Inflammatory bowel diseases (IBDs) is a condition in which there is inflammation of intestines. IBDs are categorized into two types-
- Ulcerative colitis (UC)– In ulcerative colitis, only the large intestine or scientifically known as the colon is affected.
- Chron’s disease– In Chron’s disease, any part of the entire digestive tract (mouth to anus). Chron’s disease can be caused by genes, the immune system, and the environment.
There is inflammation of the muscle in the digestive tract which causes strictures. Strictures are sections of intestines which become narrower due to inflammation and they block the passage of digested food. If these strictures are left untreated for a long period of time, they can cause severe pain and camping. Bowel resection is done to cure Chron’s disease. Bowel resection is nothing but a surgical procedure in which surgeons remove only damaged part of the intestine and then joins together the two healthy ends. Surgical treatment is recommended when strictures do not respond to standard treatment.
Symptoms-
The common symptoms of Chron’s disease include-
- Nausea and vomiting,
- Abdominal pain and cramps,
- Bloating,
- Constipation
If these symptoms are overlooked for a prolonged period of time, these can lead to dangerous complications such as perforation of the intestinal wall.
Preparation-
Before the procedure, it is beneficial for patients to undergo a set of instructions to avoid any complication post-operation. Some of them are discussed below-
- Doctors ask their patients to stop smoking several weeks before the surgery
- Medicines that are blood thinners such as aspirin, naproxen, vitamin E, warfarin, etc. should be avoided.
- A good diet of high-fiber foods along with vitamins and minerals is recommended to patients several weeks before the Small Intestinal Surgery
- It is suggested to stick to a liquid diet of clean fluids such as broth, clear juice, water after the operation. Laxatives are recommended to clear the bowels.
- Eating any food or drinking any fluid is restricted several hours before the surgery as complications may arise with the anesthesia.
Treatment-
Mainly two types of small bowel resection are carried out to diseases related to the small intestine- Traditional surgery or laparoscopic surgery.
Traditional surgery
In this type of surgery, the doctor requires a surgeon to make an incision of about 8 inches long in the abdomen. The location of the incision depends upon a variety of factors such as the specific location of the diseased area and the build of the body. The surgeon finds the affected part of the small intestine, clamps it off, and removes it.
Laparoscopic surgery
Introduced in the 1990s, laparoscopic or “key-hole” surgery uses three to five incisions, also known as ports, of not more than 1 inch. To inflate the abdominal cavity, surgeons first pump CO2 gas using a tube-like structure called cannula. This makes it easier for doctors to see as well as navigate the equipment. They then with the help of miniature lights, high-resolution cameras, and small tools to find the diseased area, clasp it off, and eventually remove it. At times, a robot aids in this type of surgery which increases precision.
Finishing the surgery
In either type of surgery, the surgeon stitches the open ends of the intestine.
Anastomosis. An anastomosis is carried out if there’s enough healthy small bowel left. An anastomosis is a surgical connection in which the two cut ends are sewn or stapled together.
Ileostomy. If the intestines can’t be reconnected, surgeons make a special opening in the belly called a stoma. The intestine closest to the stomach is attached to the wall of the belly. The intestine drains out through the stoma into an external collection pouch or drainage bag, known as ostomy pouch/ ostomy appliance. This procedure is known as an ileostomy. It may be temporarily used to allow intestine further down the system to heal completely, or permanent.
Benefits –
Some of the benefits of laparoscopic surgery for curing Chron’s disease are discussed below-
- Reduced risk of bleeding- During laparoscopic surgery, the surgeon makes one or more small incisions in the abdomen. The size of the incision size is so small that the large incision made for open surgery reduces the risk of bleeding.
- Less painful healing process- In the case of conservative methods, patients take a longer time to recover as one large incision is made. With laparoscopic surgery, the post-surgical wound is much smaller and properly bandaged with abdominal sutures. This ensures that the healing process is much less painful.
- Reduced chances of scarring- Conventionally, before the emergence of this treatment, a surgeon had to cut a patient’s belly that was 6-12 inches long. This allowed doctors to see inside the abdominal or pelvic cavity and operate accordingly. This left a mark on their abdominal activity. Scarring is reduced to minimal in laparoscopic surgery.
- Reduced risk of infection- The risk of post-operation infection is significantly reduced to a minimal in laparoscopic surgery as there is minimum exposure of internal organs to external contaminants.
A broad range of treatments is provided by IBD experts and renowned colorectal surgeons to help relieve symptoms and improve the quality of life. If these treatments aren’t successful, doctors suggest their patients undergo a small bowel resection in which they may need to have the diseased portion of the intestines surgically removed.