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Surgical Procedures for Inflammatory Bowel Disease

Surgery may be done on people with severe inflammatory bowel disease are not helped by medicine.

Surgery for Crohn Disease

Surgery may be done to remove inflamed parts of the bowel. But the problem may return to another section of the intestine or close to the part that was removed. If a blockage or fistula (abnormal link between the intestine and other organs or tissues) happens, then surgery may be needed to remove or repair the area.

Surgery for Ulcerative Colitis

Surgery may be done on people with severe disease who have not been helped by other methods. It may also be done to lower the risk of colon cancer, especially in people who have had the disease for more than 10 years.

Methods are:

  • Proctocolectomy
  • Abdominal colectomy
Proctocolectomy

Proctocolectomy removes the entire colon, rectum, and anus. A new way for waste to leave the body will need to be made. This can be done with:

Ileostomy—An opening called an ileostomy is made in the belly. The last part of the small bowel is brought out to the surface of the belly wall. This lets waste drain into a bag that is worn on the outside of the body.

Ileostomy
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Continent ileostomy—The end of the ileum is used to make a pouch inside the lower belly to collect waste. An opening is also made in the belly wall. A tube is placed into the opening to empty the pouch.

Ileoanal anastomosis—The colon and rectum are removed, but the anal sphincters are left in place. The end of the ileum is made into a pouch and connected to the anus. Waste can then flow though the ileum to the anus and out of the body.

Abdominal Colectomy

A colectomy is done to remove the colon, but keep part of the rectum. The ileum is then connected to the rectum. This lets stool (poop) exit. This surgery is not as common.

References

Crohn disease in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/crohn-disease-in-adults. Accessed April 25, 2022.

Ulcerative colitis in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/ulcerative-colitis-in-adults. Accessed April 25, 2022.

What is Crohn's disease? Crohn's & Colitis Foundation website. Available at: https://www.crohnscolitisfoundation.org/what-is-crohns-disease. Accessed April 25, 2022.

What is Ulcerative Colitis? Crohn's & Colitis Foundation website. Available at: https://www.crohnscolitisfoundation.org/what-is-ulcerative-colitis. Accessed April 25, 2022.