Crohn's Disease: Should I Have Surgery?

Picture of intestines and where Crohn's disease occurs

Crohn's disease and ulcerative colitis both cause swelling and sores in the digestive tract. They are also called inflammatory bowel disease.

Crohn's disease often occurs in the last part of the small intestine and the first part of the large intestine (colon).

But Crohn's disease can happen anywhere in the digestive tract, from the mouth to the anus.

Surgery is not usually done for Crohn's disease.

If you do have surgery, it most likely will be one of the following:

  • Resection: The diseased portion of the intestines is removed, and the healthy ends of the intestine are reattached. This surgery does not cure Crohn's disease, which often comes back near the site of surgery.
  • Proctocolectomy and ileostomy: The surgeon removes the large intestine and rectum, leaving the lower end of the small intestine (the ileum). The anus is sewn closed, and a small opening called a stoma is made in the skin of the lower belly. The surgeon connects the ileum to the stoma, creating an opening to the outside of the body. Stool then leaves the body through the stoma and collects in a small plastic pouch (ostomy bag).
  • Strictureplasty: The surgeon makes a lengthwise cut in the intestine and then sews the opening together in the opposite direction. This makes the intestine wider and helps with obstruction of the bowels. This is sometimes done at the same time as resection, or when a person has had resection in the past. Strictureplasty is used when the doctor is trying to save as much of the intestines as possible.

Who should have surgery for Crohn's disease?

You may consider surgery if:

  • You have severe symptoms, and your medicine or other treatment is not helping.

You may need surgery if your doctor thinks you have any of the following problems:

  • Your intestine is blocked or has become very narrow.
  • You have severe bleeding in your intestine.
  • You have a hole (perforation) in your intestine.
  • You have pockets of pus (abscesses) or odd connections (fistulas) between parts of your intestine or between the intestine and other organs.
  • You have colon cancer.

Pros and cons of surgery

If you are thinking about surgery, here are some pros and cons.

Pros Cons
  • Surgery may make your symptoms go away or get better.
  • Surgery does not usually cure Crohn's disease. The disease tends to come back in another part of the digestive tract.
  • Surgery may result in stool that leaks. It may also cause a blockage in the small intestine.
  • Depending on the surgery, you may need to wear an ostomy bag.
  • If much of the small intestine is removed, you may have trouble absorbing nutrients (short-bowel syndrome).


Do you have any questions or concerns after reading this information? It's a good idea to write them down and take them to your next doctor visit.