Your digestive tract is made up of millions of organisms that help your body break down essential nutrients and minerals in food so that they can be absorbed into the body and used for cellular energy. Your small intestines are where this absorption happens before delivering any leftover waste products to be processed by the large intestine. As with any part of your body, the small intestines are susceptible to damage. When this occurs, nutrient absorption and digestion are flawed and can lead to a range of painful or disruptive symptoms. Over time, this can damage your overall health and cause further complications. To help alleviate problems, small bowel resections can be performed. A small bowel resection is a type of surgery that’s done to repair damage to the small bowel, or small intestines. Here, we’ll tell you what you need to know about small bowel resections.
Why Are Small Bowel Resections Performed?
Small bowel resections are performed in order to remove a portion of your small intestine that’s been damaged, blocked, or is diseased. This is usually an area that cannot be healed through other measures. Therefore, small bowel resections are essential to your ongoing health and wellness. In other instances, your doctor may recommend undergoing a small bowel resection for tissue diagnosis.
Damage and disease can occur in the small intestines due to several reasons. Some of the primary conditions that require this surgery include:
- Bleeding
- Infection
- Severe ulcers
- Blockage in the intestines
- Noncancerous tumors
- Precancerous polyps
- Cancer
- Injury to the small intestine
- Meckel’s diverticulum
- Crohn’s disease
- Regional ileitis
- Regional enteritis
If you suffer from any of the conditions above, or begin to notice symptoms, see your doctor as soon as possible. This will help you get the best outcome and can even help prevent the need for a small bowel resection if the damages are caught early.
One of the most common causes for blockages in the small intestine is a stricture. A stricture is the narrowing in a section of the intestine that occurs due to inflammation from Crohn’s disease, causing the walls of your intestine to thicken. Catching signs of strictures early can help reduce overall complications. If you notice any signs of nausea, vomiting, severe cramping, or constipation, talk to your doctor to get a proper diagnosis. Small bowel resections can be done to repair strictures along with a strictureplasty, which helps to widen the areas affected by the stricture. Managing your Crohn’s disease is important for proactive care and reducing your chance of requiring a small bowel resection.
Preparing for a Small Bowel Resection
Prior to undergoing a small bowel resection, your doctor will perform a general physical exam. This is done to ensure that you are properly receiving any treatment for underlying conditions, especially in the case of high blood pressure or diabetes. During this time, make sure that you communicate with your doctor about any drugs you’re currently taking, regardless of if they’re prescription, over the counter, or vitamins. There are certain things that can increase your risk of bleeding during surgery, which can lead to further complications.
Try to quit smoking a few weeks before the surgery and eat a diet that’s high in fiber to help your body prepare. Oftentimes, your doctor will advise you to adhere to a liquid diet prior to surgery day and in some cases, you may need to take a laxative to help clear your bowel. Avoid eating or drinking anything before the surgery—your doctor will give you more information regarding this based on the time of your scheduled small bowel resection.
How a Small Bowel Resection is Performed
Your surgeon will take out the area of your small intestine that is affected, which may be on the duodenum, the jejunum, or the ileum. If you have question regarding the differences in these procedures, don’t hesitate to talk to your doctor. There are two primary ways that a small bowel resection is performed by a surgeon—during open surgery or laparoscopically.
Open Surgery
Open surgery is performed when a surgeon makes an incision in the abdomen, locates the part of your small intestines that is affected, clamps it from the healthy portions, and removes the diseased area. Depending on the severity of the disease or blockage, the amount of small bowel that’s resected varies.
If there is enough small intestine left to reconnect the two healthy areas, your surgeon will do so in a procedure called an anastomosis. If there isn’t enough healthy tissue to reconnect to each other, or if there’s another reason that your intestines cannot be reconnected, your surgeon will attach your small intestine to a small opening in your abdomen called a stoma. This requires an ostomy pouch and is referred to as an ileostomy.
Laparoscopic Surgery
During laparoscopic surgery, the same procedure is done using robotic devices instead of a surgeon with larger, open incisions. This means that the incisions are up to five times smaller, reducing risk and post-op scarring. Your surgeon will operate the robotic surgery using a camera, microscopic lights, and tools.
Prior to going into surgery, make sure that you’re comfortable with what’s going to occur and ask as many questions as you need. It’s important that you feel confident going into your surgery and your doctor is there to make sure that you are.
Recovering from a Small Bowel Resection
Everyone’s recovery will vary based on the severity and extent of the overall procedure. Just to be safe, you should expect to stay in the hospital for up to a week following your small bowel resection. During this time, your doctor will utilize a urinary catheter to help drain waste from your body while your small intestine recovers. Your doctor may not allow you to consume any food to ensure proper healing, so an IV with nutrients will be used to help you stay healthy.
Prior to leaving the hospital, your doctor will review your post-op treatment plan and show you how to care for your incisions and stoma. If you have any questions, don’t hesitate to ask prior to leaving the hospital.
Small Bowel Resection Risks
As with any type of surgery, there are certain risks associated with small bowel resections. Some of the risks that can occur from surgery include bleeding, infection, pneumonia, blood clots, anesthesia reactions, damage to surrounding structures, heart attack, and stroke. While these risks are associated with every type of surgery, make sure that you speak with your doctor regarding any concerns.
Some of the risks that are specific to small bowel surgery include the following:
- Frequent diarrhea
- Bleeding in the abdomen
- Intra-abdominal abscess
- Incisional hernia
- Scar tissue on the intestine
- Short bowel syndrome
- Anastomosis
- Stoma problems
- Ileostomy problems
- Dehiscence
- Infection of the incision
- Chronic anemia
Those who undergo multiple small bowel resections may be at a greater risk of developing short bowel syndrome (SBS). When this happens, the small intestine is no longer long enough to absorb the nutrients necessary for your body to properly function. This can lead to malnutrition and severe nutritional deficiencies over time. Those affected with short bowel syndrome may also notice an increased occurrence of kidney stones, bacterial growth in the intestines, malabsorption of medication, electrolyte imbalances, and acidosis.
When to Call Your Doctor
Following a small bowel resection, it’s important that you pay attention for any signs or symptoms of infection and keep the incision site clean. If you have a fever of 101°F or higher, drainage, bleeding, pain, redness, or warmth at your incision, abdominal swelling, nausea or vomiting, severe constipation, bloody, black or tar-like stool, problems with your ileostomy, shortness of breath, chest pain, or leg swelling, call your doctor immediately.
It’s also important to watch for signs of short bowel syndrome, which include chronic diarrhea, weight loss, abdominal pain, cramping, bloating, heartburn, flatulence, oily or foul-smelling stool, weakness, fatigue, bacterial infections, and food sensitivities. Call your doctor if you notice any of these in the days or months following your small bowel resection.
Small Bowel Resection Prognosis
If your small bowel resection results in an ileostomy, you will need to learn how to care for your ostomy and find the right pouching system that adheres to your lifestyle. There are plenty of options available for you to lead a happy, healthy life without restrictions. If you’re having a hard time adapting to your ileostomy, consider finding an ostomy support group to help you connect with others who understand what you’re going through. To help make your transition as easy as possible, Byram Healthcare has an array of ostomy supplies that can be delivered to your door discretely and in a timely manner.
