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BMJ Group Medical Reference


This information is for people who have Crohn's disease. It tells you about surgery to widen a scarred section of bowel, a treatment used for severe Crohn's disease. It is based on the best and most up-to-date research.

Does it work?

If you have a narrow, scarred section in your small bowel, surgeons think that surgery to widen it (strictureplasty) works well. The studies we found compared types of surgeries, so it's hard to say how well strictureplasty works compared with not having surgery. Talk to your surgeon about the risks and benefits of the operation. It's also important to remember that surgery isn't a cure. Your symptoms could always come back.

What is it?

Over time, Crohn's disease can cause scarring in your bowel. When scar tissue builds up, it can create a narrow section in your bowels. This is called a stricture. An operation to widen a narrow section in your small bowel is called a strictureplasty.

The advantage of strictureplasty is that it widens a narrow section without cutting away any bowel tissue. There are several techniques. One of them works like this: [123]

  • Imagine a horizontal tube with a narrow section. A cut is made horizontally, running along the length of the narrow part.

  • Then, the edges of the cut are then pulled apart and stitched together vertically. This makes the narrow section wider and slightly shorter. The stitches dissolve inside your body over time.strictureplasty3_default.jpg

The operation is done through a cut on your abdomen. You'll have a general anaesthetic to make you sleep. Afterwards, you'll need to spend some time recovering in hospital. In one study, the average hospital stay was around nine or 10 days. [124]

How can it help?

It's hard to say exactly how much this operation helps. Surgeons think it's helpful and safe. It also has the advantage of not removing any bowel tissue. If you have surgery that removes a lot of your bowel, it stops your body absorbing nutrients from food as well as it should.

One review of studies found that people who'd had strictureplasty were slightly more likely to need another operation three to seven years later, compared with people who'd had part of their bowel removed (with or without strictureplasty as well). But the difference between the groups was small enough that it could have been down to chance. [125]

Studies have also compared two surgical techniques for strictureplasty. One is called Finney strictureplasty. The other is called Heineke-Mikulicz strictureplasty. Here's how they work: [123]

  • Heineke-Mikulicz strictureplasty is usually used for narrow sections of bowel that are less than 10 centimetres long. A short cut, 1 centimetre or 2 centimetres long, is made lengthways along the bowel. It's sewn up widthways, making a shorter, wider section of bowel.

  • Finney strictureplasty tends to be used for narrow sections of bowel between 10 centimetres and 20 centimetres long. The narrow part is folded in two, in a U shape. The surgeon then makes a cut around the inside of the loop. When the bowel is sewn back up, both arms of the loop are combined into one, wider section. Imagine putting two toilet rolls side by side, cutting down the middle where they touch, then sticking the cut edges together to make a wider tube. That's a bit like Finney strictureplasty.

Last Updated: June 29, 2012
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

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