Crohn's Disease Complications and Surgery
Common Problems and Surgical Treatment in Inflammatory Bowel Disease
Nov 7, 2009
Crohn’s disease is a chronic condition in which the lining of the bowel becomes inflamed. Periods of symptoms such as diarrhoea, pain and weight loss (flares) alternate with periods of remission during which the symptoms improve or disappear. There is no cure at present, though diet and medical treatments can help.
Intestinal Crohn’s Disease Complications
The most common complications of Crohn’s disease in the bowel are obstruction, fistulas and abscesses.
- Obstruction occurs when the inflamed bowel wall becomes swollen and stiff; this narrows the gut, leading to blockages of its contents. The symptoms are abdominal pain, vomiting and a bloated feeling in the gut.
- A fistula is a passage that develops between two places within the body that would not normally be connected. It begins with an ulcer that gradually deepens and then tunnels through the tissues. In Crohn’s disease, fistulas can arise between the bowel and the bladder, the anus, the vagina or even the skin. They may become infected, leading to pain and fever.
- An abscess is walled-off cavity containing pus that accumulates during an infection. The body produces the cavity to stop the infection spreading. In Crohn’s disease, abscesses may occur around the anus or in the abdomen.
Less common complications include perforation of the bowel and bleeding.
Crohn’s Disease and Cancer
People who have had Crohn’s disease for several years are at increased risk of developing cancer in the inflamed part of their bowel. Screening for colon cancer may be beneficial in this group.
Malnutrition in Crohn’s Disease
Nutrients such as protein, minerals and vitamins are poorly absorbed from the food in Crohn’s disease, due to the inflammation of the bowel lining. This can result in malnutrition, and dietary supplements may be needed.
Surgery for Crohn’s Disease
Most people with Crohn’s disease need surgery at some time or another. The usual reason is to remove an obstruction or repair a fistula.
In other cases, surgery is used to remove a section of inflamed bowel, though this is done only when drug and diet treatments cannot control the symptoms. Removing bowel is not a permanent cure for Crohn’s disease, as the inflammation may return over time – often near the section that was taken out. Sometimes, the entire large intestine has to be removed, leaving the patient with a stoma (a small opening in the abdomen, attached to a pouch to collect waste).
Crohn’s Disease Prognosis
The outlook for people with Crohn’s disease depends on the severity of the symptoms and the frequency of the flares. Some people have only one or two flares in their entire life, while in others they are very frequent; most lie somewhere in between. During remissions, people with Crohn’s disease can lead normal, active lives, and with proper treatment their remissions can be extended. Research into new, more effective treatments is continuing.
References:
Canavan C et al. Meta-analysis: Colorectal and Small Bowel Cancer Risk in Patients With Crohn’s Disease. Aliment Pharmacol Ther 2006; 23(8): 1097–1104.
Jewell DP. Crohn’s Disease. Medicine 2003; 31(2): 76–81.
National Digestive Diseases Information Clearinghouse. Crohn’s Disease. Accessed 07-11-09
NHS Choices. Crohn’s Disease. Accessed 07-11-09
Disclaimer
The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
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