Bowel Resection Surgery
Crohn’s disease (CD) and ulcerative colitis (UC) are the two major forms of inflammatory bowel disease (IBD). Both cause chronic inflammation in the digestive tract. While the inflammation in UC is confined to the colon and rectum, inflammation in CD can occur anywhere along the digestive tract, from the mouth to the anus. The pattern of inflammation also differs between UC and CD. In UC, the inflammation is continuous, and in CD, patches of inflamed tissue may be separated by patches of healthy tissue. The patches of active disease can cause complications like strictures, narrowing and blocking the flow of digested food.1
Bowel resection surgery is one of the most common types of surgeries that people with CD may need to have to treat complications like strictures.1,2 The surgery involves removing a section of the patient’s intestine affected by the disease. This may be either a section of the small intestine or of the large intestine (colon).
One of the ways that strictures in the small intestine can be treated is with a procedure called a strictureplasty, but some people may need bowel resection surgery to treat them. Another reason that person may need to have bowel resection surgery is if they develop a hole or tearing in the lining of the intestine, which is also called a perforation.1
What happens during bowel resection surgery?
During the bowel resection procedure, the patient is given general anesthesia.2 The colorectal surgeon operates to remove the section of bowel that is affected by active disease. The surgeon will generally try to remove only the area of the intestine that is affected in order to leave as much of the healthy intestine as possible. The two healthy ends of intestine on either side of the section that was removed are then attached together. This attachment is called the anastomosis.
What happens after bowel resection surgery?
Patients who have bowel resection surgery will likely be monitored in the hospital for around 5-10 days. Full recovery from surgery can take between 6 and 8 weeks. Healthcare providers will talk to you about how to take care of yourself throughout your recovery and afterwards, including advice about things like nutrition and physical activity.2
Patients are generally prescribed medications for pain and/or antibiotics during the recovery period. To help keep active disease from coming back as quickly, patients may also be prescribed medicine (or a combination of medicines) such as immunomodulators or a biologic therapy.
What is the likelihood of CD recurring after bowel resection surgery?
For some patients, bowel resection surgery can be successful in reducing and even eliminating symptoms caused by CD for a long period of time.1,2 While patients often have years of relief from their symptoms after surgery, studies show that around half of patients who have bowel resection will have a recurrence of CD within about 5 years after surgery. The disease is most likely to re-occur at the anastomosis, where the surgeon joined the sections of bowel together. For many people, this can be treated with medications such as immunomodulators or biologic therapies. However, around half of patients who have CD recurrence after surgery will need to have a second surgery to treat it.
What are the potential complications of bowel resection surgery?
As with any surgery, possible complications of bowel resection include infection, bleeding, or bad reactions to the anesthesia. Patients who have undergone resection surgery also have a potential risk of dehiscence. Dehiscence is when the two sections of intestine that have been rejoined split apart or leak. Healthcare providers will give patients advice about the proper care of the surgical incision site to prevent infections or other complications. If you begin to feel ill, have a fever, or experience severe pains after surgery, it is very important to contact a healthcare provider right away.1,3,4
Some people who have bowel resection surgery may develop a complication called “short bowel syndrome.” This is a term used to describe a group of problems that cause poor absorption of nutrients in the small intestine. One of the small intestine’s most important functions is to absorb nutrients from digested food and transport them into a person’s bloodstream. When part of a person’s small intestine is removed during bowel resection surgery, the remaining portion of the small intestine may not be able to absorb enough nutrients. This can cause malnutrition or nutritional deficiencies.4