Does surgery for Crohn’s disease create more problems down the road?
Imagine a long pipe, say 20 feet long — and part of that pipe becomes damaged. You remove the corroded section and hook the remaining two pieces of undamaged pipe back together.
That’s essentially what happens in surgery for Crohn’s disease, explains Miguel Regueiro, MD, Chair of Gastroenterology, Hepatology and Nutrition.
“Part of the bowel gets inflamed and ulcerated, or marked with sores and scar tissue, and needs to be removed,” Dr. Regueiro says. Usually, it’s the last part of the small intestine, called the terminal ileum (although Crohn’s can affect anywhere in the digestive tract).
Historically, about two-thirds to three-quarters of those diagnosed with Crohn’s disease needed surgery at some point in their lives. But that’s not the case anymore.
The birth of the Pandora’s box myth
Myths are easily born, but they die hard. The reality is that up until the advent of better Crohn’s drugs, including biologic therapies, Crohn’s disease was more likely to reoccur — meaning that some folks would need a second or third surgery.
“So the myth came about that the act of actually having a surgical resection, as it’s called, leads to another surgery,” Dr. Regueiro explains. “That is not true.”
What is true? Yes, Crohn’s disease is very likely to come back (recur) at the spot where the two healthy ends of intestine were sewn back together (that connection’s called an anastomosis),” he says, “But it’s not the operation (surgery) that leads to recurrence.”
“Very likely” means that it happens in up to 90 percent of cases. But, he cautions, it would be jumping to conclusions to think the recurrence equals surgery. “It’s not always so severe that it leads to problems,” he explains. “It means if you did a colonoscopy and looked at that connection, you’ll see evidence that the Crohn’s came back — but may be mild, especially if we catch it early.”
|Read on: Does Having Surgery for Crohn’s Disease Open ‘Pandora’s Box’ and Lead to Needing More Surgery in the Future? – Health Essentials from Cleveland Clinic|