Bowel strictures are a common complication of Crohn’s disease. Strictures are a narrowing of a specific section of your intestine that makes it difficult for food to pass. They can sometimes lead to intestinal blockage.
Stenosis is a type of surgery used to correct strictures in your digestive tract. In this article, we will look at the procedure, the risks, and the recovery.
Stenosis is a surgical treatment for intestinal strictures. This is to enlarge the damaged parts of your intestines. If multiple strictures are present, they can be treated at the same time.
The authors of a Meta-analysis 2007 out of 3,529 stenosis plasties concluded that stenosisplasty is a safe and effective treatment for strictures in the lower part of your small intestine, including the ileum and jejunum. Strictures caused by Crohn’s disease usually occur here.
Stenosis is less effective at treating strictures in the upper small intestine or duodenum, which are more likely to be caused by ulcers.
In stenosisplasty, no part of your small intestine needs to be removed. This helps prevent a complication called short bowel syndrome, which can limit the absorption of water and nutrients.
Strictures are caused by inflammation in your digestive tract. They are a common symptom of Crohn’s disease, but can also be caused by:
- past surgeries
- certain types of cancer
Over time, chronic inflammation causes your intestinal walls to thicken into scar tissue, forming a stricture. Strictures are narrower than healthy intestinal tissue. If left untreated, they can block the passage of food through your digestive tract.
In a stenosisplasty, a surgeon opens your abdomen and makes a series of cuts along the stenosis. The damaged tissue is then restructured and stitched up to allow a wider opening.
Before surgery, you may be asked to have tests to determine your nutritional health. If you are malnourished, your doctor may prescribe vitamins or supplements to take before and after the stenosis.
Before the procedure
Colorectal surgeons use computed tomography (CT) or magnetic resonance imaging (MRI) to identify the size, number, and location of strictures. Before the operation, your surgeon will explain in detail the technique he will use.
The day before the operation, you may be asked to take a laxative to empty your bowels. In other cases, an enema is given before surgery to make sure your bowels are clear.
During the procedure
On the day of the operation, a nurse will check your vital signs and prepare you for the operation.
Stenosis is usually performed under general anesthesia. You will be unconscious and you shouldn’t feel anything. An anesthetist will explain the risks and side effects to you.
The surgeon will make an incision to open your abdomen. The surgical technique used to treat your stricture (s) depends on the length of the stricture.
The most commonly used stenosisplasty techniques include:
- Heineke-Mikulicz stenosisplasty. This technique is used for short strictures, usually less than 10 cm in length. This is the most common stenosisplasty technique.
- Finney’s stenosisplasty. This technique is used for strictures that are between 10 and 20 cm in length.
- Michelassi plasty stenosis. Also known as lateral isoperistaltic plasty stenosis, this technique is used for strictures over 20 cm in length.
Sometimes surgeons use a combination of these techniques. According to a Meta-analysis 2012 of 4,538 stenoplasties, conventional and unconventional stenosisplasty techniques had similar complication rates.
Once the stenosisplasty is complete, the surgeon will close the incision site.
Recovery from stenosisplasty usually depends on both your condition before surgery and how well the surgery was.
You can expect to stay in the hospital for about a week after the procedure so that your healthcare professional can monitor your condition. During this time, you will be given medication for the pain and side effects of the anesthetic.
Before you go home, you will be given additional instructions to help you with your healing process. For example, you may be asked to avoid driving or cleaning. Your doctor may suggest a light diet of low-fiber foods and prescribe medications and supplements to help restore your digestive function.
It may take several months for you to fully recover. As you gain strength, you should notice an improvement in your symptoms.
As with any surgical procedure, stenosisplasty carries a risk of complications. The most common complications include:
- gastrointestinal bleeding
- reappearance of stenosis
- incision site infections
- intestinal obstruction
- temporary changes in bowel function
According to the 2007 meta-analysis mentioned above, the complication rate for stenoplasties of the lower small intestine was approximately 13 percent.
Stenosis is a surgical procedure used to treat strictures in the gastrointestinal tract.
Strictures occur when the walls of your small intestine become thicker due to chronic inflammation. This causes your small intestine to narrow, which can obstruct the passage of food through your digestive tract.
Stenosis is a preferable option for people who have had a previous bowel resection and are at risk of developing short bowel syndrome.
Speak with your doctor to discuss the risks and benefits of this procedure and to determine if stenosisplasty might be a good option for you.