Surgery for Crohn’s Disease
Crohn’s disease is a chronic inflammatory disease of the digestive tract that most commonly involves small intestine followed by the large intestine.
The common symptoms of Crohn’s disease include abdominal pain, feeling of distension after meals, loose stools, fatigue and blood in stools.
In patients with typical symptoms several tests may be needed for a diagnosis of Crohn’s disease to be made. These include contrast CT scan of the abdomen and enetroscopy (endoscopic examination of small intestine) and biopsy and colonoscopy and biopsy (endoscopic examination of colon).
In India, high prevalence of tuberculosis often makes initial diagnosis of Crohn’s disease difficult.
The treatment for Crohn’s disease can be medical or surgical.
There are several medical treatment options for Crohn’s disease that are available. These include corticosteroids, aminosalicylates, immunomodulators, biologics and JAK inhibitors. Final treatment is treatment is prescribed by the treating team based on detailed clinical evaluation and also patient’s preference.
The usual medical practice is to prefer medical therapy and reserve surgery for those patients who do not respond to medical therapy or have complicated Crohn’s disease such as obstruction, perforation or bleeding.
Emerging evidence suggests that ileocecal resection (surgery) may have role as first line therapy in Crohn’s disease management (Gastroenterology 2023).
Surgery can be performed laparoscopically, robotically or traditional open surgery.
Our technique of laparoscopic surgery for Crohn’s disease was presented at World Congress of Surgery, Vienna, 2022.
A link to short video of our technique is provided
The course of Crohn’s disease is characterized by chances of recurrence. Hence regular follow up is essential as suggested by the treating team.