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Up to 500,000 people in America are affected by Crohn’s disease, a debilitating autoimmune disorder that is characterized by intense, painful inflammation in the gastrointestinal tract. The disease has a number of serious complications, including stricture (narrowing) of the bowel, perforations, abscesses, fistulas (abnormal connections between tissues), hemorrhages, and cancer.
While the disease itself is not usually treated with surgery, these complications often do require some type of surgical treatment – in fact, around 80% of people with Crohn’s disease will at some point need surgery to treat one or more complications. In the past, these surgeries have often been very complex and highly invasive procedures, undertaken with the risk of destroying bowel tissue as well as treating the problem.
In recent years, however, the development of innovative new surgical techniques has improved available treatment for complications of Crohn’s disease, and has improved the quality of life for people with the disorder at the same time.
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Surgical Options for Treatment of Crohn’s Complications
Until fairly recently, surgical options were limited to invasive procedures that often required the complete removal of large sections of bowel – but this is definitely no longer that case. Some of the surgical options pioneered within the last decade or two include:
Laparoscopic Surgery: Even repeated laparoscopic surgical procedures leave very little scarring, and this makes laparoscopy a particularly popular option for many patients undergoing surgery for treatment of Crohn’s disease. This type of surgery is extremely non-invasive and much less likely to cause tissue adhesions, making it safer as well. It also requires less recovery time, meaning the surgery is less expensive, and allows patients to return home sooner. The downside is that the surgery can be more time-consuming, and surgeons require more extensive training.
Strictureplasty: In the past, the only treatment option for bowel stricture was to simply remove the stretch of affected bowel – a technique that shortened the bowel and could limit severely gastrointestinal function. These days, however, a technique called strictureplasty has revolutionized the treatment of bowel strictures. No longer is it necessary to remove bowel tissue – this surgery restructures the length of bowel, making it wider and allowing the contents of the intestines to pass through unhindered.
Fistula Plugs: Fistulas – abnormal connections tissues – can be both painful and extremely dangerous. The formation of a fissure can allow the contents of the intestines to diverge from their normal course along the anal canal, resulting in abscesses, anal incontinence, and systemic infection, which can be very serious and even fatal. If the fistula cannot be drained, the insertion of a fistula plug closes off the abnormal tract by triggering the growth of tissue around the plug.
Considering that four out of five people with Crohn’s disease will require surgery at some point, these new techniques have already improved the lives of thousands of people, and will help many more.
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Stein, S., Michelassi, F. New Advances in Surgical Treatment of Crohn's Disease. Practical Gastroenterology. 2008 April Volume: XXXII Issue: 4.