Strictureplasty — Strictureplasty is a procedure used to relieve bowel obstructions by widening the intestines. It is sometimes done at the same time as a resection. For this procedure, the surgeon cuts through the narrowed intestine lengthwise and sews it shut it in the opposite direction. This widens the bowel, making it easier for fecal matter to flow through. This procedure is well suited for people who continually have blockage in a particular part of their intestines and who are at risk for short bowel syndrome (having too little small intestine left to adequately digest food) due to previous resections. It should not be performed in a person with an acutely inflamed bowel.

People who have had this procedure have had excellent results. The risk of developing a fistula or another stricture is low and comparable to resection. It is not known if keeping the diseased part of the intestine increases a person's chance of developing cancer.

Balloon dilation — This is another method of widening the bowel. For this procedure, the doctor guides an uninflated balloon, which is attached to a long, thin tube, through the bowel. When the obstruction is located, the balloon is inflated, widening the narrowed intestine.

This procedure is newer and less is known about its long-term success or safety. It may be useful, however, for people who need to postpone surgery. There is a significant risk of the bowel tearing, which should be considered before this technique is used.

RECURRENCE AFTER RESECTION — Crohn's disease will recur in most patients following resection. New symptoms related to the disease will develop in about 10 to 15 percent of people per year after surgery. However, some patients have prolonged periods of remission after surgery, lasting as long as 15 years.

Recurrence is more likely in patients who have severe disease. It is less likely in those who have disease confined to the colon. Such patients have only a 10 percent recurrence rate in the small intestine at 10 years. Some of the medications used to treat Crohn's disease may also reduce the risk of recurrence; thus most patients continue on medications following surgery.

WHERE TO GET MORE INFORMATION — Your doctor is the best resource for finding out important information related to your particular case. Not all patients with Crohn's disease are alike, and it is important that your situation is evaluated by someone who knows you as a whole person.

on September 21 2003 01:00:32 ·