Diet and Health FAQ

Tagged As: Ulcerative Colitis And Crohns

Question:
Does anyone know of any surgical techniques that are used on patients suffering from Ulcerative Colitis or Crohn's Disease? I would like to know about the physical results of the technique, success rate, dangers involved, side effects, limitations faced by patient after surgery, etc...I would like to know about experimental or commonly practiced techniques.

Answer:
In ulcerative colitis, the colon is removed and a new rectum is made with the small bowel emptying into it. This operation is successful in a good number of cases if done by a very skilled surgeon. Not just every surgeon can do it, although many may try. If they mess up, it can be a disaster, with leakage of feces. With Crohn's, the problem is the small bowel is diseased also. About all that can be done is remove stenosed pieces of bowel and hope you don't get down below the minimum length for survival (short bowel syndrome).   You ask a lot of questions in this short paragraph.  Perhaps I can answer a couple of them at a high level.  If you want more detail, you can e-mail to me, and I'll go into more detail. The basic answer to your question is that when pharmaceutical solutions (taking drugs like sulfasalazine, or sometimes carticosteriods such as prednisone) do not work, or other situations occur which require immediate action, surgery is often indicated. In both type of Inflammatory Bowel Disease (or IBD), the collective name for disease such as Ulcerative Colitis and Crohn's disease, the technique of resection is often used to remove portions of intestine which are affected by the disease.  This basically means that the intestine is cut on either side of the affected area, that portion taken out, and the two ends put back together again.  In about 60% of cases, this solves the symptoms for a 5-year period. Another technique (which will be described in an upcoming issue of the IBDlist Digest) is strictureplasty.  The basic description of this is to take a section of constricted intestine, make a slice in it longitudinally (the same direction as the intestine), then push the intestine together (resulting in a cut which looks like it is crossways to the intestine (transverse)).  The resulting transverse cut is sewn together. If you would like to get that upcoming issue of the IBDlist Digest, send a note to ibdlist-request%mva...@udel.edu and I'll put your name on the distribution list. Oops.  Sorry.  I stand corrected on this.  I'll admit to knowing a lot more about Crohn's than I do about Ulcerative Colitis.  But you are also right about surgery for UC:  it is almost 100% successful, since there is no portion of the bowel left which UC attacks.