Surgery Helps Children With Crohn's

Child Crohn's patients needing more surgery to help symptoms still have good life quality

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Going under the knife for any surgery can make patients uneasy. But for children with long-term stomach troubles, the option can do more good than harm.

Children with Crohn's disease who have surgery to help symptoms can live pretty well with nearly normal bowel function, new research has found.

"This supports the view that the impact of surgery on patients’ lives is in most cases positive, even though surgery does not cure Crohn's disease," researchers said.

"Ask questions before scheduling surgery."

Between 20 and 30 percent of children with Crohn's disease will have surgery within a decade of the diagnosis.

Surgery becomes an option when Crohn's affects children's growth, if regular treatment with infliximab or steroids doesn't help enough or there are other complications from the disease.

The study, led by Maija Piekkala, MD, of the Children's Hospital in Helsinki University in Finland, looked at how bowel surgery affects children's Crohn's symptoms and their quality of life over time.

Researchers looked at 36 children in Helsinki, Finland, who were diagnosed with Crohn's before they were 16 and had surgery before age 18.

Patients who followed up with researchers less than two years after their surgery were excluded from the study. Surgeries occurred between 1985 and 2008.

Researchers matched the patients with 24 healthy kids of the same age and gender who did not have the stomach issues.

They were surveyed during the spring of 2010 about how their bowels functioned, stool consistency, how often stools were produced, whether they had any accidents and medications taken to control the frequency and urge to go.

Questions also asked patients about their health status, satisfaction with surgery and whether they had any restrictions because of the surgery.

Among the responses, five patients had part of their small bowel or the junction between the small and large intestine removed and 13 had both surgeries. Another six had parts of colon or rectum removed.

Researchers found that 94 percent of the Crohn's patients had a relapse in the disease after medical or surgical treatment by the 13-year follow-up.

A little more than half needed additional parts of their intestines removed within two years of the first surgery.

Seventy-seven percent of patients had at least one complication from surgery but 96 percent of patients were moderately to completely satisfied with their surgery.

Stools were produced three times a day on average and none at night, and 33 percent of patients had their bowel movements under control.

Having to miss school or work lowered patients' quality of life, but it was overall comparable between both groups.

"We did not find any significant differences in the overall quality of life between patients and controls," the authors wrote in their report.

"It is possible that a high relapse rate may reduce quality of life, because patients who were absent from school or work most likely suffered from clinical disease relapses. On the other hand, patients who had undergone re-resections had a surprisingly good quality of life and poor bowel function did not significantly worsen the quality of life."

In the end, 19 percent of patients had a surgical opening in their intestines to help with their bowel function.

The authors note that their study did not look at how the timing of the surgery affected patients.

The Finnish Pediatric Research Foundation, the Päivikki and Sakari Sohlberg Foundation and the Helsinki University Central Hospital Research Fund supported the study, which was published October 30 in the Journal of Pediatric Gastroenterology & Nutrition.

Reviewed by: 
Review Date: 
November 14, 2012
Last Updated:
November 15, 2012