Crohn’s disease is an inflammatory bowel disease that causes inflammation of the lining of the gastrointestinal tract. This inflammation can occur in any part of the gastrointestinal tract, but it most commonly affects the colon and small intestine.
It’s estimated that up to 75 percent of people with Crohn’s disease eventually require surgery to treat their symptoms. Some will have the option to undergo surgery, while others will need it due to complications of their disease.
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.
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.
Partial resection surgery may also be recommended for patients with other complications from Crohn’s disease, such as bleeding or a bowel obstruction. A partial resection involves removing the damaged areas of the intestines and then reconnecting the healthy sections.
The surgery is performed under general anesthesia, which means people are asleep throughout the procedure. The surgery generally takes from one to four hours.
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 recurs at the site where the intestines were reconnected.
Some people may also develop nutritional deficiencies after the surgery.
When people have a part of their intestines removed, they have less intestine left to absorb nutrients from food. As a result, people who’ve had a partial resection may need to take supplements to ensure they’re getting what they need to stay healthy.
Many people who undergo surgery for Crohn’s disease will have a recurrence of symptoms. You can prevent or delay recurrence by making certain lifestyle changes. 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. Most people with Crohn’s disease also see an improvement in their health once they stop smoking.
According to the Crohn’s and Colitis Foundation of America, smokers in remission from Crohn’s disease are more than twice as likely as nonsmokers to have a recurrence of symptoms.
Doctors usually prescribe medications to help minimize the risk of recurrence after a partial resection.
Antibiotics are often an effective solution for preventing or delaying recurrence in people who’ve undergone surgery.
Metronidazole (Flagyl) is an antibiotic that’s commonly prescribed for several months after surgery. Metronidazole cuts down on bacterial infections in the gastrointestinal tract, which helps keep symptoms of Crohn’s disease at bay.
Like other antibiotics, metronidazole may become less effective over time as the body adjusts to the drug.
Aminosalicylates, also known as 5-ASA medications, are a group of medications sometimes prescribed for people who’ve undergone surgery. They are thought to reduce symptoms and flare-ups, but are not highly effective for preventing recurrence of Crohn’s disease.
Aminosalicylates may be recommended for people who are at low risk for recurrence, or who can’t take other, more effective medications. Common side effects include:
Taking the medication with food may minimize these side effects. Some aminosalicylates can also have negative effects in people who are allergic to sulfa drugs. Make sure your doctor knows about any allergies you have before starting treatment.
Medications that modify your immune system, such as azathioprine or TNF-blockers, are sometimes prescribed after a partial resection. These drugs may help prevent recurrence of Crohn’s disease for up to two years after surgery.
Immunomodulators cause side effects in some people and may not be right for everyone. Your doctor will consider the severity of your disease, your risk of recurrence, and your overall health before deciding if one of these treatments is right for you.