- Crohn’s disease:
It is a lifelong condition where parts of digestive system become inflamed. The symptoms usually start in childhood or early adulthood. The main symptoms are diarrhoea, stomach cramps, bleeding from back passage, fatigue and weight loss.
There’s no cure for Crohn’s disease, but treatment can help reduce or control your symptoms. The main treatments are medicines to reduce inflammation in the digestive system – usually steroid tablets, or medicines to stop the inflammation coming back – either tablets or injections.
Around 1 in 5 people with Crohn’s will need major surgery in the first five years after diagnosis. You may be offered surgery if medicines are not controlling your symptoms, or if you develop severe complications. Surgery is an effective treatment option for many people. Many of the common surgeries for Crohn’s can be done by keyhole (laparoscopic) surgery. Common types of surgery for people with Crohn’s are strictureplasty (widening of intestinal strictures), bowel resection (with or without a stoma), and surgery for abscesses and fistulas. - Ulcerative colitis:
It is a long-term condition where the large bowel and the rectum (which is the end of the large bowel where stool is stored) become inflamed. The main symptoms are recurring diarrhoea, increased bowel motions frequency, tummy pain, bleeding from the back passage, tiredness, loss of appetite, and weight loss. The severity of symptoms varies depending on how much of the rectum and colon is inflamed and how severe the inflammation is.
The main aim of treatment is to reduce symptoms (known as inducing remission), and to maintain remission state. This usually involves taking various types of medicine that can be administered orally, or through a suppository or enema.
If you have frequent flare-ups that have significant effect on your quality of life, or you have a particularly severe flare-up that’s not responding to medicines, surgery would be an option.
Surgery for ulcerative colitis involves permanently removing the colon (a colectomy). Once your colon is removed, your small intestine will be used to pass waste products out of your body instead of your colon.
This can be achieved by creating: an ileostomy – where the small intestine is diverted out of a hole made in your tummy; special bags are placed over this opening to collect waste materials after the operation. Or an ileoanal pouch (also known as a J-pouch) – where part of the small intestine is used to create an internal pouch that’s then connected to your anus, allowing you to poo normally.
As the colon is removed, ulcerative colitis cannot come back again after surgery. But it’s important to see a surgeon with special interest in inflammatory bowel disease to discuss the risks of surgery and the impact of having a permanent ileostomy or ileoanal pouch.