So Much Variability in IBD – Part 2

Inflammatory bowel disease alone is a mine field for most people in the healthcare field but when you start adding in surgery, I think people (patients, caregivers, the public, people in the medical profession, etc) become lost to a degree. It is human nature to try and compare yourself or a loved one to someone else in a similar situation who is going through the same type of surgery. It is also very understandable why a physician who isn’t incredibly knowledgeable about inflammatory bowel disease may take what happened with one patient and believe that is the case for most. There is so much variability and I wanted to take this opportunity to share why.

In my previous article, I discussed how much there is to consider with the removal of the large intestine. Now I want to focus on the following:

Small Bowel Resection

Just like with the removal of the colon/large intestine, the surgical outcome of an inflammatory bowel disease patient undergoing a small bowel resection varies greatly from person to person.

Aside from some of the above questions I mentioned when talking about a colectomy, there are other factors to consider when someone undergoes a small bowel resection. A handful of these questions are:

Was the surgeon able to get all of the diseased portion of the small bowel (that he/she could see) or is the patient still looking at a bowel that is not under control in terms of inflammation and/or ulcerations? If so, will the patient need to be on an immunosuppressive medication of some kind following surgery?
Could short bowel syndrome be an issue or does the patient still have plenty of their small intestine left? Small bowel syndrome occurs when there is not enough small intestine to absorb the necessary nutrients needed to survive. In this case, many patients are either put on TPN (total parenteral nutrition) or given food through another tube.
Does the patient still have their large intestine/colon?

Ostomy Surgery

For those IBDers who need to have an ostomy of some kind, there are also varying factors at play that will determine how someone is post-op. I have mentioned a bunch in this article already but a few others I would like to bring up are…

How many surgeries has the patient had? The extra scar tissue may play a role in how someone is able to digest certain foods, the consistency of the output, etc.
What kind of ostomy does the patient have and will it be permanent?
Does the patient still have their rectum and anus? If so, could there be any leakage issues?

J-pouch Surgery

This surgery is primarily indicated for ulcerative colitis patients, although there are many people who have Crohn’s Disease who have a J-pouch. I have probably already talked your ear off by now so I will try to wrap this up. Some additional questions/factors at play after J-pouch surgery are:

Will the patient get pouchitis and if so, will it be a mild case that is easy to handle or more severe?
Will the patient suddenly develop complications such as fistulas or abscesses that can cause a lot of infection and also may be indicative of a misdiagnosis?
Does the patient have any infection in his/her body either prior or following the surgery?

Wow…

Even I am tired of writing all of this out so I bet you are about to head off to sleep after reading all of it. I do find it important to bring up things that others might not think about. I also know how long it took me to realize a lot of the things I mentioned above and now that I am more of a veteran IBD patient, I do want to share some of the things I wish I took into account or thought about years ago.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The InflammatoryBowelDisease.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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