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crohns surgery

Read and learn more about crohns surgery. For more, visit the Crohn’s Disease website DrCrohns.org

Q: Can you have crohns and NEVER need surgery?
Can you have crohns and NEVER need surgery?
i found i have crohn’s no matter what am i going to have surgery or are there people that never need it?

A: I have Crohn’s too, and my symptoms are controlled well enough on medication that I will likely not need surgery. It all depends on how bad your symptoms are, what type of symptoms you have and how well they can be controlled with diet and medication.

The main reason that someone with Crohn’s needs surgery is for a stricture that narrows the intestine to a point where stool cannot pass, an inflammation that becomes infected and needs to be removed or such bad symptoms that surgery sounds like a relief.

Work with your doctor to control your symptoms with medication. Find your trigger foods and avoid them when you are having symptoms and you should be able to avoid or postpone surgery for a long time.

Q: 4 weeks ago I had a resection surgery do to Crohns Disease. When can I sleep on my stomach comfortably again?
Overall I’m feeling pretty good however I’m still very tired and can’t sleep on my stomach comfortably. Does anyone know how long before I get my energy back? Also, my appetite hasn’t completely returned. Is this normal?

A: Hi Joleen, I am a female crohn’s survivor like yourself.
I have had multiple surgeries as well. It’s going to take a while before your energy is back as well as your appetite.

As for sleeping on your stomach, I’d ask the doctor. That is what I do after each surgery. What are my limitations, what can I eat, what should I avoid, etc.

Are you aware of the Crohn’s & Colitis Foundation of America? They have a lot of great information regarding surgery, women’s issues, diet, coping skills, and even locating a support chapter near you. They also have a live chat as well as a hotline that is run by healthcare professionals well versed in IBD M-F 9 am – 5 pm (EST).

You and your family/friends can inquire about the latest treatments, studies, educational meetings that have dieticians, drug reps, colorectal surgeons, etc. as speakers.

Oh, by the way, make sure your GI has you on maintenance medication so you don’t flare up again like Entocort, Humira, 6MP, Imuran or Remicade. Did you know that female crohn’s pts. can not take any kind of hormonal birthcontrol b/c when there is a flare up, the blood becomes sticky thus causing clotting. It is extremely dangerous to even think that the benefits outweigh the risks b/c 1. your risk of blood clots (DVTs in the leg or even lungs) is up when you flare, 2. add the bc pill to the mix, that increases your chances of throwing a clot even more–over 75%.
I learned this from my GI and after I had my stroke 2 yrs. ago. The 1st thing they neurologists and RNs told me was that if I was taking the pill, on top of having a crohn’s flare I would’ve been dead. Lucky for me, I don’t take hormones so I know I didn’t cause the problem.

I wish you a speedy recovery. Just know that you are not alone in your journey with Crohn’s. feel free to email me if you have questions.

Q: Has anyone ever got surgery for Crohns disease?~PLEASE I NEED ANSWERS~(please read on for details)?
do you take medication for it like steroids or any other they put you on?

have you been told you need surgery and why did they say that?

have you actually had the surgery…?

thank you everyone for your answers they are very much needed and appreciated…

A: hello, i am a female crohn’s pt. that was dxed at age 12. I had my first surgery at the age of 17 after steroid treatment failed and my quality of life got to the point where I lived in the bathroom 24/7 and missed 1/2 of my senior yr. in high school. The surgery saved my life as the Crohn’s took over my entire colon.

Since then, I have had several surgeries to remove narrowing of the intestines, fix a fistula, and to fix the stoma on my abodmen.

There are newer treatments out there to keep pts. in remission after an operation such as 6MP, Imuran, remicade, entocort, and humira.

If you check out the crohn’s and colitis foundation’s site, you will find more information on diet, women’s issues, surgery, how CD is dxed, treated, as well as locating a local CCFA support chapter near you. There is also a live chat & hotline that is run by healthcare experts and an open forum where you can post questions to others like yourself.

Definitely ask your GI about the newer options before having surgery. It is always a last resort to go under the knife as most MDs would rather try the newer methods. I am on Entocort, Bentyl, and pain medication as needed. I was on remicade and humira a while back.

I hope this helps. Best of luck to you.

Q: Can surgery affect a menstrual cycle?
I am 16 years old and on January 18th I had surgery to remove part of my colon because I have Crohns Disease. The surgery went well, but it is now March 1st and I haven’t had my period since January 4th.
I know it can be just because I’m a teenager but this has been a long time. I also am NOT sexually active, which is why part of me is wondering why I’m even asking this question, but this just seems odd to me. And was making me think if my surgery would’ve prolonged my menstrual cycle somehow.
Thank you for any answers.

A: Any kind of stress can affect it, and surgery is a big stressor. Sometimes you just skip a month or two, sometimes it’s just late. Some women are irregular all thier lives.

If you don’t get one in March, contact your doctor, but it’s likely just the stress of the surgery.

Q: I had a major surgery and am wondering if I can get pregnant?
I had my whole colon removed inOct of 2004 and had reversal in May of 2005 ( colostomy taken down) and am wondering if there are others that have had major abdominal surgery and have gotten pregnant??? I am 29 and already have OOne child she is 3 but very desperate for another!! PS surgery due to crohns

A: Make sure you check with the dodcter first, that is probly the first thing. I’m not a docter, but since you did have surgery, you might want a C-section done. I have an Aunt who needed a C-section because her entire hips desinigrated and she has artifical hips right now, but yes, she did get pregnant,but the needed a C-section. She only had one child(After the first one she sorta lost the idea) but, if your DR okays it then I am sure you can. I’m pretty sure right now you can, but always check with a docter!

Q: What are the symptoms of Crohns disease?
I was diagnosed 6 months ago with Crohns Disease. By the time of my diagnosis, my colon had already abscessed and perforated and I had to have surgery to remove 3 feet of my colon. What symptoms should I keep an eye out for in order to prevent this from going so far again?

A: Go to webmed.com there is all the info you need .Great site .

Q: How long should it take to recover from bowel surgery?
I know this can only realistically be answered knowing the specifics of the case. Has anyone had this surgery? Its surgery to remove part of the intestine that is diseased due to a stricture caused by crohns disease. The patient is a lady of 53 who enjoyed good health before her diagnosis but has not been able to eat for months due to this condition. She is very thin and weak but strong mentally (and healthy elsewhere). Hope you can help or even just share your story.

Thanks

A: hi swinkers, I am a female crohn’s pt. who has had many surgeries w/the most recent in Sept. 08.

It varies in each pt. as to how long it takes to completely heal due to complications afterward such as cellulitis, fever, drugs that lower your resistance to infection, if the pt. was healthy going into surgery or if there were problems beforehand.

If you check out the Crohn’s & Colitis foundation’s site, they have stuff on surgery, diet, finding a local support group, as well as a live chat and hotline run by healthcare experts, plus there is an open forum where you can post questions to others who have Crohn’s or UC.

Definitely give that a try.

Q: crohns disease, been offered 2 choices remicaid iv drug or surgery, remicaid has some side effects ?
has anybody out there had either one of these and tell me how they are doing with it, any info would be greatly appreciated

A: hi jack, I am a female crohn’s pt. for 28 yrs. dxed at the age of 12.
First, check out the Crohn’s & Colitis Foundation site as it will really educate you as to what Crohn’s is, how it’s dxed, how it’s treated w/surgery as a LAST resort if other options fail. There is also a live chat & hotline run by healthcare experts if you have questions. They have an open forum where you can post questions to others who have CD. Family and friends are encouraged to use this as well to learn what we go through.

CCFA has local support chapters and educational meetings w/speakers such as dieticians, GI surgeons, health insurance reps, drug reps, etc. CCFA can provide information for those who don’t have insurance for health/drug coverage. Most drug companies have a program to assist folks plus most GIs have samples they can give their pts.

The prognosis is much better than when I was dxed at age 12 where there were only asacol and prednisone. Now, with the biologics, Humira, and Remicade, immunosuppressants- 6MP, Imuran, and a steroid replacement- Entocort- that won’t cause a moon face, weight gain, and not go into the blood stream, remission can be accomplished provided the pt. refrains from smoking and drinking b/c it can interfere w/treatments.

Surgery is always a last resort b/c many doctors don’t want to cut into a pt. unless they really have to. If it does occur, resections or a total colectomy w/permanent ileostomy are 2 common types.

I’ve had my ileostomy for 23 yrs. b/c all other treatments failed & my entire colon was shot. It is NOT a cure because crohn’s is known to come back at the surgical site. A recurrence can be slowed down if the GI puts the pt. on maintenance medication right after surgery.

As I said before, it is a last resort. If the pt.’s quality of life is to the point where they are in constant pain, live in the bathroom 24/7, & are not responding to current treatment, then this option would be looked at.

I learned so much about IBD by attending the CCFA meetings, meeting others like myself, and from the doctors and RNs who take care of me in and out of the hospital.

As for remicade, I was on it for 3 yrs. The 1st yr: a full remission the next day,no symptoms felt great. 2nd yr: it took a few days to for it to kick in, then I felt great. 3rd yr. didn’t do squat. This varies in each pt. mind you. The RN will premedicate first with Benedryl to avoid a reaction of Remicade, it may make you sleepy, then the actual med gets administered and takes 7 hrs. bring a book and lunch or something to occupy your time.

feel free to email me if you have questions. good luck.

Q: My friend has severe colitis. Do you know anyone who has had surgery for advanced stages of colitis or crohns?

A: I did a teaching presentation on the surgery for crohns, it’s actually a three step process… which turns out to be more like 3 surgeries, and he’ll have to have a colostomy for a while if he goes through with it. Depending how severe it is, might have to have a colostomy for the rest of his life. It’s very involved but a doctor can go through all the specifics during a consultation.

Q: I have crohns, interstitial cystitis so I was wondering if the lap band surgery would help me.?
Ive gained 50 lbs in a couple of months. I just tired of being sick . Iam overweight but not alot. doctors say my thyroid is acting up

A: hi amy, I am a female crohns pt. I can understand your concern about weight gain. If you are on certain meds to treat the crohns, like prednisone, that will definitely cause weight gain. Once you wean off of it, you should be able to lose the weight b/c steroids retain water and salt in your body. Have you looked into other treatments like Entocort, Humira, or Remicade. They don’t have the side effect of weight gain.

I am on Entocort myself and have been on Remicade which put me in remission for 2 yrs. then it didn’t work so Entocort is the wonder drug for now.

Check out the crohns and colitis foundation site and you can even call their toll free number and speak with medical professionals about your weight concerns M-F 9 am – 5 pm. 888.MY.GUT.PAIN (888-694-8872)

Also, check out the information they have such as diet, exercise, latest treaments, meds, women’s issues, coping skills, surgery, and you can locate a local support chapter where you live so you can meet others in the same situation as yourself. Hope this helps and know that you are not alone in your battle with IBD (crohns/UC).

Q: Have you undergone surgical resection of ascending colon in Crohns Colitis?
Do you know any people living with it? Well, I am undergoing that surgery tomorrow and I dont know how life is after that and I wanted to know how it is. I dont trust my Doctor very much. I think they are just experimenting with me. So any informating would be valuable.

A: Procedures Used to Remove Damaged Portions of the Colon
The invasiveness of the surgical procedure to remove damaged portions of the colon depends on the severity of the disease:

Resection of the Colon. In most cases of Crohn’s disease, only a part of the colon needs to be removed, a procedure called resection.

Subtotal Colectomy. Subtotal colectomy is more extensive than resection and removes more of the colon. Disease in the upper parts of the small intestine tends to require more extensive surgery than in the lower small intestine.
In general, either procedure requires a general anesthetic and involves the following:

An incision is made in the abdomen.
The diseased portion of the colon is identified and removed. (Strictureplasty is sometimes used alone with resection.)
Once a diseased segment of the colon is removed, the two ends are reconnected, and this connection is called an anastomosis.

Open Surgery or Laparoscopy. Resection or subtotal colectomy may be performed using one of two surgical approaches:

Open surgery, which requires a wide abdominal incision.
Laparoscopy, which uses a few small incisions through which a tube is inserted containing a tiny camera for viewing the area. To date, however, this procedure is best suited for patients with short-segment disease in the ileum who also have no other complications, such as fistulas and abscesses.

Complications after Resection or Subtotal Colectomy

1) Short-Bowel Syndrome. If large segments of the small intestine are removed, the patient is at higher risk for short-bowel syndrome, a complication in which there is a problem absorbing nutrients.

The risk is far lower with strictureplasty. which involves cutting and stitching only the areas obstructing the intestine, so that it widens the intestine without removing sections of it. Half of patients require re-operation, but strictureplasty in the jejunum and ileum of the small intestine is safe and generally effective over the long term. It may not be useful for Crohn’s disease in duodenum (the first section of the small intestine

The condition, short bowel syndrome used to be fatal, but patients now can live normal and productive lives using total parenteral nutrition (the intravenous administration of nutrients), which can now be self-administered at home in many cases.

2) Leakage or obstruction can occur in the areas where the colon has been reconnected (the anastomosis).

I3) Infections.

Disease Recurrence after Surgery
Recurrence of Crohn’s disease is very common after any procedure. One expert described the risk as being between 7% and 25% for each year after resection, with an average risk of 50% at five years after resection. (Even if the entire colon is removed there is still a high chance of recurrence in the rectum and a somewhat lower risk for recurrence in the small intestine.)

Patients at highest risk for recurrence are the following:

Smokers
Those whose disease occurred in the ileum (the lowest part of the small intestine) and colon. (One expert reported an 86% chance of recurrence.)
Those with abscesses or fistulas.
Those have had previous surgeries.
Various agents have been used to prevent recurrence. They include the antibiotics metronidazole, mesalamine and mercaptopurine. These agents, however, can have severe side effects. And it is not clear if these or any other agents are effective in preventing recurrence. Even if medications can help prevent recurrence in some patients, it is not yet known who these individuals might be. (In any case, steroids do not appear to help prevent recurrence.)

Emergency Surgeries

In some cases, surgery is needed for emergency conditions that can occur with Crohn’s disease. The conditions most likely to require such surgery in Crohn’s disease include the following:

Stopping severe intestinal bleeding.
Clearance of small bowel obstruction.
Surgery to drain and heal abscesses or fistulas.
Surgery to repair perforation

WHERE ELSE CAN HELP BE FOUND FOR INFLAMMATORY BOWEL DISEASE?

Crohn’s & Colitis Foundation of America (www.ccfa.org). Call 800-932-2423 or 212-685-3440. Primary site for information on IBD.

United Network for Organ Sharing (www.unos.org). Information on organ transplantation. At this time, the University of Pittsburgh Medical Center has performed the most small-bowel transplantations.

Crohn’s and Colitis Foundation of Canada (www.ccfc.ca). Call: 416-920-5035, or 800-387-1479.

National Digestive Diseases Information Clearinghouse (http://www.niddk.nih.gov)

American Gastroenterological Association (http://www.gastro.org). Call 301-654-2055.

American Society for Gastrointestinal Endoscopy (http://www.asge.org). Call 978-526-8330.

American College of Gastroenterology (http://www.acg.gi.org). Call 703-820-7400.

Find a Gastroenterologist (http://www.acg.gi.org/acg-dev/patientinfo/frame_phylocator.asp)

Descriptions of colonoscopy and colectomy (http://www.yoursurgery.com/Procedures.cfm?BR=1

Q: How does surgeon decide if I need surgery of a stricture in my ileum?
I am going to consult with a surgeon. He will have all of my records. What is he looking for? I have had a stricture for ten years and had a recent partial small bowel obstruction. (crohns disease)

A: The surgeon weighs the options for you. Is the stricture so bad in your ileum that it can no longer be left untreated? Can you continue to have good health if it isn’t operated on? Questions such as these are taken into consideration before surgery becomes an option. Ask lots of questions and ask this question (the one I am answering) before you commit to surgery. Ask what will happen if you opt not to have surgery. How will it help you? What are the risks involved with surgery? What is the risk to my health if the surgery isn’t performed? What is my recovery time? How good can I expect to feel having had the repair? How can I function if the surgery isn’t done? Will I harm my body if I don’t choose to have surgery? etc, etc. You have to trust your surgeon 100% before you make the decision. But if the surgeon says it is necessary you have to accept that decision and know that it will help you feel better.

Q: Will remicade treatments help rid of anal fistulas w/o surgery?
I have moderate to severe crohns disease and my anal fistula flares up about every 2 weeks or so. I am trying to avoid surgery of a colostomy. I am so sore all of the time except when the fistula drains.

A: Actually, remicade can be very helpful in the closing of fistulas.
But it sounds to me like you have boils. I, too, have crohn’s and have been on remicade since 1998. Haven’t had either of those problems since I started the treatment. Has your doctor recommended remicade? It doesn’t work for everyone.
GOOD LUCK!!!!!

Q: Does anyone else around here have crohns disease?
I was diagnosed when I was 13 after an emergency surgery.Im now almost 21 and its getting pretty severe.Just looking for someone to sympathize with.

A: I do. I was diagnosed in my mid 20s. I am now in my mid 30s. It has been a lot of up and down. Feeling good, then getting sick. Some days I can manage the mild symptoms just fine. Like living with diareah every day. But when the pain starts, thats when I have a hard time. You know its bad when even drinking plain water gives you pain.

I have not had health insurence thru most of it. So I have to treat myself the best way I can. A lot of over the counter meds. Sometimes when it gets really bad I will have to save up some cash and go to the doc. And get prescriptions .

From what I have learned over the yrs, from my own illness, and family members and others who have it. Not all people have the same symptoms. And those that take meds for it. Not all meds work for every prson.

For example, my aunt has it as well. Both of us have it pretty severe too. But meds she takes, Made me feel worse. She has been hospitalized a few times. I have not. ( if I had insurence maybe i would have). Although a few yrs back I did also have Pancreatitis. Whish she never got. She does not have as much acute sever pain like I do. But she also lives on pills.

I know it sucks to be sick. Especially with something that involves a lot of bathroom time. And there is sort of a stigma about talking about a condition that most people think is personal. (bathroom habits) But once you find a few who can relate, then it is a big help.

Q: Crohns disease question?
how common is it for a person that has crohns get surgery? is it necessary to have surgery done? and you live with thisdiseasee without getting surgery in you lifetime?

A: Try this website to find the answers you would like:

http://www.mayoclinic.com/health/crohns-disease/DS00104

Best wishes to you.

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