Crohn's disease

The disease causes the bowel wall to thicken, which can block food from passing through. The affected area of the bowel can also fail to absorb nutrients from your food. It most often causes inflammation in the lower part of your small bowel (the ileum), large bowel (the colon) and rectum. The inflamed areas are usually separated by unaffected (healthy) areas of the bowel, called skip lesions.

The most common symptoms are diarrhoea, abdominal pain and feeling generally unwell. Left untreated, you can get problems such as abdominal pain, diarrhoea, weight loss, a hole in your bowel, anal fistula and ulcers in the gut.

Crohn’s disease can be treated with various types of drugs. Your consultant will perform a full examination to confirm you have Crohn’s disease and how much of your gut is affected. They may also prescribe a special diet to help settle your symptoms.

If your symptoms do not settle your consultant may recommend surgery to remove the affected portion of your gut.

What happens during surgery for Crohn’s disease?

This operation is performed under a general anaesthetic and usually takes between an hour and an hour and a half. Your surgeon will make a cut in your abdomen and remove the diseased part of your small bowel. They will often need to remove a part of your large bowel. Your surgeon will usually join the ends of your bowel back together. If they are unable to join the ends of your bowel, they may need to remove all or part of your colon.

Sometimes surgery for Crohn’s disease is performed laparoscopically through several small incisions in your abdomen. Be sure and discuss your options for laparoscopic surgery with your consultant.

After your operation

You may need to stay in hospital five to ten days following your surgery. The hospital stay for laparoscopic surgery may be shorter.

You will be given medication for pain relief through an IV drip in your arm. Be sure and tell a member of our Healthcare Team if you are in pain or are feeling any nausea. You will have a catheter to drain and measure your urine output.

Depending on what surgery is performed you will be encouraged to get out of bed. A physiotherapist may visit you to give you gentle exercises to improve your circulation and promote healing.

Some patients are allowed to begin drinking water within 12 hours following surgery. Others are asked to wait until it is confirmed their bowels are beginning to move and they begin to pass wind. You will need to begin taking very small sips of water the build up your intake slowly. When you are drinking normally you will be encouraged to begin eating a light diet.

Going home after Crohn’s disease surgery

You will not be able to drive yourself home so please arrange for someone to pick you up on the day of discharge.

When you first leave hospital you may feel very weak and tired. Over the next few weeks you will begin to regain your strength and stamina. Everyone heals differently so it’s important to rest when you need to and build up your activity levels slowly.

You should avoid heavy lifting and strenuous activities and should not drive until you are released to do so by your consultant.

You may be able to return to work after four to six weeks. Be sure and discuss any return to work with your consultant.

Some patients experience a reoccurrence of symptoms following surgery. This can occur in a new area or in the same area of your bowel.

Most people make a good recovery and return to normal activities following surgery for Crohn’s disease. As with any surgery there can be complications:

• Pain 
• Bleeding 
• Infection of the surgical site (wound) 
• Unsightly scarring 
• Developing a hernia Blood clots 
• Difficulty passing urine 

Specific complications of surgery for Crohn’s disease:

• Anastomotic leak 
• Chest infection 
• Damage to other structures inside the abdomen 
• Injury to the bowel Abnormal joining together of tissue (adhesions)