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Surgical Treatment of IBD- An Introduction to the Various Types of Surgeries for IBD

According to IBDRelief, 70% of people suffering from Chron’s disease and 25% of patients with ulcerative colitis would require surgery to treat their inflammatory bowel disease. However, microscopic colitis hardly ever needs surgery for treatment.

What is Inflammatory Bowel Disease?

Inflammatory Bowel Disease is an umbrella term for two medical conditions, Chron’s disease and ulcerative colitis. These conditions refer to the chronic inflammation of the gastrointestinal (GI) tract. When left untreated for a long time, it ends up damaging the GI tract.

· Ulcerative colitis: In this type of IBD, the superficial lining of the colon and rectum suffers from inflammation and ulcerous sores.

· Crohn’s disease: This condition of IBD leads to the inflammation of the deeper layers of the gastrointestinal tract.

Surgical Treatments of IBD

There is only one surgical treatment of ulcerative colitis that involves the removal of the colon. However, there are several types of surgeries performed to treat Crohn’s disease, depending on the affected area and the severity of the disease. The various types of surgeries available for the treatment of Crohn’s disease include:

· Strictureplasty

When the inflammation causes a scar tissue buildup in the intestinal tract and ends up narrowing it, strictureplasty is conducted to reshape and widen the area.

· Resection

To prevent the disease from spreading to the other parts of the intestinal tract, resection is conducted to remove the existing active Crohn’s disease and the damaged part of the small intestine.

· Ileocaecal Resection

When the last part of the small intestine and the first part of the large intestine are damaged, they are both removed, and the healthy ends are joined together.

· Colectomy with Ileostomy

The colon is removed in this surgery when it gets entirely damaged by IBD (colectomy). The last section of the small intestine is then brought out through a wall opening in the abdomen, and a bag is attached to collect waste (ileostomy).

· Proctocolectomy with ileostomy

This surgery refers to the removal of the entire colon, rectum, and anal canal. Then the procedure of ileostomy (bag attaching) is subsequently performed.

· Colectomy with ileo-rectal anastomosis

When the rectum remains healthy, but the colon is damaged, the small intestine is directly attached to the rectum, bypassing the colon.

· Surgery for Abscesses and Fistulas

In this surgery, abscesses are treated by lancing. Fistulas are treated through resection or by opening and cleaning them.

· Restorative Proctocolectomy with ileoanal pouch (J-pouch)

Proctocolectomy is performed in which the colon and the rectum are removed. The lower end of the small intestine is then used to make a pouch and joined to the anus.

Surgery conducted for Crohn’s disease provides temporary relief as the condition is likely to recur after the surgery. Surgery for ulcerative colitis, in which the colon is removed, provides permanent relief. These surgeries lessen the pain and reduce the symptoms considerably. These surgeries also lead to reduced drugs, many of which come with numerous side effects.

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