Mr Anwar Hussain
Anwar Hussain
Bowel

Crohn's Disease & IBD

Surgical management of complications of inflammatory bowel disease.

Overview

Crohn's disease and ulcerative colitis are the two main forms of inflammatory bowel disease (IBD), long-term conditions in which the digestive system becomes inflamed. Crohn's disease can affect any part of the gut from mouth to anus, most often the end of the small bowel and the colon, while ulcerative colitis affects the large bowel and back passage. Both tend to follow a pattern of flare-ups and periods of remission, and are usually managed primarily with medication.

Mr Hussain works closely with gastroenterologists as part of a multidisciplinary team, and his role is the surgical management of IBD — particularly the complications that medication alone cannot control, such as strictures, fistulas, abscesses or bowel that has become too damaged to heal. Surgery is never undertaken lightly, but at the right time it can dramatically improve quality of life and relieve symptoms that have proved difficult to manage. The aim is always to preserve as much healthy bowel as possible.

Signs & symptoms

  • Recurrent diarrhoea, sometimes with blood or mucus
  • Crampy abdominal pain, often in the lower right side in Crohn's disease
  • Unintended weight loss and reduced appetite
  • Tiredness and fatigue, sometimes due to anaemia
  • Fever during flare-ups
  • Pain, swelling or discharge around the back passage (perianal Crohn's)
  • Bloating and a feeling of incomplete emptying
  • Mouth ulcers and joint, skin or eye problems in some people

Causes & risk factors

The precise cause of inflammatory bowel disease is not fully understood, but it is thought to result from the immune system reacting abnormally and attacking the lining of the gut. This is believed to involve a combination of an inherited susceptibility, the bacteria that normally live in the bowel, and environmental triggers. IBD is not caused by anything a person has done, and it is not infectious.

Several factors are associated with a higher risk or with more aggressive disease. A family history of IBD increases the likelihood of developing it, and Crohn's disease in particular is strongly linked to smoking, which also makes the condition harder to control — stopping smoking is one of the most beneficial things a person with Crohn's can do. Most people are diagnosed between their late teens and thirties, although IBD can begin at any age. Diet and stress do not cause IBD but may influence symptoms in some people.

How it’s diagnosed

Diagnosing IBD usually begins with blood tests and a stool test called faecal calprotectin, which detects inflammation in the bowel. The key investigation is a colonoscopy, allowing the bowel lining to be examined directly and biopsies taken to confirm the diagnosis and distinguish Crohn's disease from ulcerative colitis. Because Crohn's can affect the small bowel, additional tests such as MRI enterography, CT scanning or a capsule endoscopy are often used to map the full extent of the disease.

When surgery is being considered, detailed imaging is particularly important to define the location and nature of any strictures, fistulas or abscesses. An MRI of the pelvis is especially valuable for assessing perianal Crohn's disease. All of this information is reviewed by the multidisciplinary team, including gastroenterologists, radiologists and surgeons, so that medical and surgical treatment can be coordinated and timed to give the best outcome.

Treatment options

Limited bowel resection

When a segment of bowel is severely diseased, narrowed or causing complications that medication cannot control, the affected portion can be removed and the healthy ends rejoined. Mr Hussain removes only the diseased segment, conserving as much healthy bowel as possible to protect long-term digestive function. Where suitable, this is performed using keyhole surgery for a quicker recovery.

Ileocolic resection

This is the most common operation in Crohn's disease, used when the condition affects the last part of the small bowel (terminal ileum) and the start of the colon. The diseased section is removed and the bowel reconnected. For many patients this provides excellent and lasting relief of symptoms, and can often be carried out laparoscopically.

Strictureplasty

Where Crohn's disease has caused one or more narrowings (strictures) in the small bowel, strictureplasty widens the narrowed segment without removing any bowel. This is particularly valuable for patients with multiple strictures or those who have already had bowel removed, as it preserves bowel length and reduces the risk of short bowel problems. It relieves obstruction while keeping the gut intact.

Surgery for perianal and fistulating Crohn's

Crohn's disease can cause abscesses and fistulas around the back passage, which can be painful and distressing. Treatment may include draining an abscess and placing a soft drainage stitch (a seton) to control infection, working alongside the gastroenterology team and biologic medication. The goal is to control symptoms and protect the function of the anal sphincter.

Stoma formation

In some situations a stoma — where the bowel is brought to the surface of the abdomen to empty into a bag — is the safest option, either temporarily to allow inflamed or healing bowel to rest, or permanently in severe disease. Specialist stoma nurses provide detailed support before and after surgery. Many people find that a stoma greatly improves their quality of life after years of difficult symptoms.

Surgery for ulcerative colitis

For ulcerative colitis that does not respond to medication, or where there are pre-cancerous changes, removing the colon (colectomy) can be curative for the bowel symptoms. This may be performed in stages and can involve forming an ileostomy or, in selected patients, an internal pouch. These options are discussed carefully with you and the gastroenterology team.

What to expect

Inflammatory bowel disease is managed jointly with gastroenterologists, and Mr Hussain's role is the surgical side — particularly complications that medication cannot control. At your consultation he reviews your history, scans and endoscopy results, and where surgery is being considered arranges detailed imaging (such as MRI enterography, or an MRI of the pelvis for perianal disease) to define exactly what needs treating.

Because good nutrition and disease control improve surgical outcomes, the team often works to optimise these beforehand. When you do have surgery it is planned within the multidisciplinary team and, where suitable, performed using keyhole techniques with an enhanced recovery programme. Mr Hussain conserves as much healthy bowel as possible, and specialist stoma nurses support anyone who needs a stoma. Surgery is part of your ongoing care, working alongside medication rather than replacing it.

Recovery & aftercare

Recovery after IBD surgery depends on the operation and on your general health and nutrition beforehand, and the team will often work to optimise these in advance. After keyhole bowel resection, most people stay in hospital for around three to six days, following an enhanced recovery programme that encourages early eating and gentle activity. It is normal to feel tired for several weeks, and bowel habit usually settles into a new pattern over the following weeks and months.

Most people return to their normal activities within around four to six weeks, building up gradually and avoiding heavy lifting at first. If you have a stoma, your stoma nurse will support you until you feel confident. Importantly, surgery is part of ongoing care rather than the end of it: you will continue under the joint care of your gastroenterologist and surgeon, often remaining on medication to keep the disease in remission and to reduce the risk of it returning.

Costs & insurance

Initial consultation

£200

Follow-up appointment

£150

The fees above cover your consultation with Mr Hussain. The cost of any procedure, scan or operation is set and collected by the hospital, not by this website, and depends on the treatment and the hospital you choose. Both self-pay packages and insured care are available at Nuffield Chester, Spire Macclesfield and Circle Cheshire, and the hospital can provide a written, fixed-price quotation before you commit to treatment.

Recognised by all major insurers — Bupa, Bupa Global, Bupa Fee Assured, AXA Health, AXA Global Healthcare, Aviva Health, Vitality, Cigna and more. Self-pay patients are also welcome. If you are claiming on insurance, check whether your policy requires a GP referral before booking.

When to seek urgent help

  • Severe, constant abdominal pain with a swollen, rigid tummy and vomiting, suggesting obstruction or perforation
  • High fever with shivering and feeling very unwell, which may indicate an abscess or serious infection
  • Heavy or persistent rectal bleeding, or passing large clots
  • Inability to pass stool or wind alongside severe bloating and pain
  • Rapidly worsening pain, redness or discharge around the back passage

Crohn's Disease & IBD — frequently asked questions

Will surgery cure my Crohn's disease?

Surgery does not cure Crohn's disease, because the condition can return in other parts of the gut, but it is very effective at treating complications and relieving symptoms that medication cannot control. Many people enjoy long periods of good health after surgery. It is best thought of as one important part of your overall treatment, working alongside medication.

Is surgery different for ulcerative colitis?

Yes. Because ulcerative colitis only affects the large bowel, removing the colon can effectively cure the bowel symptoms, which is not the case in Crohn's disease. Options include forming an ileostomy or, for selected patients, creating an internal pouch to avoid a permanent stoma. The right approach is discussed in detail with you and the gastroenterology team.

Will I need a stoma?

Not everyone with IBD surgery needs a stoma, and where one is required it is often temporary to allow the bowel to rest and heal. A permanent stoma is usually only needed in more severe cases or when it offers the best quality of life. Mr Hussain and the specialist stoma nurses will explain clearly whether a stoma is likely in your case and support you fully.

How likely is it that the disease will come back after surgery?

Crohn's disease can recur after surgery, often near the site where bowel was rejoined, which is why ongoing medication and monitoring are important after an operation. Stopping smoking significantly reduces the risk of recurrence in Crohn's disease. Your gastroenterologist and surgeon will arrange follow-up to detect and treat any recurrence early.

What is strictureplasty and why might it be preferred?

Strictureplasty is an operation that widens a narrowed segment of bowel without removing it, relieving blockage while preserving bowel length. It is especially useful for people with several strictures or who have already had bowel removed, helping to avoid problems caused by losing too much intestine. Mr Hussain selects the technique best suited to your particular disease.

When should surgery be considered rather than more medication?

Surgery is generally considered when complications develop that medication cannot resolve, such as a tight stricture, a fistula, an abscess or bowel that is too damaged to recover, or when medical treatment is no longer controlling the disease. The decision is always made jointly between you, your gastroenterologist and Mr Hussain. Timing surgery well can greatly improve quality of life.

Can I live a normal life with IBD?

Yes. While IBD is a long-term condition, most people lead full and active lives, work, travel and have families, particularly when the disease is well controlled. Surgery, when needed, often relieves troublesome symptoms and improves wellbeing. Ongoing care from your IBD team helps keep you as well as possible.

Does diet cause or cure Crohn's disease?

Diet does not cause Crohn's disease and there is no single diet that cures it, but what you eat can influence symptoms and nutrition, especially during flare-ups or if you have a stricture. Good nutrition is important, particularly before surgery, and dietitians are an important part of the team. Mr Hussain and your IBD team can advise on dietary support tailored to you.

How soon can I be seen?

Privately, Mr Hussain can usually offer a consultation within a few days, working alongside your gastroenterologist. If you have a complication such as an abscess or obstruction, this is treated as urgent. Continuity of care between your medical and surgical teams is a priority.

Will I still need my medication after surgery?

Usually, yes. In Crohn's disease especially, medication is often continued after surgery to keep the disease in remission and reduce the chance of it returning near the site where bowel was rejoined. Your gastroenterologist and Mr Hussain coordinate this. Surgery treats complications rather than replacing medical therapy.

Can keyhole surgery be used for IBD?

Yes — many bowel resections for Crohn's disease and ulcerative colitis can be performed laparoscopically, which usually means less pain, an earlier return of bowel function and a shorter hospital stay. Whether keyhole surgery is suitable depends on the extent of disease and any previous operations. Mr Hussain assesses each case individually.

Does smoking affect my Crohn's disease?

Yes, and significantly. Smoking makes Crohn's disease harder to control and increases the risk of it returning after surgery, so stopping smoking is one of the most beneficial things you can do. The relationship is different in ulcerative colitis. Mr Hussain and your IBD team can support you to stop.

See Mr Hussain about crohn's disease & ibd

Private consultations at Nuffield Chester, Spire Macclesfield and Circle Cheshire, usually within a few days.

Book a consultation+44 1244 680 444

Procedures offered

  • Strictureplasty
  • Limited bowel resection
  • Stoma formation
  • Ileocolic resection

Typical recovery

5–10 days hospital stay; full recovery 4–8 weeks.

Related conditions

Hernia

Hernia Repair Surgery

Read the guide

Anorectal

Haemorrhoids (Piles)

Read the guide

Anorectal

Anal Fissure

Read the guide