Surgical Therapy for SB CD

In general, surgery for CD is reserved for failure of medical therapy, intolerance to or toxicities from medical therapy, or complications of CD. Complications that may require surgical interventions include obstruction, fistulas, and abscess. Less commonly patients with SB CD may have cancerous or precancerous lesions present. When determining the need for surgery, it is important to recognize that the sequelae of chronic disease may manifest as symptoms resembling typical exacerbations of CD. On the other hand, complications such as fibrotic strictures are not amendable to medical therapy and should be managed surgically.

The overriding principle to surgery for SB CD is to minimize the length of bowel resection. Because clinical relapses occur in 20 to 40% of patients within 1 year and up to 85% at 3 years after surgery, the risk of short-gut syndrome is a serious concern in patients with SB CD. Segmental resection is performed for active SB disease. Although SB stricture can be managed with resection, stric-turoplasty is an option for fibrotic strictures and has the advantage of preserving that segment of bowel (Fazio and Galandiuk, 1985). Patients with intra-abdominal fistula or abscess require surgical draining of abscess along with antibiotics, followed by resection after several weeks.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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