In addition to medicines, there are more treatments for inflammatory bowel disease (IBD) that your healthcare provider might suggest to help you feel better. This can include:
Surgery for Crohn's disease
Approximately 4 out of 5 people with Crohn’s disease will have surgery for their IBD at some point following their diagnosis. People with Crohn’s disease may have surgery for several reasons:
- repeated inflammation in the gastrointestinal (GI) tract that is not getting better with medicine
- repair of a fistula, abscess, or stricture (scar tissue that causes the intestine to narrow)
- removal of a stricture causing obstruction (blockage)
- management of a perforation (rupture), bleeding (hemorrhage), toxic colitis, or toxic megacolon
- removal of a tumour or suspected tumour
The most common type of surgery for people with Crohn’s disease is an ileo-cecal resection. For this surgery, the surgeon removes the end of the small intestine (called the terminal ileum) and the part of the GI tract that connects the small and large intestines (called the cecum). This surgery is often a laparoscopic surgery. To learn more about ileo-cecal resections and to see an illustration of the procedure, visit small and large bowel resection.
Other common surgeries for Crohn’s disease include strictureplasties and resections. Strictureplasties are used to repair strictures that have occurred in your intestines. Resections are used to remove parts of your intestines that are especially diseased or damaged. To read more about strictureplasty and to see an illustration of the procedure, visit strictureplasty.
Your healthcare team will give you all of the information you need before, during, and after surgery. They will work together to manage your recovery after you have had surgery.
Surgery for ulcerative colitis
Approximately 1 out of 5 people with ulcerative colitis will have surgery for their IBD at some point. People with ulcerative colitis may have surgery for several reasons:
- repeated inflammation in the GI tract that is not getting better with medicine
- severe inflammation resulting in acute fulminant colitis, a serious form of colitis with toxic symptoms including continuous bleeding, fever, and more than 10 stools a day
- management of a perforation, major hemorrhage, or toxic colitis
- removal of a tumour or suspected tumour
The most common type of surgery for people with ulcerative colitis is a total proctocolectomy. For this surgery, the surgeon removes the rectum and all of the colon. For some people, a total proctocolectomy also includes a procedure called an ileoanal pouch anastomosis. For this procedure, the surgeon will perform the total proctocolectomy, but will preserve the muscles and opening at the end of the rectum. They will then create what is called a J-pouch by connecting the end of the small intestine to the preserved part of the rectum. While the J-pouch is healing, you will have a temporary opening in your abdominal wall called a stoma where waste will pass through. Once your J-pouch is healed, you will have a second procedure, and the surgeon will close the stoma, allowing you to pass stool through your anus. To learn more about the creation of a J-pouch and to see an illustration of the procedure, visit J-pouch surgery.
A similar type of surgery that is common for people with ulcerative colitis is a colectomy with ileostomy. For this surgery, the surgeon removes the colon but leaves the rectum intact. It may be removed at a future date. The surgeon then creates an opening on the outside of your abdomen and attaches the end of your small intestine to the opening. The opening is called a stoma. A bag is attached to the stoma outside of your body and the waste you create when eating passes through the stoma and into the bag instead of passing through your intestines.
The different types of surgeries that create a stoma are called ostomies. To learn more about the different types of ostomies, including ileostomies, see ostomy. If you have had an ostomy, learn more about caring for your ostomy, living with an ostomy, eating well after a colostomy, and eating well after an ileostomy.
Your healthcare team will give you all of the information you need before, during, and after surgery. They will work together to manage your recovery after you have had surgery.
Alternative treatments
As you live with IBD, you’ll become an expert at understanding your symptoms and triggers and what makes you feel better. Although no one knows better than you how you are feeling, it is important to work with your healthcare team to manage your disease.
Current medicines and treatments for IBD are based on decades of research done by scientists and doctors. The treatments currently available are supported by strong evidence that proves they are safe and effective.
Treatments that are different from those recommended to you by your healthcare team often do not have the same level of evidence to support that they are safe or effective. Treatments not recommended by your healthcare team may interfere with the medicines prescribed by your healthcare provider and can make them less effective. It is important to always tell your healthcare provider if you are trying other treatments for your IBD. With this information, your healthcare provider can explain any potential risks to you and make sure you remain healthy and safe.
If you have questions or concerns about your treatment plan, talk with your healthcare provider before making any changes by yourself.
