It is common for people with Crohn's disease to have diseased parts of the bowel separated from each other by "skip areas" of normal bowel. Over time, these diseased areas can narrow (known as strictures) and can block the passage of digested food.

 

But because most of the small intestine is still normal, healthcare providers may recommend a strictureplasty. A strictureplasty widens the narrowed area in the small intestine without removing any of the small intestine. This is an effective surgery for people with mild or moderate Crohn's disease with skip areas. It is more effective when the stricture occurs in the second or third part of the small intestine (jejunum or ileum).

 

If a larger amount of the intestines are affected by Crohn's disease, doctors may recommend a resection. In a resection, the diseased parts of the intestine can be removed and the two healthy ends are sewn back together (known as an anastomosis).

 

If it is necessary to rest the intestine from its normal digestive work while it heals, doctors may create a temporary opening (stoma) of the intestine onto the abdomen (ileostomy). A temporary ileostomy will be closed and repaired later. If a large portion of the bowel is removed, the ileostomy may be permanent.

 

With this type of surgery, a reoccurrence rate of 50 to 75 percent over a five-year period of time is not uncommon.

 

For a person with severe Crohn's disease that affects the colon, healthcare providers may recommend a colectomy. With a colectomy, a large part of the colon or the entire colon is removed, with the small intestine being attached to the rectum. When the colon and rectum are removed, it is known as a proctocolectomy.

 

A colostomy or ileostomy may be done after the diseased colon is removed. A colostomy or ileostomy creates an opening in the abdomen (stoma) for the drainage of stool (feces) from the large intestine (colon) or small intestine (ileum). The stoma may be temporary or permanent. The stoma is about the size of a quarter and is usually located in the right lower part of the abdomen near the belt line. The patient wears a pouch over the opening to collect waste and empties the pouch as needed. The majority of colectomy patients go on to live normal, active lives.

 

Following surgery, most people have a significant improvement in symptoms. Reoccurrence rates for this type of Crohn's disease surgery vary from 10 to 30 percent, although reoccurrence is not often disabling.