Small and Large Bowel Resection

Knowing what to expect before your bowel resection and what questions to ask your healthcare team can help alleviate some of the fears you may have about surgery.

A bowel resection is a surgical procedure to remove a portion of your small or large intestine, that has been damaged by Crohn’s disease.

During the surgery, the diseased section of your intestine is removed and the two healthy ends are joined together.

Small Bowel Resection

This surgery is recommended to treat a stricture, which is a narrowing in a section of the intestine that occurs when inflammation from Crohn’s disease causes the wall of your intestine to thicken.

Strictures that are left untreated can lead to blockages, which prevent stool from passing through your intestine.  

Symptoms of a stricture

• Nausea

• Vomiting

• Severe cramping

• Constipation

This surgery may be also be required if a perforation, or hole, develops in the wall of the small intestine. Inflammation of the bowel wall may cause a perforations as the wall weakens. Perforations can cause a serious infection and must be treated immediately.

What You Should Know about Small Bowel Resection

Small bowel resection is one of two surgical procedures used to repairs strictures. The other procedure is a strictureplasty, which widens the narrowed section of intestine.

• Small intestine resections are typically recommended for patients with longer sections of damaged intestine, or when a patient is not a good candidate for strictureplasty.

• The amount of small intestine to be removed depends on how much of your bowel is damaged by inflammation from Crohn’s disease.

• Small intestine resections can offer you many years of symptom relief.

• The disease can reoccurs at the site where the healthy ends of the intestine were joined together, also known as the anastomosis, however it is important to discuss your options with your doctor and the expected outcomes as it relates to your disease.

• While recurrent Crohn’s disease can often be successfully treated with medications, some patients who do have recurrent symptoms may be successfully treated with medication. You, your gastroenterologist, and your surgeon may also discuss the additional surgeries if needed.

Ileocecal Resection

This procedure removes diseased tissue at the end of the small intestine, an area called the terminal ileum, which is often severely affected by Crohn’s disease. This surgery is often required for patients with a stricture, fistula, or abscess in the terminal ileum.

During an ileocecal resection, the end of the small intestine and the start of the colon, called the cecum, are removed. Your appendix may also be removed during this surgery as it is attached to the cecum. The healthy end of the small intestine is then reattached to the colon.

Short Bowel Syndrome

One possible complication of multiple small bowel resections is a condition called short bowel syndrome (SBS).

The small intestine absorbs necessary nutrients from digested food into the bloodstream, which provides nourishment for the rest of your body. If too much of the small intestine is removed, short bowel syndrome can develop and cause nutritional deficiencies or even malnutrition.

Other complications of short bowel syndrome can include kidney stones, electrolyte imbalance, bacterial overgrowth in the intestines, malabsorption of medication, and acidosis, a condition caused by too much acid build up in the body.

Symptoms of short bowel syndrome

• Chronic diarrhea

• Weight loss

• Abdominal pain and cramping

• Bloating

• Heartburn

• Flatulence

• Oily and/or foul-smelling stool, known as steatorrhea

• Weakness and fatigue

• Bacterial infections

• Food sensitivities

View our additional resources on short bowel syndrome so that you can recognize the signs and symptoms and know when to seek medical attention.

Large Bowel Resection

This surgery is similar to the small bowel resection, except it’s performed to remove diseased portions of your large intestine commonly referred to as the colon but includes both the colon and rectum.

As with small bowel resection, Crohn’s disease reoccurs about half the time after large bowel resection, usually at the site where the intestine was connected.

Ask Your Doctor

• What preparations will I need to make before my small or large bowel resection?

• What are the potential complications from surgery?

• What kind of restrictions will I have after my surgery?

• How long will it take me to recover from my bowel resection?

• How will the surgery affect my diet and bowel movements?

To learn more about surgery in Crohn's disease, watch these helpful videos:

• Transatlantic Talking Heads - Early Surgery in Ileal Crohn's
• Emerging Bowel-Sparing Procedures in Crohn's disease