The Risks And Rewards Of Intestinal Resections
Did you know most sufferers of Crohn's disease have at least one surgery at some point? One reason for this is the small intestine is a relatively narrow passageway (at least as compared to the colon). After years of disease, then, we often develop scarring, abscesses, fistulas, and other abnormalities that eventually lead to obstruction.
Surgery for Crohn's disease
The most common surgery for Crohn's disease to correct this obstruction is an intestinal resection. I had one in 2001. Basically, this involves a surgeon removing the most diseased section of your intestine and connecting the two healthier parts via an anastomosis. This connection can be made via stitches or staples. Both methods have advantages.
A resection can work wonders since it is removing a highly-diseased area of your intestine, but there are some elements to consider before undergoing such a serious operation.
First, many resections, with Crohn’s patients, take place in the terminal ileum. This is the final stretch of your small intestine. It is an area Crohn’s patients tend to have problems, although, of course, with Crohn’s, inflammation can be at any point in the digestive tract.
Vitamin and other nutrient absorption
When a piece of your intestine is removed from the terminal ileum it may be harder for you to absorb nutrients. For instance, many people who’ve had resections become B-12 deficient. This can lower your energy and overall well-being.
If possible, take B-12 supplements and/or monitor your B-12 levels. Several other important vitamins and nutrients are also absorbed in the terminal ileum, so you will really need to work hard to maintain the same level of nutrition you had pre-surgery, particularly since nutrient absorption is already a problem with Crohn’s disease (even without surgery). [Note: Many of these same issues arise with resections in other parts of the small intestine].
Why do adhesions happen after surgery?
Another concern is adhesions. While surgeons can correct the original problem in most cases, this new problem can be just as agonizing. Basically, adhesions often form after surgery.
They are bands or strings that often attach to organs from the intestinal wall, often near the point of incision. There is no medical therapy outside of further surgery to alleviate problems revolving around adhesions.
Making matters worse, some adhesions can twist or kink a bowel. This can lead to blockages. Or severe abdominal pain. I've had a few blockages that are likely a result of adhesions. It’s a whole other problem to worry about in addition to Crohn’s disease.
Making the decision for surgery
What is more every surgery you have gives you a risk of more adhesions, so, the feeling is now, that you should only operate when truly needed.
There are other risks with an intestinal resection as well...anesthesia risks, bowel leakage risks, ostomy risks, even the risk of death. Hence, surgery is not a decision that should be made lightly. That said, if you're having a major issue it may be the only way to fix the problem.
I hope this overview was helpful to those unfamiliar with the risks and rewards of intestinal resections. I have mixed feelings about these operations, like mine, in 2001, had complications that required another surgery in 2002. Still, at the end of the day, if there is no other choice, remember this could be the thing that saves your life. That is something to be grateful for and hence it should always be considered as a potential treatment.
Thanks for reading, and, as always, feel free to comment below.
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