When Can Crohn’s Disease Require Colon and Rectal Surgery

When Can Crohn’s Disease Require Colon and Rectal Surgery

Have you or a family member been diagnosed with Crohn’s Disease? Are you worried you might need surgery? Although this chronic disease may lead to more serious complications that require surgery, people with Crohn’s can still lead quality lives. Continue reading to learn more about the different levels of colon and rectal surgery as well as other non-surgical treatments.

Common Symptoms and Diagnosis

Crohn’s Disease (CD), part of a group of diseases known as Inflammatory Bowel Disease (IBD), is due to chronic inflammation of the gastrointestinal tract. The disease most commonly affects the ileum, the last portion of the small intestine, and the colon.

The chronic GI tract inflammation associated with Crohn’s Disease can cause symptoms such as diarrhea, severe abdominal pain, fatigue, blood in the stool, and fever. If you are experiencing some or all of these symptoms, contact your doctor immediately.

Doctors use a few methods to diagnose Crohn’s Disease, such as a colonoscopy for the colon and a regular endoscopy for the upper GI tract.

Patients may swallow a tiny camera if the doctor needs a capsule endoscopy to see parts of your intestine that aren’t easily visible through a regular endoscopy.

How the Digestive System Works

To help you understand your diagnosis and treatment options, here’s a quick overview of the GI tract. Since Crohn’s Disease can affect any part of the digestive system, it’s important to have a basic understanding of how the parts work together.

Digestion begins in the mouth as the teeth and saliva work to break down your food before it enters the stomach.

The stomach breaks down the food further, preparing it for the small intestine. If your stomach has the right level of acidity, it acts as a high-speed blender that turns your food into a soupy substance.

The small intestine is responsible for absorbing a majority of the body’s nutrients, so it is important that the food it receives has been properly broken down. If this organ is impaired, you can have a wide range of issues, including malnutrition.

Indigestible material travels from the small intestine to the colon, or large intestine. In addition to absorbing water and electrolytes and expelling waste, the colon also produces and absorbs vitamins, particularly the B vitamins and Vitamin K.

The colon is also home to trillions of friendly bacteria that protect the GI tract, thereby playing a vital role in the immune system.

First Line of Treatment

Prior to recommending surgery, medical professionals will try medicine first, such as steroids, to decrease inflammation. 

Since there is currently not a cure for this condition, the goal of medication is to bring the patient into a stage of remission.

Colon and Rectal Surgery

Surgery for Crohn’s can be optional, often to increase the quality of life when medications haven’t worked. Other times, it is required.

According to the Crohn’s Colitis Foundation, 75 percent of patients with this disease will eventually need surgery. But there are various levels of surgery.

Surgery is not a cure for Crohn’s Disease, and so it is important to discuss diet and other post-surgical recommendations with your doctor.

Listed below are a few examples of complications that may require surgery. Ultimately, the decision is between you and your healthcare provider. 

Complications Requiring Surgery

The nature of the complication determines the type of surgery needed. The most common complications are listed below:


A collection of pus that requires surgical drainage. Symptoms include severe abdominal pain, pain during bowel movements, swelling, and fever.


Ulcers, a symptom of Crohn’s Disease, can develop into tunnels that are not naturally occurring. These tunnels sometimes connect two organs that should not be connected.

Stricture/Intestinal Blockage

Intestinal walls may thicken as a result of inflammation, creating partial or complete blockage.

Intestinal Bleeding

If the bleeding is excessive and cannot be controlled through other measures, surgery will be required to stop the bleeding.

Bowel Perforation

This occurs when inflammation weakens the intestinal wall, causing a hole. Bacteria can then enter the abdomen, leading to infection. 

Types of Surgery

According to this research article, 70-90 percent of patients with Crohn’s will end up needing surgery. The surgeries listed below are from the least invasive to the most invasive:


The purpose is to widen the diseased part of the small intestines. Nothing is removed during this type of surgery.

Resection (Small Bowel)

Here, part of the intestine is removed. The healthy sections are sewn together after the diseased parts are removed.

Colectomy or Large Bowel Resection

If the disease has progressed to a severe enough state, the doctor may recommend this form of surgery in which the entire colon is removed. If the rectum is healthy, it may be connected to the small intestine.


When both the rectum and colon are severely affected, both are removed through this form of surgery. The surgeon will create a stoma, or hole in the abdominal wall, through which waste will exit into a bag via the small intestine.

Improving Colon Health

Malnutrition is common in patients with Crohn’s Disease, so it’s important to develop a plan with your healthcare team to address this.

Crohn’s Disease Diet

Nutritional deficiencies such as iron, potassium, magnesium, and B12 are common in people with Crohn’s, so eating foods high in these nutrients while minimizing the intake of refined sugar is key. Also, avoid alcohol and caffeinated beverages. 

Check out our Crohn’s Disease Diet page for more information about gut-friendly foods as well as those to avoid.


Doctors, nutritionists, and other health professionals are touting the benefits of probiotics, particularly for those who have gut issues. These beneficial bacteria aid in digestion and also fight off bad bacteria. 

Not all probiotics are created equal, so taking probiotics that are bioavailable is key. Click here to learn more about probiotics and qualities to look for when making your selection.

Beyond the Diagnosis

Thanks to the increasing research on gut health, living with a chronic GI condition such as Crohn’s is manageable with medication, probiotics, dietary changes, and in some cases, colon and rectal surgery. The good news is that whether or not you end up needing surgery, you can live a vibrant life. 

For inspiration, read about Jordan Rubin’s miraculous recovery from a severe case of Crohn’s Disease and the “drug” he used to do it.

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