Crohn’s disease can affect any part of the gastrointestinal tract. It is a chronic inflammation that develops in the gastrointestinal tract which can involve all the layers of the bowel. The pathogenesis is associated with T-cell activations which lead to tissue injury. Complications of Crohn’s disease involve small bowel obstruction, intestinal strictures; free perforation, abscesses, toxic megacolon and fistulae.
Diarrhoea during Crohn’s disease is treated pharmacologically due to acute C.difficile infections. Anti-inflammatory and immunosuppressant medications such as sulfasalazine are prescribed for small bowel and colon inflammation. Diet modifications and nutritional therapy are important modalities to facilitate bowel resting.
Indications for surgery: formation of intra-abdominal abscesses; fistulae that are medically intractable; symptoms persist in spite of high-dosage corticosteroid therapy; fibrotic strictures with obstruction; toxic megacolon; cancer; perforation; bleeding;
Recommended surgical procedures are: bowel resection; ileocolostomy; strictureplasty; total or segmental colectomy; proctectomy or total proctocolectomy
We are approached for several complications of IBD and Crohn’s disease all of which we have treated successfully for many years now.Authored by Dr. Deepak Varma, MBBS, MS (General Surgery)
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