Table of ContentsView AllTable of ContentsWhat It IsPurposeHow to PrepareDay of SurgeryRecoveryLong-Term Care
Table of ContentsView All
View All
Table of Contents
What It Is
Purpose
How to Prepare
Day of Surgery
Recovery
Long-Term Care
Crohn’s disease, a form of inflammatory bowel disease (IBD), is sometimes treated with surgery. This is not a cure, but serves to manage symptoms, and with a good outcome, to improve quality of life.However, surgery does not reduce the risk of Crohn’s disease from recurring; about 40% of people who have undergone surgery have Crohn’s return.There are several types of surgery to treatCrohn’s disease, depending on the location of inflammation and whether there are any disease complications. Crohn’s surgery recovery depends on the surgical procedure, a person’s health, and the extent of the disease.Verywell / Ellen LindnerWhat Is Surgery for Crohn’s Disease?Surgery may be required when medications are not effective or are causing severe symptoms, or complications develop. Surgery is used to remove inflamed or damaged parts of the intestine and/or to manage complications.Surgery for Crohn’s disease may be done on an emergency or elective basis.Reasons for emergency surgery may include:Bowel blockagePerforation (hole in the intestine)FistulaAn abscess (collection of pus)Excessive bleedingSevere symptomsSurgery as a TreatmentIt is important to remember that surgery is a good treatment option for Crohn’s disease. It can help with improving quality of life and managing the disease. Surgery, however, is not a cure for Crohn’s disease.Types of SurgeriesAbscess drainage: People with Crohn’s disease may be at a greater risk forabscesses. This might occur in the glands that surround the anus. Abscesses can be painful and difficult to cope with, so they might be drained to provide relief.Colectomy:During acolectomy, the colon is removed. Some or part of the rectum is left.This procedure is done with either anileostomy(a piece of the small intestine is brought through an opening in the abdomen (called astoma), or a straight pull-through where the end of the small intestine is connected to the rectum.Fistula repair: A fistula is an abnormal connection between two organs; it usually involves the intestines with Crohn’s disease.Different types of surgerytreat fistulasdepending on their extent and location.Afistulotomymight be done for a fistula in or around the anus that connects to the skin.Ileostomy: Anileostomyinvolves bringing a piece of the small intestine through the abdomen and an appliance is worn over it to collect stool. It might be created after part or all of the large intestine is removed. An ileostomy can be temporary or permanent.Proctectomy:Proctectomysurgery is the removal of the anus and the rectum and requires an ostomy to be created. A proctectomy might be done when Crohn’s disease affects theperianalarea (the skin around the anus).Resection: A resection removes a damaged or inflamed portion of the small orlarge intestine. The two healthy ends of the intestine are then attached back together.Strictureplasty:A stricture is anarrowing in the intestine. This can occur when inflammation or scar tissue causes the wall of the intestine to thicken.A narrowing can mean that a blockage is more likely. The stricture can be surgically opened, and it doesn’t lead to a loss of any part of the bowel.There may be the possibility oflaparoscopic surgeryvs. open surgery for some procedures. In laparoscopic surgery, only small incisions are made and a camera guides the instruments. In open surgery, a larger incision is made to access the area. Your healthcare provider will determine which is the best option for you.ContraindicationsNot everyone is a good candidate for surgery. Crohn’s disease may lead to complications such asanemia(lack of healthy red blood cells to carry oxygen to tissues) ormalnutrition(deficiency of nutrients), which can make surgery and recovery more challenging.Surgery may be delayed to give a person who isn’t well time to heal and get into better shape. Your healthcare provider will weigh the risks of surgery against the benefits.Potential RisksThe risks of each type of surgery may be different for each person and procedure. Consult your surgeon and the rest of their team to understand the potential risks. Some of the risks can include:AbscessBleedingBowel blockage (obstruction)InfectionReadmission to the hospitalSurgical adhesionsRisks of InfectionInfection is also an important risk for people taking certain medications to treat Crohn’s disease. One study showed that those receiving anti-TNF medications such as Remicade (infliximab),Humira (adalimumab), Cimzia (certolizumab pegol), andSimponi (golimumab)had an increased risk of postsurgical infection.Purpose of Crohn’s Disease SurgeryThe main reason for surgery for Crohn’s is to manage the disease. The type of surgery used will depend on the extent of the inflammation and any complications. However, as medications to manage the disease continue to improve, there are fewer people who require surgery.How to PreparePreparing for surgery will depend on the type of surgery and the timing. In general, it’s important to understand the procedure, the potential complications, and what the recovery period will look like.Preparing for some surgery might mean cleaning out the bowel, similar to how you wouldprepare for a colonoscopy. Other types of surgery might need preparation, including fasting, stopping certain medications, or taking antibiotics.For those having surgery to place an ileostomy or a colostomy, the preparation will include information about managing astoma.Meeting with anenterostomaltherapy (ET) nursewill be important in deciding where to place the stoma on the abdomen.After surgery, an ET nurse and other healthcare providers will provide instructions on how to best manage a stoma appliance.What to Expect on the Day of SurgeryDepending on the procedure, there may be several meetings with members of the healthcare team before the day of surgery. This will help answer questions about what will happen before, during, and after surgery.Some types of surgery require a stay in the hospital, averaging from three to seven days. The day of surgery will mean checking in to the hospital. Patients will have their vitals taken and meet with the surgical team. An IV (intravenous) drip will be started to give fluids and any needed medications before and after surgery, including anesthetic and pain medications.For outpatient surgery, there may be local medications given to numb the surgical area. The surgical site might also need preparation to prevent possible infection.RecoveryFor many types of surgery, recovery will include pain management. This may include intravenous (IV) medications for more extensive inpatient procedures.For outpatient surgery, there could be prescription or over-the-counter (OTC) oral pain medications. Consult your healthcare provider to learn how to manage pain after surgery.For procedures such as a resection or ostomy surgery, patients will be managed in the hospital. Patients may have an IV, surgical drains, or anasogastric (NG) tubein the nose. Diet may be started slowly, first withclear liquidsand eventually progressing to a regular diet in preparation for being discharged to home.Be sure to consult your healthcare provider if you have signs of infection at the incision site or any other symptoms you were told to watch for.Recovery time depends on the procedure, the extent of complications, and the overall health of the person with Crohn’s. On average, recovery can take between four and six weeks.It’s important to note that there is a possibility of Crohn’s recurring after surgery. Some things that may make it more likely include:Smoking cigarettesMultiple bowel resectionsFistulasLong-Term CareThe long-term care will often include follow-up appointments with the gastroenterologist, the surgical team, and, in the case of ostomy surgery, an ET nurse.It’s important to understand how to care for any surgical sites at home. The healthcare team will give instructions, which might include keeping the site dry, changing dressings, or making a follow-up appointment to remove any staples that are used.In the long term, patients should expect some relief from the symptoms for which they had the surgery. In some cases, that might also mean a change in medications and other treatments. While recovering, some patients may find that they can work with a dietitian to add more foods back into their diet.SummarySurgery for Crohn’s disease is not curative, but it may offer a good option for managing symptoms and any complications. You may be concerned about having surgery, but there is potential for a good outcome that can improve your quality of life.Several types of surgery are used to treatCrohn’s disease. These include abscess drainage, colectomy, fistula repair, ileostomy,proctectomy, resection, and strictureplasty.Some of these procedures may be done with minimally invasive laparoscopy, while others may be open surgical procedures. They might be done as outpatient surgery or require a hospital stay. Consult your healthcare provider to discuss which procedure may be best for you and any potential risks.
Crohn’s disease, a form of inflammatory bowel disease (IBD), is sometimes treated with surgery. This is not a cure, but serves to manage symptoms, and with a good outcome, to improve quality of life.
However, surgery does not reduce the risk of Crohn’s disease from recurring; about 40% of people who have undergone surgery have Crohn’s return.
There are several types of surgery to treatCrohn’s disease, depending on the location of inflammation and whether there are any disease complications. Crohn’s surgery recovery depends on the surgical procedure, a person’s health, and the extent of the disease.
Verywell / Ellen Lindner
What Is Surgery for Crohn’s Disease?
Surgery may be required when medications are not effective or are causing severe symptoms, or complications develop. Surgery is used to remove inflamed or damaged parts of the intestine and/or to manage complications.
Surgery for Crohn’s disease may be done on an emergency or elective basis.
Reasons for emergency surgery may include:
Surgery as a TreatmentIt is important to remember that surgery is a good treatment option for Crohn’s disease. It can help with improving quality of life and managing the disease. Surgery, however, is not a cure for Crohn’s disease.
Surgery as a Treatment
It is important to remember that surgery is a good treatment option for Crohn’s disease. It can help with improving quality of life and managing the disease. Surgery, however, is not a cure for Crohn’s disease.
Types of Surgeries
Abscess drainage: People with Crohn’s disease may be at a greater risk forabscesses. This might occur in the glands that surround the anus. Abscesses can be painful and difficult to cope with, so they might be drained to provide relief.
Colectomy:During acolectomy, the colon is removed. Some or part of the rectum is left.
This procedure is done with either anileostomy(a piece of the small intestine is brought through an opening in the abdomen (called astoma), or a straight pull-through where the end of the small intestine is connected to the rectum.
Fistula repair: A fistula is an abnormal connection between two organs; it usually involves the intestines with Crohn’s disease.
Different types of surgerytreat fistulasdepending on their extent and location.
Afistulotomymight be done for a fistula in or around the anus that connects to the skin.
Ileostomy: Anileostomyinvolves bringing a piece of the small intestine through the abdomen and an appliance is worn over it to collect stool. It might be created after part or all of the large intestine is removed. An ileostomy can be temporary or permanent.
Proctectomy:Proctectomysurgery is the removal of the anus and the rectum and requires an ostomy to be created. A proctectomy might be done when Crohn’s disease affects theperianalarea (the skin around the anus).
Resection: A resection removes a damaged or inflamed portion of the small orlarge intestine. The two healthy ends of the intestine are then attached back together.
Strictureplasty:A stricture is anarrowing in the intestine. This can occur when inflammation or scar tissue causes the wall of the intestine to thicken.
A narrowing can mean that a blockage is more likely. The stricture can be surgically opened, and it doesn’t lead to a loss of any part of the bowel.
There may be the possibility oflaparoscopic surgeryvs. open surgery for some procedures. In laparoscopic surgery, only small incisions are made and a camera guides the instruments. In open surgery, a larger incision is made to access the area. Your healthcare provider will determine which is the best option for you.
Contraindications
Not everyone is a good candidate for surgery. Crohn’s disease may lead to complications such asanemia(lack of healthy red blood cells to carry oxygen to tissues) ormalnutrition(deficiency of nutrients), which can make surgery and recovery more challenging.
Surgery may be delayed to give a person who isn’t well time to heal and get into better shape. Your healthcare provider will weigh the risks of surgery against the benefits.
Potential Risks
The risks of each type of surgery may be different for each person and procedure. Consult your surgeon and the rest of their team to understand the potential risks. Some of the risks can include:
Risks of InfectionInfection is also an important risk for people taking certain medications to treat Crohn’s disease. One study showed that those receiving anti-TNF medications such as Remicade (infliximab),Humira (adalimumab), Cimzia (certolizumab pegol), andSimponi (golimumab)had an increased risk of postsurgical infection.
Risks of Infection
Infection is also an important risk for people taking certain medications to treat Crohn’s disease. One study showed that those receiving anti-TNF medications such as Remicade (infliximab),Humira (adalimumab), Cimzia (certolizumab pegol), andSimponi (golimumab)had an increased risk of postsurgical infection.
Purpose of Crohn’s Disease Surgery
The main reason for surgery for Crohn’s is to manage the disease. The type of surgery used will depend on the extent of the inflammation and any complications. However, as medications to manage the disease continue to improve, there are fewer people who require surgery.
Preparing for surgery will depend on the type of surgery and the timing. In general, it’s important to understand the procedure, the potential complications, and what the recovery period will look like.
Preparing for some surgery might mean cleaning out the bowel, similar to how you wouldprepare for a colonoscopy. Other types of surgery might need preparation, including fasting, stopping certain medications, or taking antibiotics.
For those having surgery to place an ileostomy or a colostomy, the preparation will include information about managing astoma.Meeting with anenterostomaltherapy (ET) nursewill be important in deciding where to place the stoma on the abdomen.
After surgery, an ET nurse and other healthcare providers will provide instructions on how to best manage a stoma appliance.
What to Expect on the Day of Surgery
Depending on the procedure, there may be several meetings with members of the healthcare team before the day of surgery. This will help answer questions about what will happen before, during, and after surgery.
Some types of surgery require a stay in the hospital, averaging from three to seven days. The day of surgery will mean checking in to the hospital. Patients will have their vitals taken and meet with the surgical team. An IV (intravenous) drip will be started to give fluids and any needed medications before and after surgery, including anesthetic and pain medications.
For outpatient surgery, there may be local medications given to numb the surgical area. The surgical site might also need preparation to prevent possible infection.
For many types of surgery, recovery will include pain management. This may include intravenous (IV) medications for more extensive inpatient procedures.
For outpatient surgery, there could be prescription or over-the-counter (OTC) oral pain medications. Consult your healthcare provider to learn how to manage pain after surgery.
For procedures such as a resection or ostomy surgery, patients will be managed in the hospital. Patients may have an IV, surgical drains, or anasogastric (NG) tubein the nose. Diet may be started slowly, first withclear liquidsand eventually progressing to a regular diet in preparation for being discharged to home.
Be sure to consult your healthcare provider if you have signs of infection at the incision site or any other symptoms you were told to watch for.
Recovery time depends on the procedure, the extent of complications, and the overall health of the person with Crohn’s. On average, recovery can take between four and six weeks.
It’s important to note that there is a possibility of Crohn’s recurring after surgery. Some things that may make it more likely include:
The long-term care will often include follow-up appointments with the gastroenterologist, the surgical team, and, in the case of ostomy surgery, an ET nurse.
It’s important to understand how to care for any surgical sites at home. The healthcare team will give instructions, which might include keeping the site dry, changing dressings, or making a follow-up appointment to remove any staples that are used.
In the long term, patients should expect some relief from the symptoms for which they had the surgery. In some cases, that might also mean a change in medications and other treatments. While recovering, some patients may find that they can work with a dietitian to add more foods back into their diet.
Summary
Surgery for Crohn’s disease is not curative, but it may offer a good option for managing symptoms and any complications. You may be concerned about having surgery, but there is potential for a good outcome that can improve your quality of life.
Several types of surgery are used to treatCrohn’s disease. These include abscess drainage, colectomy, fistula repair, ileostomy,proctectomy, resection, and strictureplasty.
Some of these procedures may be done with minimally invasive laparoscopy, while others may be open surgical procedures. They might be done as outpatient surgery or require a hospital stay. Consult your healthcare provider to discuss which procedure may be best for you and any potential risks.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chiarello MM, Cariati M, Brisinda G.Colonic Crohn’s disease - decision is more important than incision: A surgical dilemma.World J Gastrointest Surg. 2021;13(1):1-6. doi:10.4240/wjgs.v13.i1.1.Crohn’s & Colitis Foundation.Surgery.American Society of Colon & Rectal Surgeons.Abscess and fistula.Kamrava A, Mahmoud NN.Prevention and management of nonhealing perineal wounds.Clin Colon Rectal Surg. 2013;26(2):106-111. doi:10.1055/s-0033-1348049.Patel KV, Darakhshan AA, Griffin N, Williams AB, Sanderson JD, Irving PM.Patient optimization for surgery relating to Crohn’s disease.Nat Rev Gastroenterol Hepatol. 2016;13(12):707-719. doi:10.1038/nrgastro.2016.158.Yang SS, Yu CS, Yoon YS, Yoon SN, Lim SB, Kim JC.Risk factors for complications after bowel surgery in Korean patients with Crohn’s disease.J Korean Surg Soc. 2012;83(3):141-148. doi:10.4174/jkss.2012.83.3.141.Hanzel J, Almradi A, Istl AC, et al.Increased risk of infections with anti-TNF agents in patients with Crohn’s disease after elective surgery: Meta-analysis.Dig Dis Sci. 2021 Feb 26. doi:10.1007/s10620-021-06895-6. Online ahead of print.Chiarello MM, Cariati M, Brisinda G.Colonic Crohn’s disease - decision is more important than incision: A surgical dilemma.World J Gastrointest Surg. 2021;13(1):1-6. doi:10.4240/wjgs.v13.i1.1.Crohn’s and Colitis Canada.Surgery.American Gastroenterology Association Institute.Disease after surgery: A patient guide.Gastroenterol. 2017;152(1):296-297.Additional ReadingToh JW, Stewart P, Rickard MJ, Leong R, Wang N, Young CJ.Indications and surgical options for small bowel, large bowel and perianal Crohn’s disease.World J Gastroenterol. 2016;22(40):8892-8904. doi:10.3748/wjg.v22.i40.8892.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chiarello MM, Cariati M, Brisinda G.Colonic Crohn’s disease - decision is more important than incision: A surgical dilemma.World J Gastrointest Surg. 2021;13(1):1-6. doi:10.4240/wjgs.v13.i1.1.Crohn’s & Colitis Foundation.Surgery.American Society of Colon & Rectal Surgeons.Abscess and fistula.Kamrava A, Mahmoud NN.Prevention and management of nonhealing perineal wounds.Clin Colon Rectal Surg. 2013;26(2):106-111. doi:10.1055/s-0033-1348049.Patel KV, Darakhshan AA, Griffin N, Williams AB, Sanderson JD, Irving PM.Patient optimization for surgery relating to Crohn’s disease.Nat Rev Gastroenterol Hepatol. 2016;13(12):707-719. doi:10.1038/nrgastro.2016.158.Yang SS, Yu CS, Yoon YS, Yoon SN, Lim SB, Kim JC.Risk factors for complications after bowel surgery in Korean patients with Crohn’s disease.J Korean Surg Soc. 2012;83(3):141-148. doi:10.4174/jkss.2012.83.3.141.Hanzel J, Almradi A, Istl AC, et al.Increased risk of infections with anti-TNF agents in patients with Crohn’s disease after elective surgery: Meta-analysis.Dig Dis Sci. 2021 Feb 26. doi:10.1007/s10620-021-06895-6. Online ahead of print.Chiarello MM, Cariati M, Brisinda G.Colonic Crohn’s disease - decision is more important than incision: A surgical dilemma.World J Gastrointest Surg. 2021;13(1):1-6. doi:10.4240/wjgs.v13.i1.1.Crohn’s and Colitis Canada.Surgery.American Gastroenterology Association Institute.Disease after surgery: A patient guide.Gastroenterol. 2017;152(1):296-297.Additional ReadingToh JW, Stewart P, Rickard MJ, Leong R, Wang N, Young CJ.Indications and surgical options for small bowel, large bowel and perianal Crohn’s disease.World J Gastroenterol. 2016;22(40):8892-8904. doi:10.3748/wjg.v22.i40.8892.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Chiarello MM, Cariati M, Brisinda G.Colonic Crohn’s disease - decision is more important than incision: A surgical dilemma.World J Gastrointest Surg. 2021;13(1):1-6. doi:10.4240/wjgs.v13.i1.1.Crohn’s & Colitis Foundation.Surgery.American Society of Colon & Rectal Surgeons.Abscess and fistula.Kamrava A, Mahmoud NN.Prevention and management of nonhealing perineal wounds.Clin Colon Rectal Surg. 2013;26(2):106-111. doi:10.1055/s-0033-1348049.Patel KV, Darakhshan AA, Griffin N, Williams AB, Sanderson JD, Irving PM.Patient optimization for surgery relating to Crohn’s disease.Nat Rev Gastroenterol Hepatol. 2016;13(12):707-719. doi:10.1038/nrgastro.2016.158.Yang SS, Yu CS, Yoon YS, Yoon SN, Lim SB, Kim JC.Risk factors for complications after bowel surgery in Korean patients with Crohn’s disease.J Korean Surg Soc. 2012;83(3):141-148. doi:10.4174/jkss.2012.83.3.141.Hanzel J, Almradi A, Istl AC, et al.Increased risk of infections with anti-TNF agents in patients with Crohn’s disease after elective surgery: Meta-analysis.Dig Dis Sci. 2021 Feb 26. doi:10.1007/s10620-021-06895-6. Online ahead of print.Chiarello MM, Cariati M, Brisinda G.Colonic Crohn’s disease - decision is more important than incision: A surgical dilemma.World J Gastrointest Surg. 2021;13(1):1-6. doi:10.4240/wjgs.v13.i1.1.Crohn’s and Colitis Canada.Surgery.American Gastroenterology Association Institute.Disease after surgery: A patient guide.Gastroenterol. 2017;152(1):296-297.
Chiarello MM, Cariati M, Brisinda G.Colonic Crohn’s disease - decision is more important than incision: A surgical dilemma.World J Gastrointest Surg. 2021;13(1):1-6. doi:10.4240/wjgs.v13.i1.1.
Crohn’s & Colitis Foundation.Surgery.
American Society of Colon & Rectal Surgeons.Abscess and fistula.
Kamrava A, Mahmoud NN.Prevention and management of nonhealing perineal wounds.Clin Colon Rectal Surg. 2013;26(2):106-111. doi:10.1055/s-0033-1348049.
Patel KV, Darakhshan AA, Griffin N, Williams AB, Sanderson JD, Irving PM.Patient optimization for surgery relating to Crohn’s disease.Nat Rev Gastroenterol Hepatol. 2016;13(12):707-719. doi:10.1038/nrgastro.2016.158.
Yang SS, Yu CS, Yoon YS, Yoon SN, Lim SB, Kim JC.Risk factors for complications after bowel surgery in Korean patients with Crohn’s disease.J Korean Surg Soc. 2012;83(3):141-148. doi:10.4174/jkss.2012.83.3.141.
Hanzel J, Almradi A, Istl AC, et al.Increased risk of infections with anti-TNF agents in patients with Crohn’s disease after elective surgery: Meta-analysis.Dig Dis Sci. 2021 Feb 26. doi:10.1007/s10620-021-06895-6. Online ahead of print.
Crohn’s and Colitis Canada.Surgery.
American Gastroenterology Association Institute.Disease after surgery: A patient guide.Gastroenterol. 2017;152(1):296-297.
Toh JW, Stewart P, Rickard MJ, Leong R, Wang N, Young CJ.Indications and surgical options for small bowel, large bowel and perianal Crohn’s disease.World J Gastroenterol. 2016;22(40):8892-8904. doi:10.3748/wjg.v22.i40.8892.
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