One of the more common complications of inflammatory bowel disease (IBD) is narrowing of the intestinal tract, also known as stricture. Slight narrowing of the intestines is often managed conservatively. However, partial to complete obstruction of the bowel may cause serious complications unless surgically corrected. Strictureplasty is a well-established procedure used to widen and preserve an obstructed segment of intestine.
At the IBD Center of Excellence, our patients benefit from a team of physicians dedicated to the comprehensive management of IBD symptoms and complications. When surgery is necessary, our GI and colorectal surgeons are adept at performing the most advanced and effective procedures to deliver the best results. To learn more about complications of IBD or to schedule a consultation with one of our surgeons, contact us at (888) 593-1042.
How Do Intestinal Strictures Form?
When a segment of the intestinal tract is chronically inflamed, scar tissue begins to develop within the lining. Over time, this segment can become narrowed or obstructed and is then known as a stricture. Strictures are far more common in patients with Crohn’s disease, because this form of IBD is a transmural disease and affects all layers of the intestinal wall.
A stricture may not cause any symptoms until the narrowing impedes flow of intestinal contents. Once an obstruction occurs, patients often experience pain, abdominal cramping, bloating, and an inability to pass stools. Diagnostic examination of the intestinal tract should be performed at the first sign of an obstruction.
Preparation for Surgery
Before undergoing a strictureplasty, the extent and location of intestinal obstruction must be confirmed. This is typically done using a CT or MRI scan of the abdomen. In some cases, an upper GI endoscopy (EGD) or colonoscopy may be performed to locate the stricture. If the obstruction is severe, emergency surgery may be necessary to prevent further complications.
Prior to surgery, you will be placed under general anesthesia and closely monitored by one of our expert anesthesiologists. An incision is then made in the abdomen over the precise section of damaged intestine. Once the stricture has been located, it may be repaired in one of several ways depending on the length and number of obstructions.
For small strictures or multiple obstructions that are close together, an incision is made longitudinally along the length of intestine. The incision is then pulled transversely and tied with sutures to widen the segment. Medium length obstructions require a technique in which the segment of intestine is folded and then joined to widen the interior.
If a large obstruction has narrowed the intestine beyond the capacity of traditional repair, the damaged segment can by bypassed with the joining of healthy intestinal tissue from either end. After the segment of bowel has been widened, the incision is closed with sutures.
Recovery from Surgery
Following a strictureplasty, an expert team of health professionals will closely monitor you to ensure optimal recovery. Complications from strictureplasty are rare, but may include bleeding, infection, or obstruction of the intestine. Since Crohn’s disease is a chronic condition, some patients will develop new strictures in different portions of the intestine that may require additional surgery. Studies have shown that there is a very low risk of a recurring stricture at the original site following strictureplasty. Patients who undergo strictureplasty can sometimes experience a quicker recovery than those who have resection surgery.
Contact an IBD Specialist in Beverly Hills
The IBD Center of Excellence in Beverly Hills offers a team of world-renowned gastroenterologists and colorectal surgeons who have trained at some of the top medical schools and residencies in the country. Our extensive experience in the treatment of inflammatory bowel disease, coupled with a highly individualized approach, helps us to deliver compassionate and effective care to each patient. For more information on the complications of IBD and surgical treatment, or to schedule a consultation with one of our physicians, please call (888) 593-1042 or fill out our contact form.
Next, read about colectomy.