The Benefits Of Crohn's Surgery Involving Strictureplasty
Last updated: November 2023
I wrote an earlier blog post about an intestinal resection, a common type of surgical procedure for Crohn’s disease that I had many years ago. That post seemed to attract some interest, so I’m following it up with a post on a different surgical technique called strictureplasty.
Strictureplasty for Crohn's disease
A strictureplasty involves widening a narrow section of the intestine without removing any of the intestines. These areas become narrow, or form strictures, owing to chronic inflammation or adhesions from prior surgeries.
The benefit of this surgical procedure over an intestinal resection is unlike in a resection where the surgeon cuts out a section of your intestine and reattaches the two sides of your bowel, here you don’t lose any intestine. This is an important benefit since it’s better to have as much intestine as possible to absorb nutrients and maintain optimal health.
Indeed, some patients who have a few resections eventually develop short bowel syndrome, where they are not able to absorb enough nutrients.
Intestinal resection vs. strictureplasty
Whether your surgeon decides to do a strictureplasty or an intestinal resection, or some combination (such as a strictureplasty in one area and a resection in another), experientially the surgery should be pretty much the same. The surgeon still needs to make an incision and operate and you still need similar pain meds like morphine and will have a similar recovery time.
The main difference is really that the strictureplasty preserves more bowel, so it is worth considering provided your medical team suggests it.
Strictureplasty at former anastomosis site
My third surgery was labeled exploratory. I had been having problems eating, severe abdominal pain, bloating, diarrhea, and I dropped 45 pounds. The surgeon found a piece of my intestine stuck in my duodenum. I also had adhesions from prior surgeries. Repairing these issues helped me feel better and eat relatively normally again. It also eliminated the extreme bloating.
Additionally, the area around the anastomosis, or the spot where two pieces of my intestine were surgically connected during a prior resection, had narrowed down. An earlier balloon procedure had helped a bit. (A balloon procedure involves putting a balloon on the end of a colonoscope that is dilated to widen an anastomosis.) But because this area was narrowing again, the surgeon performed a strictureplasty at the former anastomosis site.
Together these surgical repairs were beneficial. This surgery did not necessitate me to lose any more bowel. Further, the anastomosis area never narrowed down again.
Crohn's surgery overview
While my feeling is that you should only do surgery when there are no better options, this time it was required. Fortunately, I haven’t needed surgery since. God willing I will stay out of the operating room!
To review, a strictureplasty is a surgical procedure common among Crohn's patients. I explained what it involves, how mine went, and compared this procedure to an intestinal resection so as to give the uninitiated an idea of what to expect. I also reviewed other key surgical terms such as anastomosis and intestinal resection.
Advice for post-op
Finally, if you are post-op, and not sure what surgical procedure you had, but want to learn more, I recommend requesting a copy of your medical records. Somewhere in there should be your surgical report. Reading this is very educational.
Mine explained exactly what the surgeon did while I was under anesthesia. Owing to this self-education, on subsequent visits I was able to discuss my symptoms with my medical team more cogently.
Thanks for reading, and, as always, feel free to comment below.
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