oral dosing can help prevent recurrence in these patients and are safe enough to take long-term. Sold as Flagyl, metronidazole cuts down on bacterial infections in the intestinal tract, which helps keep symptoms at bay. Like any antibiotic, however, over time it will become less effective as the body adjusts.
Aminosalicylates, also known as 5-ASA, have been found to be effective in Crohn’s patients under remission. These aminosalicylates sometimes contain sulfasalazine, which has negative effects on the many patients who have an intolerance to it. Headaches, diarrhea, nausea, and rashes are some of the side effects. Some side effects may be minimized by taking the medication with food.
Budesonide is sometimes prescribed for post-resection patients. Generally prescribed for sinus issues and allergies, Budesonide is a steroid sold ?under the brand names Rhinocort, Pulmicort, and Entocort. In Crohn’s patients, budesonide works to reduce inflammation in the intestines, acting once it comes in contact with the affected tissues. It acts via slow release: the liver breaks it down into chemicals that then work to lower inflammation. Budesonide has not been clinically proven to be effective in maintaining long-term remission in Crohn’s patients, so although it’s relatively safe, it may not be the best medication to meet your remission goals.